Change from Bisoprolol to Diltiazam.

[Pdotg]

My doctor has recently switched me from Bisoprolol to Diltiazam. (I’m not sure why - I think he explained, but there is always too much information to take in during consultations so I’m guessing it’s because I mentioned a hand tremor and balance problems.) I’m put off by all the warnings about the Diltiazam: 12 hour slow release capsules, phone your doctor if you miss a dose (It takes a whole day to get through to my surgery , so that’s not useful), it has to be brand-specific etc. After 3 weeks I’m not noticing any difference so wondering whether I should ask to go back to Bisoprolol because it’s less complicated to take. (I’m also on Flecainide.)

I’d like to hear about others’ experience with Diltiazam. Thanks.

[Hidden]

Prior to my CV back in 2014, I was taking Bisoprolol and Diltiazem. The CV was successful and the Doctor said I could stop one so I opted to keep the Diltiazem and have no regrets. After a year, AF returned but was controlled with a maintenance dose of Flecainide whilst waiting for my first ablation. I had no problems and side effects were significantly less than when I was taking Bisoprolol. I had a second ablation in 2018 and have been in NSR for most of the time since 2014 so that may have a bearing but I still take Diltiazem and it works fine for me……..

[Pdotg in reply to Hidden]

Useful to know that you were on both Bisoprolol and Diltiazam Flapjack. I was wondering whether I could take Bisoprolol as a PIP if I have an episode of AF. That’s another question I need to ask.

[JOY2THEWORLD49]

Hi

Are you controlled.

I wasn't controlled on Bisoprolol.

Diltiazem CCB as main now. 120mg am and 2.5 Bisoprolol.pm.

If you have Essential Tremor (it sounds like it) a BB beta Blocker is better for you.

The unsteadiness - not being able to walk a straight line that are the first steps to Parkinson Disease.

Cheers. JOY. 73. (NZ)

[Pdotg in reply to JOY2THEWORLD49]

Yes, my AF was controlled with Bisoprolol.

I am waiting to see a neurologist ( sometime next year, or the year after, such is the NHS at the moment) about possible Parkinson’s.

[Auriculaire in reply to Pdotg]

Have you had your thyroid levels checked? Hyperthyroidism can cause both afib and tremor.h

[kkatz]

I have been on Adizem 180 for 5 years.Was not aware of any warnings and have not had any probs.I was not aware of phone docs if missed a dose ?I have occasionally missed a dose.I think I might call docs or 111 if I took it twice?

[Buffafly in reply to kkatz]

I took an extra 180 by mistake last week but only noticed when the next capsule was missing, but realised it was why I felt a bit odd earlier on - according to my watch my lowest HR had been 49 which is not actually much lower than normal.

[Pdotg in reply to kkatz]

Adizem instructions say you can take a missed dose within 4 hours, but after that contact your doctor. And if you take extra by mistake, go to hospital. However, I am reassured by the sensible comments below! Thanks all.

[Ducky2003]

Ive been on Diltiazem fir about 6 years as I couldnt tolerate Bisoprolol. Not been aware about notifying GP if I miss a dose, not that I have. Its keeping my HR under control so Im happy with it.

[SuziElley]

I take slow release Diltiazem and also on flecainide. No problems with it and not aware about notifying GP if I miss a dose. Don’t think I ever have though. It a calcium channel blocker rather than a beta blocker. I can’t tolerate beta blockers, hence the Diltiazem

[MainlyMyself]

I have been on Diltiazem for many years (2x 90 grams daily) to work with my Ramipril to control hypertension and to help with my heart rhythms irregularity ( chronic a fibrillation).

Drugs, our tolerance of them and their efficacy vary enormously, Incan only speak from over a decade on such drugs that I could not tolerate the beta blockers as they slowed me down almost to a halt when going upstairs or uphill.

I have never had any problems with my Diltiazem but yes asit is released for 12 hours, one does need to be taken at the right time - a tablet tray helps here if you are new to taking lots of meds. Talk to your Doctor is the best advice .

[Buffafly]

I have both missed and taken an extra dose by mistake and still here. The brand specific bit is very important because your body gets used to one brand and they do differ somewhat. There should be no problem with that either. I have had a switch of brand as well and that wasn’t a disaster but your pharmacy and gp should know that. I didn’t get on with Adizem but Slozem and Zemtard were ok. I take a 24 hour slow release capsule.

[Ablation7]

I take 360 mg Diltiazem daily. I have missed just a few times. Only issue was that my heart rate was a little higher that day. When I realized it the next day, it made sense. Good luck!

[mav7]

Question please.

When you switched, did you do it the following day or did they say wean off of Bisoprolol ?

I am considering a switch.

Thanks !

[Pdotg in reply to mav7]

Sorry about the delayed response. The cardiologist said I should switch immediately rather than wean off the Bisoprolol. As it happens, I chose to switch back after five weeks as the Diltiazam made my heart jump around, and I had some chest pain. Again, I was told to switch back the next day.

[mav7]

Good to know. Thanks !