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Bisoprolol reduced

NLGA profile image
NLGA
57 Replies

hi

I tried to today to reduce my medication

I am in 15mg ( yes) I reduced it to 12.5 mg 4 days ago today I tried to get down to 5mg morning 5mg at night

I felt breathless at s as bout 7pm held in to 930pm took a 2.5mg dose and was fine in half hour

I can’t understand why I am in need of a higher dose than most . Should I go against the cardio doctor and take 10mg in the mornings only ?

I have AF non persistent

Heart wise mild MR .EF 50 , mildy dilated left atrium

lungs wise peak flow tonight 670 prior to medication above

any ideas ?

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NLGA profile image
NLGA
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57 Replies
colin772 profile image
colin772

In my experience Bisoprolol has to be reduced slowly, so try reducing it a tiny bit at a time with a few days in between. Hope that helps.

NLGA profile image
NLGA in reply to colin772

Thank you

in reply to colin772

I have been reducing my dose at 10 day intervals ................... what I mean is I am on 7.5, so I reduce it by 1.25 and hold it at 6.25 for 10 days, then reduce it to 5.75 for another 10 days then reduce it to 5.0 mg which is where I want it to be ...... as my bog standard dose - which was the original dose prescribed by Cardio consultant back in 2010. I don't plan to take it lower. I do have medication review with Pharmacist on 1 September. when hopefully all my meds will be assessed and reviewed.

John

Jalia profile image
Jalia

Altering your medication should only be done with your doctors approval! Do make contact to get the ok in reducing your Bisoprolol! We are not qualified on this forum to advise you to do this.

NLGA profile image
NLGA in reply to Jalia

I dont remember saying you was qualified ???? I’m hardly going to jump into something without a care in the world I am asking peoples views

Jalia profile image
Jalia in reply to NLGA

I was merely stating that we are not qualified. From your post you have given the impression that you have started to reduce your dose without consulting your doc but based on comments from forum members.

NLGA profile image
NLGA in reply to Jalia

Yes I know that but I have been left on a repeat 15mg dose without any help or advice from anyone at the hospital the last doctor I saw was the morning I was discharged on the 20th of June apart from one trip to A and E on the 16th of July when I was diagnosed with hay fever that actually turned out to be bacteria in my lungs

Billblue profile image
Billblue in reply to NLGA

A lot of doctors do not understand A Fib I reduced my bisoprolol from 5 to 1.25 4 years ago monitored my heart rate and blood pressure have blood tests and checks every year all ok so it worked for me. Know your own body we all need doctors but they are not always right and a fib is a minor problem to them

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to NLGA

HiGood on you NLGA.

You are doing what you think will improve you.

Actually taking am and pm which I was on and reducing from there didn't make any difference. I guess it was the introduction of CCB which made the difference.

Going down to 10mg which is usual dose has no harm Jalia.

Woman's intuition is great. I was taking 5mg x twice a day of Bisoprolol when CCB introduced. I had intuition to reduce bisoprolol.

Within 2 hours and only 5mg Bisoprolol my H/R fell on 180mg Diltiazem 105 H/B per minute to 51. Where I became lightheaded.

I rung Healthline and got the doctor who said reduce Bisoprolol down to 2.5mg. Then on 3 days later Heart Foundation Nurse who knew my specialist said Get a prescription or 120mg and separate the Bisoprolol taking 2.5mg at night.

Perfect. 123/72. 77-88 H/R. TODAY. 47H/R at night

cheers JOY. 73. (NZ)

Buffafly profile image
Buffafly

It doesn’t matter what dose other people take, what matters is what your consultant thinks is right for you. I seem to remember you have LVH as well. You may have high BP? If you feel your dose is too high you should try to find out why your cardiologist thinks that’s what you need because taking less could be dangerous. But if you want to try to reduce your dose I believe it has to be done very very slowly because you can have withdrawal symptoms - as you have experienced. This might involve cutting your pills in half.

NLGA profile image
NLGA in reply to Buffafly

Hi Buffafly No blood pressure has always been good . Yes I did cut the pills in half as mine are all 5mg . I do not have a cardiologist I have never been given one in fact the 11 days I spent in hospital I didn’t see the same doctor twice

I am surprised that I don’t have one point of contact I actually have no one not even a number to ring to discuss my situation

Buffafly profile image
Buffafly in reply to NLGA

Discharged to ‘care’ of GP I guess…..

