Can anyone tell me by what degrees the medics reduce Bisoprolol dosage ? I take 10 mgs ( 5 mgs morning and evening ). I am obviously not going to change anything myself without the doctor’s support, but he said it was on the cards and will review my situation on my next visit. I really am just interested in anyone else’ s experience with this.
Annie.
Hi Annie.
My own personal experience was I didn't have any problem just stopping. However, many others do. You are on a high dose and I think it's highly unlikely your medic will say just to stop. It's more likely to be tampered down over a number of weeks to allow your body to adjust.
For lower doses (from memory) this is usually done over a few weeks. For 10 mg the period might well be longer. Talk to your doctor if you have concerns and explain you would like to reduce the dose over a longer period. I'm sure (s)he will understand.
Paul
Thanks Paul. I am a little concerned only because after being on this dose fore over a year, with a nice heart rate between 58 and 65 ish at rest, I am now finding that my heart rate is sometimes between 50 and 60 at rest. I actually cut my 5 mg pill tonight and discarded a quarter 🫢 I might do the same tomorrow…..
Annie.
Hi Annie. I can't tell you to do this without your doctor's say so of course. I wonder if it might be worth calling your pharmacist tomorrow morning to seek their advice. A heart rate between 50 - 60 at rest suits me down to the ground and personally, I would be very happy with that.
It is of course your decision but always be careful self-medicating without consulting a heath care professional first. I have my personal views about what you are doing, but sorry, it's against forum rules to disclose this as I am not a doctor.
Have a great evening.
Paul
Whilst on the subject is Bisoprolol prescription only in the UK?
Ivan - yes, prescription only.Annie - I think the smallest pill they do is 1.25mg. time to check with the Dr, I would ask him/her why they chose to start on 10mg and if the intention was to keep you there.
Gary
Hello Gary. Thanks for replying. I have only been on 10 mgs for the last year. Since being diagnosed with Afib in 2017, the dose has been increased in ‘steps’ after short bouts of mild tachycardia. As my heart rate has been excellent since the last increase, ( ok, because of the higher dose ! ), I was wondering if I could gradually reduce it and see what happens. If tgd tachycardia returned, I would be sure I needed the higher dose. I might find though, that I am ok on a lower dose.
Annie
Makes sense, but I'd check with the medic 
Yes, it is prescription only.
This year I've bought it over-the-counter in Portugal (as I recall) and Russia. Having said which when I've asked in other countries if I could buy codeine over the counter they've looked at me as though I was mad, but you could buy it over-the-counter in Britain until very recently.
They stopped codeine over the counter as its highly addictive. I had an op a few months back. Hospital pharmacy messed up and forgot to issue it as part of my leaving package. Nurse said can't you buy some from the supermarket! Made me laugh.... & I replied not unless it's the black market.
In my wife's case she was on 3.75 when HR regularly drifted down to the low 40s. GP reduced her dose to 2.5 but did not take her off it entirely.
Ah, so there might be a case for the doc reducing my dose by a couple of mgs. Now, for trying to get a GP appointment !
Thanks Anne. What you say makes a lot of sense. My only concern is that after a year of a nice steady my heart rate averaging say, 60 - 63 at rest, sometimes a little bit higher or lower, the average has, over the last couple of weeks been more like 55 - 60, which I know is negligible ( and I can hear everyone’s ‘tutting’ scornfully over the ether ! ) it’s just different for me. A change, but - I am getting quite a few non- Afib palpitations now so I doubt the doc will reduce the dose. But I take your point about the lower rate, in general terms, not being significant. Thank you Anne.
Annie
Hi Annie,
I’ve been on Bisoprolol and Flecanide for AFib for 18 months with two failed ablations and numerous unsuccessful cardioversions prior.
I’ve been reducing my meds since Christmas with the blessing of my cardiologist. Basically the rule of thumb he gave me was:
Always reduce in increments over a two-week period. Reduce in the evening first (so full dose still in the morning) then even up (maybe after a week rather than waiting the full two if you feel ok) to reduce the morning does as well.
If you suddenly feel bad, you can always go back up again – this option educed some of my anxiety about it all.
