Further to my recent posts on Bisoprolol and Nebivolol

[BenHall1]

Hi everyone,

Late yesterday morning I had a surprise phone call from my preferred Pharmacy down here at the pointy end of Cornwall. Boots.

Well, a surprise for me. So I thought I'd just share this with you all although it really only has relevance to those of you in Britain.

Following discussions with my GP and Surgery employed Pharmacist they agreed to my request for a change of Beta Blocker from Bisoprolol to Nebivolol. I stopped taking my 5mg of Bisoprolol on the night of 7 August starting my new Beta Blocker on the night of 8 August ........ Nebvivolol 2.5mg. (It only comes in pills of 5mg ) so its a case of just whacking the pill through the highly sophisticated piece of technology known as the Pill Cutter.

Anyway, back to yesterdays Boots phone call. It was actually a Pharmacist from Boots checking in that if I had started the Nebivolol, how was I going with it. Was I OK with the dose ? Was I experiencing any bad side effects ? How was I administering it ? What was it doing to my BP and HR .... all that sort of stuff. Amazing I thought, I'd not had this before ... but then - I'd never changed Beta Blockers before either. Maybe they are legally obliged to make a follow up phone call like this - I don't know but I was really impressed.

So, I guess the next thing is to pass on some feed back to you. The switchover went just fine as many of you had forecast. It is interesting that it took 6 days to get my BP and HR to settle down but in that time I'd had to do a 580 mile return road trip to Hindhead, Surrey a short stay supporting my sister who is caring for my brother in law having end of life care from Vascular Dementia. Seated for so long in the drive did nothing either for my lower back pain and Si joint pain. BP certainly shot up and averaged around 141/90 with HR at 70 ish. My normal with Bisoprolol back over the months would be around 132/70 ish with HR at around 64 to 67 bpm. Now I'm home and much more relaxed and preparing for The Matildas v England football tomorrow my BP has settled down to a nice steady 135/80 with HR at 72 .......... so, given that my dose of Beta Blocker has been halved (5mg down to 2.5mg) AND AS A BONUS .... I'm just starting to feel less tired and more normal. So, on balance I can live with all that.

My thanks to all of you who provided encouragement for me to go for the change of B Blocker.

John

[BobD Volunteer]

Been on 2.5 mg for ages John. My pills come with either one or two crack lines on the back so you can break into two or four. Never had any solid ones.

[BenHall1 in reply to BobD]

Yeah, they're the ones Bob .... two crack lines. White. I'm quite happy with the reduction in dose to.

[Jalia]

Interesting John. I'm going to see about a switch over myself

[BenHall1 in reply to Jalia]

Hi Jalia,

I did a bit of research into the two drugs. Bisoprolol is an older drug introduced medically in 1986 and Nebivolol introduced in 1997. So one assumes Nebivolol carries the benefits of improvements over time .... it is certainly appearing that way to me - very happy to halve my doseage too. Good luck with the planned switch.

John

[Jalia in reply to BenHall1]

Just had a text from surgery to say they've sent me Carvedilol! I'm having very debilitating SV Ectopics so I hope this will help with all the stress I'm under coping with husbands escalating Parkinson's . I just need to go into my fast AF now to complete the picture 🙄 Must keep positive . I'm expecting the drug to work. I've never tried it before.

[BenHall1 in reply to Jalia]

I hope it works well for you Jalia ........... it's in the same family of drugs as Bisoprolol and Nebivolol ( a beta blocker) and I really hope it works as well for you as the Nebivolol is for me so far. I can imagine the stress you have with your husbands Parkinsons, I've never had the caring respopnsibility for someone like you have but have seen how it was for my wife caring for her mother with the same condition. Stay well, stay safe.

