How quickly do tablets work?

[Blueangelgate]

Day 1 of taking 2.5mg of bisoprolol and 60mg edoxaban...how quickly should the tablets start to work? Monitoring blood pressure and worried if the dosage is too high

[BenHall1]

Hi,

Can't comment on Edoxaban but 2.5 mg of Bisoprol is quite low. Bisoprolol lowest is 1.25mg and as far as I know it comes in increases of 1.25. Again, in my experience and mine only, it is slow acting.

[Blueangelgate in reply to BenHall1]

Thank you

[Popepaul]

A single dose of bisoprolol reaches peak concentration in 2-4 hours, it has a half life of 9-12 hours, steady state serum levels are achieved in 5 days.For edoxoban these figures are 10 to 14 hours, 1-2hours and 3days respectively.

My understanding is that both these medications will start to work within a an hour or so but the concentration will go up and down as the drug is broken down by the body over the next few days. Maximum effect should occur after 5 and 3 days respectively, assuming that you continue to take the medications.

I dare say that this may be a simplistic explaination. Others on this forum are likely to be more knowledgeable.

Regards

[Blueangelgate in reply to Popepaul]

Thank you, that's really helpful. Just been so cautious over taking these tablets and nervous about how it will effect my dad. Not sure what's normal and what isn't

[Charles1967 in reply to Popepaul]

Haha...loved the depreciation at the end of your reply popepaul

[Jalia]

When I've been given Bisoprolol in A&E ( more times than I care to remember...) it is expected to work within 30 mins to reduce heart rate.

[Blueangelgate in reply to Jalia]

Thanks Jalia. It's not the heart rate as such it's the blood pressure

[Jalia in reply to Blueangelgate]

While I couldn't say definitely, I would have thought you would find similar time scale. I used to watch my BP drop on the bedside monitor.

PS....in saying that the drop in my BP may not have been due to the Bisoprolol. I'm no medic ! I would have been in fast AF

[Ppiman]

Edoxaban works very quickly but you wouldn't know since it has no or few side effects. It must be taken daily. Bisoprolol works within an hour, peaking perhaps at 2-hours. A single dose can still be reducing the over 24-hours later. If taken daily it soon reaches a steady state in the bloodstream and works continually to lower the heart rate and, to a small degree, the blood pressure.

One aspect of bisoprolol is that people seem to differ in their response to it. Even a single 1,25mg dose affects me noticeably and has a similar effect to 2.5 or 5mg; even 10mg had not very much more effect. This means that 1.25mg is not, necessarily at all, a low dose.

Steve

[waveylines]

Endoxapan is an anti coagulant used to lower stroke risk. Works quickly withing an hour or so of taking it.nhs.uk/medicines/edoxaban/a...

Bisoprolol would be the one that lowers heart rate & blood pressure. It also works quickly and should kick in a short period of time. However the full effects can build over a few days.

Any concerns and ring 111 who will arrange a doctor to ring back. Otherwise contact GP or Consultant tomorrow.

[Singwell]

When you say 'work' what do you mean? As in - I'm in AF and I'd like the tablets to calm it down/stop it. Or as in - I've been diagnosed, when does it stop me having AF?Sounds like you've been given the standard guide dose of Bisoprolol and am anticoagulant - and no further information. It's a confusing time and lots of us have been there.

As a reference point - when I first ended up in A and E with AF it took a couple of hours to.bring me.down to normal and they sent me off with my pills.

Three months later I had AF again despite the pills and was given am extra half dose. It took an.hour and a cup of tea and sandwich to see it off.

I later switched to a different anti arrhythmia medication called Flecainide, which I preferred but still had to take extra doses when AF called in. It could take between 40 and.75 minutes for the extra pill to work.

I guess what I'm saying is - for some people the medication keeps AF at bay - for others not. Alas once you have it, you are prone to it.

There are procedures to help with this situation but that's enough info for now.

Hope this helps.

[Blueangelgate in reply to Singwell]

That's the thing....never had an 'episode' just got told my dad had an irregular heartbeat and to take these tablets. No referral, no follow up, no confirmation it's AF. It's just mentioned on his record.

[Buffafly in reply to Blueangelgate]

How old is your dad? And why are you concerned about his BP? If AF is on his record then that would be confirmation. Are you his official carer? Because if not you need to contact his health centre and say so otherwise they will not share info with you.

[Blueangelgate in reply to Buffafly]

He's 70. His BP was a little on the low side yesterday and I wasn't sure if it was the tablets but he'd only taken his first dose in the morning

[Buffafly in reply to Blueangelgate]

What was his BP?