So I was on 5 mg Bisoprolol + 100 mg Flecanide morning and evening. I reduced to 2,5 Bisoprolol and 50 Flecanide, then after two weeks, halved of those doses etc. starting with the evening dose first.
I am now on what looks like a crumb of Bisoprolol and 25 mg of Flecanide. I did have some days when I didn’t take them at all because I felt, actually, amazing – but then things got stressy at work, so I’ve gone back to my minimum dose for now and feel better.
My cardiologist said that, at least for me, the AFib isn’t dangerous per se – although it is really uncomfortable and is impactful on my quality of life. It is rather the risk of a stroke that’s the problem, so as long as I stick to my blood thinner (Lixiana = Edoexaban), I’m ok to experiment with the betablocker and Flecanide.
Being trusted by him to trust my own instincts has really empowered me to manage my condition and to come to terms with the fact that I shouldn’t be waiting for my AFib to be cured but to accept it as a part of me and how I need to live my life now.
Hope this helps!
Marieanne
Thanks for sharing your experience. This is why this forum is so valuable - people taking time to support others. I’m grateful to you.
I feel some doctors don’t ( mine certainly didn’t get the reducing before stopping bit), so once they said it could be reduced I used my pill cutter and reduced it much more slowly as I’d read others expériences on here. I didn’t have any problem’s and would do the same again. Good luck.
Hi
Ewloe you shouldnt need a cutter as it breaks in 1/2 alonf the kine and skinny part of the pill.
cheers JOY. 74. (NZ)
Thank you !
I was on a relatively low dose 2.5mg, but it still made me tired- when my GP took my blood pressure, she considered to be too low, and immediately halved the dose. I still get tired from time to time, but my BP has gone up and I will stick with 1.25mg Biso as I really think it's the most successful for AF - but certainly there was no tapering down.
I have done very well on Bisoprolol. When I told the cardiologist it was making me tired ( last year ), he said the cause was more likely to be the Afib - most episodes of which I don’t notice. He said any side effects are usually noticed when staring the drug, and I was fine then. I think I will have to raper from 10 mgs.
I think it depends upon how healthy the heart otherwise is. My prescription was reduced without any effects, then stopped abruptly but within days I did have a surprise bad episode of AF. For people with heart conditions, it seems the effects of stopping beta blockers can be severe as a rebound effect occurs.
I suspect your dose will be tailed off over a couple of weeks.
Steve
My heart is sound with good function, except I have mild Mitral and Aortic leakage. It would be nice not to have high dosage if unnecessary.
My GP has been excellent with my post ablation issues. From what he has told me the dose of beta blocker can be titrated downwards safely until (if and when) symptoms reappear. I take 1.25mg daily at present as my AF and palpitations worsened three weeks ago. I’m a bit stuck to take more as I have a slow resting heart beat and I’m also taking losartan for LBBB prophylaxis.
Steve
mine was reduced to 7.5 in a morning
Hi
I twinked Bisoprolol but heart spec priv introduced CCB Diltiazem for H/R rapid and persistent with AF.
Bisoprolol is a BB Beta Blocker. The dose comes in 5mg/2.5mg not sure about 10mg. They all have a 1/2 line through the middle.
I found that Bisoprolol works on BP and better than others if you have AF.
CCB Calcium Channel Blocker better for rapid Heart Rate.
Both for Rythmn.
Always work with GP.
An ECG will give a good indication of how your meds and heart is.
cheriJOY 74. (NZ)
A Company in the UK called Zentiva have a 1.25mg dose, but here in South Africa the lowest is 2.5mg and they are a silly heart shape which is awkward to split - they don't fit in my pill splitter and I have to do it by hand and they are seldomly completely accurately halved!
Hi
Mine 2.5mg Biso are not heart shape
Its called Bisoprolol Mylan manufactured by MYLAN.
Try ordering Bisoprolol Mylan in 2.5 and you can break it in the foil.
It is long with a line and skinny inward shape there.
It has an expiry date, properly secured plastic container 90 foiled
pills.