John

[Jalia in reply to BenHall1]

Thanks John

[cassie46 in reply to Jalia]

I have not taken Cardivolol myself but about 4 1/2 years ago I was trying to get bisoprolol changed to Nebivolol because I was having problems wth biso, causing breathing problems, I have mild asthma. At my next cardio outpatient appointment I explained to the registra why I wanted to change to Nebivolol, he looked up his drugs manual and gave me a prescription for Cardivolol said he thought it would be better. When I went to open the box of Cardivolol I noticed a warninig on the back of the packet - Do not take if you have asthma lung issues (words to that effect). I just could not believe it, after sitting there for ages giving my reasons for a change to Nebivolol. Nebivolol is recommended for those with asthma and breathing issues. I did not take the Cardivolol.

I did eventually get my GP to change me to Nebivolol, have you ever taken Bisoprolol and had any problems with it or is this your first beta blocker in the lol family of drugs. It may work well for you but just be aware of side effects. Sorry to hear about your husband, keep strong and stay well.

[Jalia in reply to cassie46]

Yes I've taken Bisoprolol. I felt I was walking through treacle with it plus it made very little difference. I've also had sotalol and atenolol in the dim and distant past. I shall be very aware of untoward side effects as I've noticed a major interaction with my anti arrhythmia drug Disopyramide flagged up on Drugs .com. However same thing appears with Bisop and nobody seemed concerned apart from me ! I shall put my Dr Google hat on & get back to surgery if necessary 😀

[Hidden]

Good news John, also encouraging to hear about the level of support you are getting from the pharmacist too. We use Boots as well, and the pharmacist there is well known and respected for the care and support he give his customers. There have been a lot of good reports about Nebivolol so fingers crossed that it works for……

[BenHall1 in reply to Hidden]

Thanks Flapjack. 🙂

[Hallane]

Why didn’t they start you on Nebivilol?

I was diagnosed with persistent AF in May,. Started on Bisoprolol and then moved to Nebivilol after a few weeks as apparently it would improve Echo scan interpretation.

I have the same side effect with both. Tight chest, slightly worse with Nebivilol.

[BenHall1 in reply to Hallane]

Well, my Cardiac Consultant made the decision and prescribed Bisoprolol back in the day (2010) when I was diagnosed with paroxysmal AF. Apart from an initial hiccup with it in the beginning which was resolved by my taking it at night instead of daytime ( as it was originally prescribed) it has done me well over the last 13 years, until about 10 months ago when I started feelings of overwhelming tiredness, then at the beginning of July 2023 I had a bit of a 'wobbly' and my GP stopped me from driving until things were sorted. Had eyesight tests, blood tests (which showed a slight drop in my Thyroid TSH Level) but apart from that nothing sinister.

I put a post on this forum nearly a month ago about Bisoprolol and as a result of reading peeps comments, and recommendations on Nebivolol I spoke to my GP and the Surgery Pharmacist and we agreed to the change to Nebivolol. I have follow up blood tests this Friday to check on the TSH Level count. So far the Nebivolol is doing fine - and giving me a resulting BP and HR not much higher than with Bisoprolol ....... but with only half the dose.

John

[wilsond]

Excellent news John and thorough care by pharmacy. Best wishes

[DevonHubby1]

Wife also did the switch from Bisoprolol to Nebivolol (via a few weeks on Atenalol). She's on 7.5mg do again has to cut a pill in half. Pharmacist (Boots) has rung her twice to check all OK. Consultant also has rung her twice to see how she's doing. Needless to say no calls from GP.

She tolerated the Bisoprolol quite well when paroxymal but when she went persistent and they upped the dose she struggled. Nebivolol is allowing her to do a lot more.

[Mrsvemb]

So pleased that your switch has been a success John. One thing though is that you can get 2.5mg tablets of Nebivolol. I have had them for 3 years now.

Val

[BenHall1 in reply to Mrsvemb]

Oooh ! Wow, thanks Val. I wasn't aware of that, that'd be brill. It's a bit of a pain with the Pill Cutter 😥😥. When I have my next talkfest/ review with the Pharmacist I'll ask for these. Thanks Val.