[Singwell]

It's not untypical although in my opinion not appropriate, for people to be somewhat sidelined past a certain age as to treatment modalities. I could.be off beam here but - he's 70 - well just treat with Bisoprolol and anticoagulants and no need to arrange a cardiology appointment. Your Dad is totally entitled to be booked in to see a cardiologist so if that's what he wants then you can advocate for him by going with him tomhis next appointment. Assuming he's agreeable.Now we have more information it seems to me that trying to get confirmation of a diagnosis from an online cardiologist might not have been that productive. They only have an ECG reading to rely on and won't have palpated your Dad's pulse oraybe listened with a stethoscope. Since this GP was a locum I'd say a good next step would be for your Dad to request an in person appointment ASAP with someone in the surgery who perhaps knows him better. He can say he's very anxious and needs to have it all explained to him. That the lack of information has disturbed him and he doesn't know what to expect.

[Dippy22]

For me Bisoprolol was fast acting and it dropped my BP very quickly - too low! Like a lot of people I don’t tolerate betablockers at all.

[Blueangelgate in reply to Dippy22]

So what did you do?

[Dippy22 in reply to Blueangelgate]

Oh Lord, they tried every drug on me, none of which worked. Betablockers, anti arrhythmics, calcium channel blockers and then last resort Amiodarone. My BP has alway been normal and my heart is healthy.

As the episodes were coming thick n fast averaging about twice a week and HR was up round 160-180, I was expressed through for an ablation on 22nd June. I was told it was “acutely succcessful” and so far so good! All I take now is 30mg Edoxaban.

[Blueangelgate in reply to Dippy22]

Dad has had no episodes or any symptoms, just an irregular heartbeat picked up on an ECG by the GP. Pulse always within range. I'm not convinced he should be taking either tablet but have an appointment with the GP in the week to check on things. Glad things are settling down for you and continue!

[AussieHeart]

Dosage is tailored to the patient so it’s difficult to advise. If your Dad’s BP remains low on 2.5mg, check with the medic whether you can halve the dose to 1.25mg (half a tablet) morning and half at night. Bisoprosolol dropped my BP too low which eventually lead me to taking only 1/2 tablet daily. I trialled mornings but found at night was best for me. Beta Blockers are powerful drugs so you have to experiment … under supervision of course.

[Blueangelgate in reply to AussieHeart]

Thanks. Although deemed 'healthy' on the NHS chart dad's blood pressure is too low for my liking since starting the tablets. Says he feels absolutely fine so that's something. We have an appointment in the week to see the doctor

[AussieHeart in reply to Blueangelgate]

That’s good to know you only have a week to wait to ask about BP. Take your dad’s BP daily (at same time, note if before or after taking Bisoprosolol) and show the Dr the results. PS: I found it kicked in within 20-30 mins. Interestingly my EP advised after agreeing to drop my dose that if I experienced high HR/BP to take the other half tablet as PIP (pill in pocket). It’s a new world of jargon/understanding to negotiate when AF is involved. Sending you and your dad a virtual hug!

[Blueangelgate in reply to AussieHeart]

Thank you so much! Lost my mum a couple of years ago due to a heart condition not treated properly so being very cautious

[AussieHeart in reply to Blueangelgate]

I’m sorry to hear that … knowledge sure is power for any medical condition but particularly AF as everyone’s experience is different. I couldn’t tolerate the drugs in the end and agreed to an ablation… not sure I’d recommend going down that path but 9 months later I feel way better. Some people remain on the blockers and that’s all they need. Your dad is lucky to have you. Take it a step at a time. AF treatment is trial and error

[Blueangelgate in reply to AussieHeart]

Thank you 🙂

[Engineer46]

To see if your Dad is experiencing AF at any time, just take his pulse at the wrist. AF produces a very irregular pulse that you should be able to detect. It feels as if some beats are missing and some are additional, or that there are several fast beats followed by one or more slow beats or missed beats. Basically it feels anything but regular!

The Bisoprolol is given to restrict a fast heart rate that is often seen in AF, to keep it below 100bpm. It will also reduce BP a little too. If you feel that his BP is too low while his HR is well below 100, get him to ask the GP to reduce the dose of Bisoprolol.

AF often comes and goes, so if your Dad does have periods of AF (which can be symptom-free), the anticoagulant will reduce his stroke risk.

Best wishes,

Paul

[Fitbit-Joe]

If like me, I started on 2.5mg of Bisoprolol, and after 5 days this was increased to 5mg. Think its quite common to start on a low dose, and then increase it a few days later.

On 2.5 mg, not real side affect had showed up, but on 5mg, slight headache, and for the first week, getting out of breath. Medication took affect around 2 hrs after taking tablets