I changed my thyroid synthetic hormones thyroxine to all Synthroid, 100 and 25 because other bulk buy was not reliable as I have no thyroid. Pluses
it comes with a expiry date, it is securely locked, it has 90 (3 months) supply and
it has a condensation thingy in it.
Let me know how you go?
cheri JOY. 74. (NZ)
Hi Joy, I checked with my Medical Aid Society (that's what we have here not Insurance) and they only have two brands on their formulary and they are both heart shaped, I said to the young girl in the chronic department, now you know what to give your boyfriend for Valentine's day - a packet of 2.5mg Cardicor by Merck !!!!!!
Hi
Um. My 77 year old boyfriend already takes 1/2 aspirin which is in heart form.
I was going to say "are you sure that you are not taking a Junior Aspirin".
So we are back to the start aren't we!
By the way I was on 10mg 5mg x twice. But when I was introduced to CCB
bisoprolol needed to be reduced pronto. NZ Heart Foundation helped me.
cheri JOY
No definitely Bisoprolol - The various brands if baby aspirin are all a sensible shape.! I said to my pharmacist that he must find out why they don't import 1.25mg or manufacture it here (just for me of course !!!!!). He said that he hardly ever sees the drug rep, as there are new rules on drug pricing and suppliers can't offer special deals anymore, so I guess I must stick with the 'hearts'. The Medical Aid Societies are non-profit making, so they may do special deals with suppliers but they have to pass it on to the consumer - the medical laws are very complex. They tried to bring in a NHS system but it was a dismal failure.
Hi
I was checking my 3 months of Bisoprolol. Dr prescribed 2.5mg and she knows that I have it at night.
I see the chemst has given me 5mg and 5 foiled sheets x 10 pills. So I have 100.
I will ring them up as it reads 1 a day and at morning!
That is unforgivable I'm taking them back to exchange for 2.5's. But I tried 1/2 2.5 = 1.25 but my BP was up. So returned to 2.5.
cheers JOY
The medical advice is not to reduce Bisoprolol without a doctor's agreement with this. It really doesn't matter what we out here may say because each patient is different and we all have differing associated conditions (or maybe none) - this all weighs on the decision to reduce medication so that we are kept safe. My advice was that Bisop. has to be weaned off very slowly.
I reduced mine ( with Dr in the loop ) from 10 mg down to 1.25mg. It took a few weweeksk but I just went on how it felt and took it as slow or as fast as my body responded.
How different we all are- The lowest dose of Bisoprolol was too much for me to take daily!
My EP told me to come off immediately after my P and A but that sent my BP up, so with his approval, I weaned myself off very gradually. It took about 18 mths with regular home BP testing and adjustments, up or down, as necessary. I have kept a packet, just in case and home test every couple of weeks now.
Hi Annie, I'm in process of reducing. My consultant advised I reduce by half per 2 wks, until nil. If my BP goes up he said there are better BP drugs to use and if my AF reoccurs they'll try something else.
My dose has been gradually reduced from 10mg because of side effects - slow heart beat, ankle swelling and shortness of breath on exercising. The cardiologist recommended cutting by 2.5mg at a time, but after hearing from others here, my GP agreed to reduce it more slowly - by 1.25mg for 3-4 weeks, and if all was well, then down another 1.25mg.
I got down to 5mg once a day, and then a 24 hour tape showed I was in NSR but getting quite a lot of supraventricular ectopics and thehe cardiologist recommended putting my dose back up to 6.25mg. I feel fine, but haven't had another 24 hour tape yet.
I do feel rather better on the lower dose - heart rate mostly in the 50s now, and ankles don't swell, but still get a bit short of breath on walking more than short distances.
Hope all goes well for you.
hi Annie
I see you have made it perfectly clear that you have no intention of taking any action without first seeing your doctor, rather just asking what other people’s experience has been... which is very sensible and you now have lots of feedback.
I think it’s evident that really everyone is individually different depending on their particular health circumstances.
Personally I am the other way around, gone from 5mg to 7.5 to 10mg. no matter what I do (split half morning or PM dose/all in am/all in pm) Bisoprolol continues to make me feel absolutely appalling, and at 10 mg still averaging circa 90+.