NLGA profile image
NLGA in reply to Buffafly

Who increased the dose so I’m kind of going around in circles

pusillanimous profile image
pusillanimous in reply to NLGA

I always think that the potency and type of medication prescribed is a thorny question. Mostly we consult the GP or specialist who diagnoses your problem and then prescribes what he believes or whatever are the default drugs for your condition, and off you go! I firmly believe, when it comes to chronic and long term medication, there should be an observation period of say two weeks in one of the 'step down' facilities - that's what they are called here in South Africa, not sure of what they are called in the UK - but they are for minor non surgical conditions and rehabilitation after serious illnesses - I was in one after a dog bite and had to be on a anti-biotic drip for 3 days, where the correct minimum doses can be calculated by regular testing and observation.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to pusillanimous

HiIn NZ we have a 6-weeks post operation.

but

after a stroke and on a medication I didn't want metroprolol no follow up at hospital.

Breathless and tired for 2 years 3 months frustrated I asked to be referred to DHB Cardiac Specialist.

Then I was moving forward on Bisoprolol but still UNCONTROLLED.

A private specialist put on CCB and reduced Bisoprolol and rereferred me back to public.

Find someone who will listen to your history and prescribe appropriately.

I did notice that the specialist always said I will discharge her from outpatients but if you have any concerns let me know.

But the wait was 6 months!

cheri. JOY. 73. (NZ)

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to NLGA

HiAfter my stroke with AF I never had a followup.

It seems it is up to you to ask your Dr to refer you to a Cardiac Specialist.

It was 2 years 3 mths before I'd had enough with dosages simply put up.

Then I had an ECHO and ECG and saw the specialist. She changed me off Metroprolol which was making me breathless, tired and fatigued to Bisoprolol.

But Bisoprolol although it dropped me down from 186 to 156 I was not controlled. Heart Beats per minute at night.

I had 3 x24-hr monitors last year.

A private cardiologist CONTROLLED me on introducing CCB Diltiazem 120mg.

ManageMyHealth is that. Not happy need to see a specialist. If that one is not very interested go private

cheers JOY 73. (NZ)

Nick1957 profile image
Nick1957

You need to get your GP to refer you to a cardiologist specialist or your GP can advise you of the next step to take. There must have been a valid medical reason why you are on such a high dose.

NLGA profile image
NLGA in reply to Nick1957

It’s never been explained I have spoke to my GP and they have said it’s a safe dose . I had a heart rate of 170 and spent 5 days in hospital . Then I had 5 days in hospital pulse 145 a month later referred to cardioversion then got diagnosed with pneumonia. Went for my pre op for CV to be told it’s not persistent which I new and had told them . I still feel my heart jumping every few days but pulse is lower good . I have mild MR mild LVH . EF 50 all the other bits seem fine going by the echo I am on a waiting list for a monitor

I have never seen a cardio doctor apart from the morning I was discharged from the hospital who told me I should have been discharged prior to the weekend

Buffafly profile image
Buffafly in reply to NLGA

Aha, a monitor! Then you should get more information.

NLGA profile image
NLGA in reply to Buffafly

Do you think they will be better than the echo or is it used for thing the echo and ECG don’t pick up

Buffafly profile image
Buffafly in reply to NLGA

The monitor shows what your heart is doing from minute to minute day to day depending on how long you have it for. It shows rate and types of arrhythmia and how long they last. I had one for a week and thought I didn’t have any AF at all but my monitor showed I had frequent episodes. You usually have a button to press if you feel anything from your heart.

That is a good reason why not to change your dose because the monitor will be reviewed on the basis that you are taking the dose given. Taking less will invalidate the results and you could be prescribed an even higher dose.

As you haven’t been given any explanation of all this I strongly recommend you read some of the AFA leaflets on your diagnosis. British Foundation will have similar.

TracyAdmin please help!

NLGA profile image
NLGA in reply to Buffafly

Thank you for that information that’s clear to me now . Hopefully it don’t be to king to they allow me to collect one

Ppiman profile image
Ppiman

I would not do anything without the explicit approval of my cardiologist. When I was taking 10mg of bisoprolol (and feeling awful - but maybe it was the atrial flutter and tachycardia not the bisoprolol), my doctor said taking more wouldn't help the flutter. Eventually, I was given a small dose of digoxin, which was recommended by a member here, and this did the trick and allowed me to take much less bisoprolol.

Steve

NLGA profile image
NLGA in reply to Ppiman

Hi Steve I can not get to see a cardio doctor . At this moment I am on 15mg that no one seems to take and no appointments only told I can pick up a heart monitor when they have one in stock to this day I haven’t had a 1 to 1 with anyone

Buffafly profile image
Buffafly in reply to NLGA

You’ll get to see one after the monitor hopefully. Someone should have had a chat in hospital though. There are ways to complain if you still feel unhappy after that.

Ppiman profile image
Ppiman in reply to NLGA

I was about to be given a higher dosage (up to 20mg is okay I gather) but the digoxin came along instead.

