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what’s a good bisoprolol dose.

Electricblue1 profile image
15 Replies

hello, I’m on bisoprolol 1.25 twice a day and it seems to be too low a dose to keep my heart happy. The Arrhythmia nurse I spoke to wants to put it up as my HHR today has been up to 140 for about 10 hours now and extra pills so far have not got it down. My question is does a 2.5 make you too tired and will the extra dose cause more weight gain. Silly I know but just don’t want more problems to worry about. It’s only showing HHR on Apple Watch not showing AFIB.

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15 Replies
BobD profile image
BobDVolunteer

Impossible question to answer as we all metabolise drugs differently. Some people on 10mg or even higher. All you can do is try and if it doesn't work or make you feel worse then look for a different drug. AF is a long journey.

mjames1 profile image
mjames1

It's not a simple as what is a "good dose". It depends on what you are trying to accomplish.

To simplify, rate control meds like bisoprolol are given either on a daily or PIP (pill in pocket) basis/strategy. PIP is used when your heart rate gets very high, like it is now.

The 1.5mg I assume is a daily dose but sounds like you don't have a PIP dose/strategy. Something you have to discuss with your ep. Because just raising your daily dose is unlikely to work and will just give you unnecessary side effects.

Lastly, please email your Apple Watch ekg to your ep and find out what type of arrhythmia you have. That can be very important for future interventions, whether it be medical or surgical.

Jim

Electricblue1 profile image
Electricblue1 in reply tomjames1

hello, yes I sent my readings off to arrhythmia nurse and it picked up an Arrhythmia but they didn’t know what , it wasn’t AFIB. My 1.25 dose of bisoprolol is not doing anything for me, I take it morning and night, I’m now taking 2.5 morning and night.

Autumn_Leaves profile image
Autumn_Leaves

I’ve only ever taken 2.5g. I don’t think it’s caused me to gain weight but some people can gain weight on beta blockers so it is a consideration. It depends how important your weight is to your overall health. My weight on 2.5g Bisopolol is stable and hasn’t changed much over the past year or so but we’re all individuals. My biggest concern is my BP dipping too low so I cannot realistically increase my dose beyond 2.5g.

mav7 profile image
mav7

In your bio you state a determined therapy/plan for managing AFib has not been determined.

Is that still the case ? If so, consult with your doctor on proper dosage and management of your AFib.

Perhaps you were given a lower dose due to your symptoms at the time. With a hr of 140 for 10 hrs, definitely need a reevaluation if not a trip to A&E/ER.

Lastly, with AFib we have to accept medication side effects to properly manage the condition which is very important.

Hiya,

I'm on 5 mg daily taken at night for HR control. My GP tried me on 7.5mg to attempt to deal with a rise in BP 2 years ago but it only succeeded in making feel like the Zombie from the land of the living dead. Went back to 5 mg. All is well. Resting HR these days is around 62 to 67 bpm ... ideal! Not in the least tired but try and pace myself.

jimlad2 profile image
jimlad2

I think it's all been said already. We all react to and process medication differently. I was prescribed 2.5 mgs daily in October 2015 but for the last year I've only been taking half that amount daily, in order to reduce the gout side effect that affected me so badly that walking was becoming very painful. My resting heart rate rose slightly from upper 50s to mid 60s, my BP remains healthy enough, and my feet pain has decreased markedly. The incidence of AF episodes doesn't appear to be affected. I'm probably on target for 18-22 this year, unfortunately, but, after 16 years of AF I've come to terms with it, though I'd much prefer to be without the AF and the Bisoprolol. Your rapid heart rate of 140 may be completely unrelated to AF and presumably diagnostic efforts are being made to identify the cause? Hope you find the answers soon and that your heart settles down.

Electricblue1 profile image
Electricblue1 in reply tojimlad2

hello, I spoke to the arrhythmia nurse and she said my dose of 1.25 wasn’t doing anything for me , I’m trying 2.5 and just seeing how I go. I have an appointment for ECG at heart hospital in April and to chat about my circumstances. I sent my Apple Watch tracing in and it picked up an Arrhythmia but it wasn’t AFIB. I can have a 3rd ablation but I’m not sure if I want to have another one.

jimlad2 profile image
jimlad2

Hi. Hope the 2.5mgs dose works for you. The ECG might help to clarify what caused the rapid HR. Blood analysis might be useful too, in case you're deficient in magnesium or some other crucial mineral . . Fingers crossed that you're sorted soon.

Electricblue1 profile image
Electricblue1 in reply tojimlad2

thank you.

MacGrumphy profile image
MacGrumphy

I've been on a 5mg Bisoprolol tablet a day for over twenty years without any problems. If I have an attack of AF I immediately take a second 5mg and I am back in sinus rhythm within a couple of hours.

Autumn_Leaves profile image
Autumn_Leaves

The cardiologist I saw told me it wasn’t the bb that converted back into sinus rhythm, but in my experience taking an additional bisoprolol has definitely helped bring me out of it. I agree with your experience.

Healthy65 profile image
Healthy65 in reply toAutumn_Leaves

Gosh that's interesting but not for everyone taking that extra 5mg can push the heart into a big drop in cardiac output and also bp fall so dangerous for some as can advance a cardiac arrest and yes the GP should warn of this mine did as did the consultant . However different people have different sensitivity to bisoprolol .Im saying this as it's important to have that strategy of the extra tablet discussed and agreed with doctor for safety

Hope that's helpful and intended for others reading the feed okay

Healthy 65

Healthy65 profile image
Healthy65

Just looking at the feedback your getting and the nature of your problem looks like a trip to A and E is needed to get that 140 bmp sorted it properly identified. As well medication is always related to your overall health and any other factors . Even timing of meds can make a difference for instance some blood pressure meds taken pm instead of am . I think meds should not just be increased unless weighed up against the events triggering them always get ask for the A and E medical report show it to consultant as it gives the picture of the event and immediate treatment my experience this has been very useful to consultant to look at circumstances and relate to questions then Hopefully you get some relief but at 140 bmp no way should you just sit on it ring OOHs or NHS query no or BHF and if you have A fib then nurse contact as a min

Take care

Christobel23 profile image
Christobel23

Agree with BobD. I'm on 5mg daily and told to take 5mg if HR goes high(140 bpm) Four hours later take extra as rescue dose. So different for all. AF every 10 days lasting 17 hours. Now waiting for pace and ablate. I get on with bisoporol but dronedarone not working. Back to sotolol. Can anyone let me know if they have any side effects from these meds. My fingers and toes are extremely sore, sensitive and hot.Would appreciate any thoughts. Doc said dermatitis but I'm not so sure.

Cheers keep cool!

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