My cardiologist was happy to allow me to adjust my dose downwards myself (within given parameters) to see if any benefitted me, but told me not to split the dose.. (as I say not only are we all different but so are cardiologists advice accordingly).
Downwards didn’t work for me so cardiologist going to potentially try CCB after CV planned in a couple of months.
Good luck with getting a docs appt and sorting out your meds.👍
Thanks for your considered response. I think the fact we are all so different is what makes this condition so annoying ! There are few hard and fast rules, and the lucky people ( like myself ) are the ones who have a contactable GP and are also under the care of s cardiologist they trust. I would like to add an EP to my care team 🤪 but that’s probably asking too much ! I am waiting to hear whether or not my recent run of PVCs and SVEs are anything to worry about, but as I wouldn’t notice them too much without my Kardia picking them up, and my Afib not causing much trouble, I think maybe I should count my blessings. What is CCB ? Fingers crossed for your CV in a few weeks.
Annie
EP? fat chance. I had never even heard of one until I came on this forum, let alone been referred to one. I am sure they do exist... somewhere....😀 Sorry... Calcium Channel Blockers... nice that you have a contactable GP...
Hi, just reading this older post. I am thinking my situation sounds a bit like yours …in that put on ten mg bisoprolol and yet heart rate still about 100. Am waiting for cardioversion. Have you since had yours? Would appreciate any further advice from you please
Hi JF
Bisoprolol just didn’t work for me in regards to it making me feel dreadful so changed to Calcium channel blocker diltiazem, which is not so good at controlling rate, but side effects were a bit more tolerable.
Ultimately, being medicated (and feeling like a zombie) for my persistent, long standing AF for the rest of my life was not appealing. EP gave me only a 50% chance of a catheter ablation working (no thanks might as well flip a coin)… cardio versions didn’t work longer than a few hours…
So after a lot of reading about the Wolf mini maze, and being in touch with Mummyluv here on this forum, I ended up having a full surgical ablation 3 months ago.
It was far from a walk in the park but now 3 months after the op I have been in normal sinus rhythm for nearly two months.
You don’t really say much else about your circumstances but that’s my story for what it’s worth …
I sympathise with your situation and hope you find something that works for you. 👍
well they reduced mine in hospital as I had a brain bleed, but docs have highered my dosage as HeartRate resting at 100bpm but waiting for echo stress test. See what happens. Good luck with your reduction but keep an eye on yourself
Bisoprolol should bring that heart rate down, but as my GP has told me “ we have plenty of tools in the box - if something doesn’t work, we will find something that does “. Best of luck !
I write this to add my experience, and hope that may be of help to Annie, or anyone else reading through these posts. I had a successful cryo ablation to stop afib from the left atrium in 2016. Last year I tripped into Atrial Flutter (right side of heart) with an HR of 150 - 160 at rest. I was given 10mg bisoprolol (with other drugs). This was dropped to 2.5mg bisoprolol b the consultant 4 weeks later immediately after I had a cardioversion to normalise me heart rate. I was lucky enough to be put on the urgent list for another ablation (right atrium) to stop the atrial flutter. I had this procedure in October last year, and am in sinus rhythm.
My EP has now dropped my bisoprolol to 1.25mg. I have reduced doses overnight at each change and had no problem doing so. The Consultant has talked about possible issues with spikes in blood pressure but seemed fairly relaxed about things with respect to my health.
I have occasional issues with what seem to me to be quite frequent ectopic beats, but am pleased to be reducing the bisoprolol as I do feel it makes me sluggish at times. I am fit, in my late 50s, my resting HR is usually in the low 50s, but did go below 40 for extended periods when on 10mg bisoprolol. It has now settled to the mid 40s. Ectopic beats are few and far between 4 months after the ablation, and coincidentally removing my sports watch (which monitors HR, sleep etc). Personally I think the sports watch helped trigger episodes of ectopics. Covid triggered my Atrial Flutter.
