Bisoprolol/Edoxaban side effects?

[TickityBoo]

Hi all, I’m a fit (I thought!) 66 year old woman. I was diagnosed with AFib four weeks ago after I went to hospital thinking I was having a heart attack while playing golf. Settled itself after 30 mins with no intervention and was kept in overnight for monitoring, but no further episodes. Since then I’ve had a 24 hour ECG, an echo and three further 12 Lead ECGs, all in SR. I run an ECG on my Apple Watch every day, always in SR and my watch also tells me my AF burden is less than 2% (the lowest measurement it gives). My daily BP now is around 116/62 (don’t know what it was before). HBA1C is 4.4%. My echo showed only very mild dilation of both atria and otherwise normal. I was prescribed edoxaban 60mg and Bisoprolol 5mg daily. I feel ok on these except I'm not sleeping very well and I’ve developed persistent diarrhoea twice a day - so it’s not constant but is VERY urgent, usually early morning and late evening. I don’t have any other signs of being unwell and this did coincide with starting the medication. Are these common side effects? Are they likely to settle even after 4 weeks or am I stuck with them? I’ve been discharged from cardiology now without follow up. Thanks in advance!

[javo123j]

I can understand you being given edoxaban but the 5 mg of bisoprolol seems high especially as you've had no further symptoms. I suppose the doctor knows best. Your BP is great. Do you have a fast heartbeat. I'm on both tablets but only 2.5 Bisoprolol but get no side effects

[TickityBoo in reply to javo123j]

yes, I only really realised after reading round the forum today that it seemed quite a high starter dose, I had just assumed it was normal. I don’t particularly have a high heart rate normally, I don’t think, but it was never something I paid particular attention to - it was about 150 for an hour while the episode lasted (and that certainly made me scared enough to head to A&E) but both rate and rhythm sorted themselves out without any intervention - rhythm first quite quickly then rate more gradually over the next few hours. My heart rate overnight on Bisoprolol seems to be about 50, and around 65 when I’m up and about, going up to about 120 if I’m exercising.

[Crumble2]

I was diagnosed with paroxysmal AF after one bout of 18hours about 10 years ago. I was given 1.25mg bisopropol as a pill in the pocket. It has taken 10 years progression of AF for me to to be on 2.5mg bisopropol daily. Yours seems a high dose after one short period of af.

[TickityBoo]

Thanks. I’ve got a (very rare!) appt with my GP booked for 16 Jan. You are only allowed one issue per appt but I think I will change the subject of the appt to discuss the drug regime. Can’t deny I’m feeling very anxious about the AF to the tent that I’m now not sure if my symptoms are drug related, arrhythmia related or anxiety related. Given they started within 48 hours of starting the drugs and me being scared witless I guess it could be any three of these. It does seem that diarrhoea can be a side effect of Bisoprolol but the NHS site says it’s usually mild and short lived but I guess that’s pretty subjective!

[Auriculaire in reply to TickityBoo]

One issue per appointment! What unscientific nonsense. Was your doctor never trained to diagnose conditions that might have several seemingly unrelated symptoms eg hypothyroidism where a constellation of things like constipation, feeling cold , tiredness, oedema and hair loss might point in the right direction? How is he/ she supposed to get a proper picture of your health? Bisoprolol does not suit everybody due to it's many nasty side effects and 5mg is too high a dose for a lot of people - if your heart rate can be controlled with 2.5 mg or even 1.25 mg you would probably suffer less with side effects. On 5mg I felt like a zombie.

[TickityBoo in reply to Auriculaire]

Well, I suppose it’s more that you can’t take a sore knee (which I was going with) and an unrelated issue of cardiac medication. At least, I hope that’s what it means! But interesting that everyone thinks it’s a high dose of Bisoprolol. I do actually feel ok on it except for the bathroom issues, but obviously I’d like as little medication as I can safely get away with.

[valwin in reply to TickityBoo]

I asked for a longer appointment to discuss a couple of issues, no problem had to change the time, and got 20 minutes

[Devondan]

Hi, I think the best advice I would give to ask you GP to refer you an EP (an electrophysiologist assuming you haven’t already and discus with them), GP’s have good all round knowledge but few have extensive experience with arrhythmias. I’ve had PAF for 12 years and it’s progressed slowly but I’m only on 3.75 mg bisoprolol.

I’ve also heard that apple watches and fitbits are not good a picking up arrhythmias but the Kardia devices are designed to do just that, they also record the ecg and you can email it to your consultant/GP

Finally don’t worry I think most of us have taken a while to get our meds sorted

[TickityBoo in reply to Devondan]

I think I’d be lucky with that referral tbh. It wasn’t even a cardiologist I saw at the hospital, just someone from general medicine. Apparently they can’t recruit cardiology consultants atm and you only get referred to one with what they described as complex arrhythmias. Otherwise it’s just a general physician you see.