Steve

NLGA profile image
NLGA in reply to Ppiman

That’s a lot your the first person that’s mentioned bring offered that amount it’s hard to find anyone on more than 5mg a few forums members didn’t even think I new what amount I was on 😂

Ppiman profile image
Ppiman in reply to NLGA

I had atrial flutter which I was told is harder to control the racing heart than with AF. My rate stuck at 105 even on 10mg until digoxin came along.

Steve

Ewloe profile image
Ewloe

This is what I’m doing. After electrophysiologist gave ok to reduce dose from 7.5mg to 5mg to see if it will reduce some symptoms as we believe the slow pulse (37) at times is aggravating my arrhythmia’s. we’re hoping my arrhythmia’s won’t increase on the lower dose.

Whilst waiting for the letter from electrophysiologist to get to GP to reduce it I’ve started myself. I usually take a 3.75mg tablet twice a day. For the last 3 weeks every other evening I’ve halved one of the tablets. Then my plan is to halve my evening tablet every day until the 5mg sorted with my GP. So far so good I’m less breathless and feeling like I’ve got a little energy. I’m taking things much more slowly than the GP would.

NLGA profile image
NLGA in reply to Ewloe

My trouble is since I had covid then the bacteria infection in my lungs I honestly feel my breathing has never recovered and my GP told me it’s asthma getting worse so increased my inhaler dose plus I was taking to much Ventolin so my heart was racing , by AF wasn’t really that bad before I thought I just had the odd heart flutter And it was normal

Auriculaire profile image
Auriculaire in reply to NLGA

I don't remember you mentioning before that you have had covid. Even though any infection has been cleared up you might still have lung damage that will take longer to resolve. Were you given antibiotics for your pneumonia and if so which ones?

NLGA profile image
NLGA in reply to Auriculaire

Hi yes I had covid in February but I wasn’t really sick more a cold , the anti biotic was amoxicillin

Auriculaire profile image
Auriculaire in reply to NLGA

That should not have caused any problems with your breathing. It is FQs that can cause air hunger.

NLGA profile image
NLGA in reply to Auriculaire

Sorry what is the FQ ?

Auriculaire profile image
Auriculaire in reply to NLGA

Fluoroquinolone family of antibiotics like Ciprofloxacin, Levofloxacin, Moxifloxacin . They can have very nasty side effects and one of the rarer ones is air hunger.

NLGA profile image
NLGA in reply to Auriculaire

I don’t have any of these medications so that shouldn’t be the reason thanks

Buffafly profile image
Buffafly in reply to NLGA

Bisoprolol isn’t suitable for asthmatics, makes it worse 🙄 I hope you’ve got a ‘combi’ inhaler, not just Ventolin. Try to be patient until you’ve had the monitor then hopefully you’ll get sensible treatment. That would be a good time to see a cardiologist or EP privately if you can afford it as they will have the full picture.

NLGA profile image
NLGA in reply to Buffafly

I have seritide 250 mg and normal ventolin I have never thought the seritide worked and the Ventolin isn’t great which kind of started me off asking for test last winter plus even when I feel like I have what I am told is asthma my peak flow is 650 plus

Buffafly profile image
Buffafly in reply to NLGA

I had the same problem. GP kept upping my asthma meds when my breathlessness was caused by undiagnosed AF. Although there is a kind of asthma that doesn’t affect peak flow much. It’s all complicated 😤

Ewloe profile image
Ewloe

No wonder you’re feeling rubbish. The ventolin and bisoprolol will be fighting with each other. Difficult situation for you to manage I hope you find a solution soon.

NLGA profile image
NLGA in reply to Ewloe

Thank you

NLGA profile image
NLGA

Well I had 40 min on the phone Friday 30 today with no one picking up on the cardio department at hospital so I tried the GP secretary local and they told that they know new nothing about my pre op for cardio or that I was due for cardio on the 8/8/22 only that I had a x Ray on the 16th July and a appointment made for a follow up X-ray to see if my lungs were clear which I was informed by the GP reception that they were So it’s difficult as they referred me back to the number that doesn’t pick up

just tried the general hospital switch board and of course after being out on hold forever I was connected to a number that doesn’t pick up

in reply to NLGA

Try 111

Belle11 profile image
Belle11

Hi NLGA

The leaflet in the bisoprolol packet says that for "elevated blood pressure/angina pectoris" the maximum dose is 20mg once daily, so you are on a normal dose.

Do you have symptoms that you think are bisoprolol side effects?

