Bisoporol dosing

[TanteMuh]

Hi, guys! I need your help, please!Until now i was on apix (5mg x2 daily), bisop (2.5mg) and losartan (25mg). I had a rare cardiology app the other day. I told him that, every morning, when i take my bisop 2-10 mins later i have got palpitations, but only for a very short period (less than ½minute). And he told me to increase the bisporol! Well to me it sounds counter productive! To me it sounds that 2.5 is already too much! Am i getting things the wrong way around??

[Hidden]

Hiya TanteMuh,

I was put on Bisoprolol in January 2010 when first diagnosed with paroxysmal AF. 5 mgs to be taken with other morning meds which at the time were blood pressure meds ..... Ramipril 10 mgs.

After some 3 to 4 months I began getting nosebleeds, all at random, full flow difficult to stop. I went and complained to my GP (back in the day) and she got out her book of magic potions and brews, looked it up and said keep the dose the same BUT take it at night.

I did as she said and I've never had a nosebleed since ..... ever! ever! I have had no untoward, bad, sinister side effects from Bisoprolol since ( 13 years now). It holds my HR perfectly at around 64 to 67 bpm. I might I have had very few full blown AF events either and each year, even though I'm getting older, I have less and less.

I am surprised that your healthcare professional never asked you to do this first before trying anything else. All I did was miss the morning dose and take the morning dose that night, with my other night time meds around 8 pm.

To avoid your healthcare professional why not take the time to consult a Pharmacist ( as the collapsed NHS authorities are telling us to do) and seek his/her advice on taking it at night. You never know you might hit on a winner as I did all those years ago.

John

[TanteMuh in reply to Hidden]

Thank you, i will consider taking bisop at night.

[mav7]

Hi Tante

If you have not, would recommend to ask your doctor to wear a holter monitor or other medical heart rate device for a consistent period.

Will give info on exactly what your heart is doing to aid in proper dosage of medications.

[Paulbounce]

Hi Tante.

It is possible that increasing the dose of bisoprolol might not be the best course of action if you are experiencing palpitations as a side effect - however, I am not a doctor so you must follow your cardio's advice as he/she knows your medical history and has far more knowledge than I.

I think John's idea of adjusting the timing of when you take it is a good one.

One thing occurs to me. If your palpitations start within two minutes of taking bis I wouldn't have thought it's the bis causing them. Your body won't have had time to absorb it. Maybe try adjusting the time of day you take the dose and see what happens then.

Paul

[Singwell]

I'm with Paul re the timing of thr palpitations. Highly unlikely that the Bisoprolol hits within 5 minutes- maybe within 10. Ask your pharmacist. And changing time of day for dose, why not? Bodies tend to be more relaxed in the evening and you may find the dose holds well throughout the day.

[Ppiman]

Contrary as it seems, there is always method in a doctor's madness: they are clever devils with a mass of knowledge and experience. I was thinking, as I read your post, much the same when I was given losartan, since as I don't have any problems with my BP. When I asked about this, the doctor told me that it has a range of beneficial effects that are useful for the heart and he felt I would benefit in the long term. When I later read around the topic, I learned that both drugs extend life, for example. That'll do for me!

I found when I took 10mg bisoprolol (well, any dose if taken regularly) that I developed chest discomfort from it. It was never serious, but noticeable. That said, I get the same when my heart races, with or without arrhythmia. I get mostly ectopics and mild racing these days and take just 1.25mg bisoprolol as needed.

Steve

[momist]

Another approach you could possibly explore with your doctor, if you are worried about the increased dose, would be to split the dose so that you are taking the bisoprolol twice a day, as you do the apixaban. Even on your current low dose of 2.5mg it could be split into two at 1.25mg (the lowest dose made AFAIK). I asked for mine to be split when I was first put onto bisoprolol many years ago, as the initial hit made me very slow at climbing the stairs! I've been on split dose ever since, even when it was doubled to 5mg per day.

[mhoam]

Hi, Lots of good advice on here but just one word of warning. I was on a low dose of Bisoprolol which I was taking in the evening, just before bedtime. I encountered a lot of vivid dreams, very stressful. When I mentioned this side effect in passing to my Cardio Nurse he suggested taking it in the morning. This has stopped the strange dreams that I had been having. Please be aware that taking it in the evening may have this sort of effect on you, although of course we are all different and it may not affect you in the same way.

Good Luck

[TanteMuh]

Thank you all for your good advice!!

[55zuzanka61]

it is not bisoprolol doing this to you, after you swallow the pill it takes at least another 30 minutes for the drug to start entering the bloodstream, then it has to bind to beta1 receptors in the heart and full peak therapeutic level is reached after several hours,4-6 to say the least. Symptoms occurring 10minutes after pill ingestion cannot be induced by your bisoprolol.

Stay well TanteMuh, Jerry(semiretired us physician)