Hello i cut my bisoprolol down from 7.5 to 2.50 in a week it made lttle difrence yes heart rate as gone up a few beats but no ill effects and i do feel a bit lighter
hi Annie,
I’ve had a lot of side effects issues with BISOPROLOL and have reduced very slowly down from 7.5 to 3.75 as advised by my pharmacist though my GP and my EP said I could just stop. The pharmacist advised that the heart can go into rebound when you suddenly remove the amount it’s used to and it’s better advised to do it in slow increments, over a longer period of time - each reduction every second day then every day - so for example 7.5 to 6.25 every second day then after a week/10 days depending how you feel to every day. Then when you’ve stabilised at 6.25 to reduce in the same way to 5mg.
Post cardioversion on Feb 15th I was told by the hospital EP that I could just stop the BISO, but I didn’t, I followed the same advice down to 1.25 and am now slowly reducing to .675 (advised by the cardiologist Dr Ohtsuka) - I’m still in NSR and I’d like to see how my heart feels without Biso at all. If it doesn’t like it then I’ll start at the lowest dose again. Dr O said that you can get Biso at .675 dosage but currently I’m just biting them in half (not an absolute science I know but it works for me)
I think women have very different reactions to the effect of Biso and this was explained by my pharmacists too.
Good luck.
It sounds like your pharmacist is more sensible than your doctors ! ☺️. Like you, I would like to see how I am now on a lower dose, although I wouldn’t expect to be abke to reduce it too much. However, if I can manage for a time with a lower dose, it gives me a little leeway if/when I get an episode of tachycardia. As that is so rare, I feel 10mgs of Bisoprolol is a lot to take ‘just in case’ the heart rate increases a bit. It wasn’t even very fast tachycardia, I just felt awful. Anyway, my cardiologist was pondering whether to put me on Sotalol, which he could do as I’m getting a lot of palpitations now ( not much Afib though ) and Sotalol affects rythm, where as Bisoprolol only affects rate. I didn’t know there was a difference in the effect between men and women….. Sounds like you have been/are working hard to manage your quality of life. Keep at it !
Annie.
Annie, the side effects of withdrawal can mimic these symptoms and that’s why the slow slow slow approach is best. Give it a go, incrementally. You might be surprised that a lower dose is just as effective. That happened with me - at 3.75 I was pretty much the same as I was at 7.5 with much reduced side effects, though I still had them. The brain fog is so much better and actually I’d say I was depressed rather than brain fog at that higher dose - so so happy to have realised it was the meds causing that feeling. I was completely overwhelmed and kept attributing it to the end of my long term and abusive relationship but in fact the majority of it was the drug!
I find cardiologists are very blasé about changing or stopping saying “just stop them”… I agree doing things gradually makes more sense… ultimately what harm can it do so you do right 🥰
Hi Annie
That's quite a high dose... I know when I was on 5mg (as an 18st fit guy) I felt really slowed down and not great. I was put on Fleccanide instead and that's been really effective along with just the 1.25 Bisoprolol tablet. I take the Flec as a prophylactic to prevent Afib episodes and it's way more effective than Bisoprolol. Main thing is to stay in NSR. The EP in Edinburgh said just to take the small Bisoprolol dose to make Flec more effective. My heart rate isn't fast, and in fact was getting too slow. Best of luck with your change - just take it easy. Tiny reductions each week, definitely no sudden changes to upset your applecart!
Thanks for your response. The cardiologist has never mentioned any other drug apart from Sotalol. He suggested when last saw me, that it was an option if Bisoprolol no longer worked at this high dose. As I’m going through a ‘good patch’ I thought maybe I could reduce the Bisoprolol, and then have the option of increasing it again if necessary at a later date - rather than change the drug. However, as I have noted, the Bisoprolol doesn’t have any anti-arrhythmic qualities, whereas the Sotalol does. I saw my GP after a spell of multiply ectopics and premature contractions ( all mild ) and he has written to my cardiologist for advice. The palpitations are only mild, so now I’m wondering if I made s fuss over nothing 🙄.
Reducing Bisoprolol 
reducing Bisoprolol to 1.25
Reducing Bisoprolol dosage.