I started getting quickly short of breath on walking, and also my ankles swelled, which can be a side effect of bisoprolol, so I consulted my GP, who referred me back to the cardiologist. After he excluded other causes I am now reducing my dose very slightly - only by 1.25mg, and will stay on that dose on alternate days with the previous higher dose on the other days for a couple of weeks before trying doing the lower dose every day if all is well at this level. So it could take me quite a while to find what level works for me without speeding my heart rate too much or upsetting my heart rhythm.

Your GP and cardiologist should be able to explain why you've been prescribed the dose you're on, and discuss any changes that might work. I hope all goes well for you.

NLGA profile image
NLGA in reply to Belle11

Hi Belle11 it does sound similar the only thing is it was this shortness of breathe that started the whole thing off that led to them finding I was AF and then put me in the medication I am starting to think about the covid in February

Belle11 profile image
Belle11 in reply to NLGA

Covid is being found to cause all sorts of health issues some time later, so that's certainly possible.

I didn't have breath problems before I got AF. My AF was likely triggered by steroid injections just before. It's been since I've been back in normal rhythm after a cardioversion 2 1/2 years ago that I've had increasing shortness of breath - still on the same dose of biso as when my heart was out of rhythm.

I probably misinterpreted your post, but I thought you were saying that you were more breathless when you took the lower dose of biso, which is different from my situation. Sorry if I misunderstood.

NLGA profile image
NLGA in reply to Belle11

No your right that’s why it’s so confusing I had breathing issues then got out in the 15mg but when I reduce the me the breathing issues is worse

Belle11 profile image
Belle11 in reply to NLGA

Could it be that in your case, Bisoprolol is helping your breathing? We all seem to be so different where this drug is concerned. Also a lot of people have said that sudden changes to dosage can have bad effects.

Belle11 profile image
Belle11 in reply to NLGA

I hope you find a solution for better breath.

NLGA profile image
NLGA in reply to Belle11

Thank you

Afibflipper profile image
Afibflipper

At one point I was put on 17.5 bisoprolol (each time it had been raised by 2.5 - but the 17.5 was way to much felt faint low bp so was reduced back to 15 - following CV dropped to 10 but following failure 12.5 is current dose)Some people only need 2.5 total - all different and reasons for being prescribed are different

Between 10 & 12.5 (on 10 I feel palpitations but 12.5 I don’t) but yes check with your practitioners

NLGA profile image
NLGA in reply to Afibflipper

You are the first person to Bevin close to my mg that’s encouraging

Afibflipper profile image
Afibflipper in reply to NLGA

I was told the 15 was a hefty dose but I personally tolerated it but the extra 2.5 to 17.5 tipped me over the edge - I believe very few but some are prescribed more - were all very fine tuned

NLGA profile image
NLGA

Just been looking up Dyspnea Anyone had issues with this that had AF ? I am also asthmatic

NLGA profile image
NLGA

So finally got through to cardio at the hospital to be told my monitor has not been ordered yet and my follow up following my cardioversion is in 3 months which would be great if I had the cardioversion so I took the time to ask the cardio nurse I was passed into about the dose and length of time I need to be on the medication to be told I should speak to my GP I then said I don’t see how the GP would wish to take that on when it was the hospital that put me in to the tablets but the advice was the same

JOY2THEWORLD49 profile image
JOY2THEWORLD49

HiI was introduced to CCB A calcium channel Blocker Diltiazem.

This was because H/R day was 156. Night 47.

While bringing down H/R on the CCB bisoprolol was reduced from 10 to 5 to 2.5 and separated to night.

What controlled me was

CCB 120mg Diltiazem am and BB 2.5mg pm. Bisoprolol.

If Bisoprolol is not controlling your H/R ask specialist to add CCB carefully.

But separate them - that is the hint because they can be contra. Bisoprolol should be up to 10 only and not controlled or side effects introduce another drug.

I was kept on Bisoprolol to assist rhythmn.

cheers JOY. 73. (NZ)

maxred1 profile image
maxred1

When I started on Bisoprolol I was at 17.5mg per day. This is late 2015. I was concerned to put it mildly. I am permanent AF. Over the years I have attempted to reduce but only ever in sync with my Cardio. I am stabilised at 10mg per day, but with an increased Digoxin level of 312.5 mcg per day. I take the meds including 10mg Apixiban in the morning. I recently underwent tests and the usual Holters to see if I could reduce but the advice from my Cardio after tests etc is do not fix which is not broken. I have resigned for the moment to stay where I am. My advice would be do not try this yourself without some assistance from your GP/Cardio. FWIW I am feeling as good as ever of late and have not had events for some time. Did lose a bit of weight and changed my whole diet. Heart still bonkers, but then I always knew that. I have a bizarre arrhythmia just to add to the mix....

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