John

[reinaway]

It's good to hear that a change to Nebivolol has been a success to you Ben as it was to me. I have been on various beta blockers since 1994 when my surgery initially prescribed Antenalol for high blood pressure. In the following years I developed PAF and I think I've been through most of the various beta blockers there are. It has been the best one with least side effects of the lot. It also controls my BP and helps my migraine and anxiety and although, since my Pace and Ablate procedure last year, I don't take it for AF, I still take a small dose for these.

[Finvola]

I'm impressed with your pharmacist John, and it's great news that things have started to improve for you.

I take a 2.5mg tablet and I remember when I researched Nebivolol 5 or 6 years ago that the 5mg tablet costs much less than 2.5mg accordingly - not much more than Bisoprolol. Some posters said they had been prescribed 5mg to cut in two as the 2.5mg was so expensive.

Edit - in 2017 Nebivolol 2.5mg cost the NHS £16.01 for 28 tabs and Nebivolol 5mg cost £1.10 for 28 tabs. I haven't got up to date prices but wonder if the profiteering is still going on.

[BenHall1 in reply to Finvola]

Thanks Finvola - thats an amazing price differential .... amazing. I must do a bit of research on that now you've mentioned it. Dosen't bother me putting a pill through my pill cutter, just lazy thats all 😱😱😱😱. That would be something that would need referrring to some sort of Prices Justification Authority.

John

[gixxerboy in reply to Finvola]

l take 12.5mg of Nebivolol and l asked to go on the 10mg tablet.....they totally refused stating it cost more to give me a 10mg tablet than 2 x5mg tablets....work that 1 out lol

[BenHall1 in reply to gixxerboy]

gixxerboy ...... nothing to work out ! The devious Big Pharma at work ...yet again !

[Finvola in reply to gixxerboy]

Ridiculous, isn't it gixxerboy.

[Silvasava]

I was put on Bisoprolol automatically after investigations for my stroke in 2019. I was changed to Nebivolol in 2020 as I'm asthmatic, also on 2.5mg from 10mg of Bisoprolol. I don't use a pill cutter, just snap them in half. Halving Spironolactone is another matter though.

[richard_jw]

HiTwo things

2.5mg pills do exist of nebivolol but the NHS has to pay vastly more for them something like 5 times so GPs are encouraged to prescribe 5mg

I think that the equivalent nebivolol is the same size as Bisoprolol (I. E 2.5 Bisoprolol is 2.5 nebivolol)

There are websites to back it up

I changed recently and my rhr with nebivolol is actually higher with the same dose of Bisoprolol

Certainly the GP prescribed the same dose

[RichMert]

Would be great to hear how you get on over time with Nebivolol Ben. I tried Nebivolol for Ectopics but now on 1.25 Bisoprolol. I started to get pins and needles in my left hand and minor chest pain with Nebivolol after using it for a month. Hope it works for you. Richard, in the fat middle bit of Cornwall.

[BenHall1 in reply to RichMert]

Hi Richard (in the fat middle bit of Cornwall),

Thanks for that. Its really useful reading everyones comments/experiences with Nebviolol and I certainly will provide an update as time moves on.

John

[Ppiman]

Good news and a pleasant post to read — thank you. How anyone can have heart trouble living in your glorious part of the country, the land that inspired Hardy’s treasured poems and the world where chough wheel around the clifftops, I’ll never understand! 😉

“O the opal and the sapphire of that wandering western sea,


And the woman riding high above with bright hair flapping free—
“

Steve

[BenHall1 in reply to Ppiman]

Well Steve, it all started when I lived in N.W. Surrey and I transferred it down here but, mercifully, I have it (AF) highly controlled - its just not being able to cope with Bisoprolol anymore. Time will tell.

John

[Peacefulneedshelp]

John, good news! Interesting how the pills come. I too am on Nebivolol and here in the states they do come 2.5 as I too was horribly tired on the 5ml. I don't have lines on mine to cut in half but I do anyway.