Nebivolol dosing during an Afib episode.

[Ribbony]

Hi all, yesterday I had a really bad sore throat. Today I also have a temperature- 98•9 in the left eat and 98.4 in the right ear, plus body aches, possibly fly? Feel terrible.HR was peaking at 175. I wasn't told how much Nebivolol to take when having an episode. Does anyone know the top limit?? With Bisoprolol it was 10mg max per day.

[BobD Volunteer]

Nebivolol is not something to take during events like flecianide so just take you normal daily dose.

[Auriculaire in reply to BobD]

My cardiologist told me to take extra Nebivolol during an episode to bring my heartrate down.

[Dodie117 in reply to Auriculaire]

Me too but I am on very low dose of 1.25mg. I take and extra 1.25 when in AF.

Can you call doctor?

[Auriculaire in reply to Dodie117]

I am not that bothered by my afib episodes. They are not now very symptomatic. I just take the extra Nebivolol and try to carry on normally. I find they stop after 9-12 hours and I feel pretty wiped out for a day afterwards but I think that is partly due to the extra 1Nebivolol. I don't get on well with meds in general! So I have never called the doctor since my first diagnosed attack when I went to A&E in an ambulance . Then they kept me in for 4 days till my INR was in the required range.

[jeanjeannie50]

Sorry to hear you have this worry. It sounds as though you could have Covid. Have you done a test for it? People are saying how it's affecting their heart rate too. You need medical advice if your heart rate is still high. I'd give the NHS no. a call. Jean

[Ribbony in reply to jeanjeannie50]

You are spot on Jeanjeannie! I had some old LFT's in the cupboard and did a test= positive!! Never seen that before! As my bro- in-law is a retired GP, I ran my AF and other symptoms past him and he said it needs looking into to find the cause of the infection. (That was B4 I did the LFTtest). So hubby rang 111. I did the test just B4 that. They sent an Ambulance. The paramedics said I needed to go to Hospital so they took me. I was amazed to only have to wait maybe 5 minutes to be put in a single room. (Took 8 hours last time I walked into A &E with Diverticulitis.) Within 20 minutes I had a comfortable trolley to lie and sweat on, was hooked up to a drip + dexamethasone. Given Bisoprolol. It took several hours for the Heart Rate machine to stop giving alarm calls, but by the end of the Night Shift I was informed the Afib was under control & I could go home. I have never had a top spike of 175 BpM with Bisoprolol, but it could have been due to the Covid infection. Duty Dr is calling today as A +E Dr didn't know about Nebivolol. Many thanks for all your responses everyone!

[jeanjeannie50 in reply to Ribbony]

Glad you were quickly sorted out by A&E and hope you soon recover from Covid. Were the paramedics or hospital staff dressed in Covid protection gear?

[Ribbony in reply to jeanjeannie50]

The Staff wore Masks, especially the Nurses who came into my side room, but they weren't bothered by me not wearing mine. I couldnt get my breath with it on. The paramedic I traveled with wanted me to wear one but I pointed out that very fast Afib was not conducive to getting sufficient oxygen and I turned my head away from him. He was the only one who was fussed, oh plus the Driver! A no nonsense woman who made me change out of my night wear as they were soaking wet from the fever, and wear very little. Which was fun 12 hours later when I left the Hospital in the pouring rain!

[BobD Volunteer in reply to Ribbony]

Not too high then. Many people go well over 200!

[Ribbony in reply to BobD]

You are joking, Bob?! I am a bit dizzy & wobbly over 158. I was going to ask how I can get it down? Head of practise rang me and I asked about the dose. He said"did we ask you to go on Nebivolol?" I said no but I was like the living dead on Bisoprolol, and Nebivolol had fewer side effects , to which he replied "yes, and it's less effective". So I'm rather disappointed. Hubby has Covid too and trying to walk upstairs no hands with his lunch caused me to stumble, get stressed and 15 minutes later-craxy Afib. Probably have it for 20 hours. All this sucks!! I have a normal temperature now but am so weak. Will it always be at this higher rate on Nebivolol does anyone think??

[BobD Volunteer in reply to Ribbony]

We all have different levels of acceptance as I frequently say. Yes lots of people have much much higher rates. I flew to France to see my sister at 140 for two weeks till I got back and had a DCCV,

[Ppiman]

The only way to find out about dosage is to phone your GP as each of us will a different background to our AF, or have different resting rates and BP, all of which will affect the maximum dose of beta-blocker that is allowed.

I was wondering whether your high rate was owing to AF or to fever? Jean suggests testing for covid if things don't settle soon. and that's a good idea. Nebivolol dosage does look very similar to bisoprolol, and both are, like most beta-blockers, considered relatively safe drugs (although it does have a rather different mode of action).

Steve

[cassie46]

On Monday I was taken by ambulance into hospital with suspected chest infection and high heart rate. I have AF, midl heart failure and asthma. My temperature was high, felt as if I had severe flu aches and pains and breathing difficlties, paramedics decided time for hospital and blue lighted me in, apparently my ecg readings were showing something odd, by the time I got to hospital it had settle down, still very high but oaky. One of my medications for AF is Nebivolol 5mg. Came home yesterday after lots of test scans and I have an uknown infection and given antibiotics. Your heart rate will be affected by any infection, so I was not given anything to make that come down just take my usual heart medications and wait for antibiotics to work. My HR is now back to its normal range, I am in permanent AF so it fluctuates quite alot but within normal ranges. I think you need to get the infection sorted out quickly. If you are in the UK ring your surgery or ring 111 who will help you, its probably quicker to ring 111, its very difficult getting through to my surgery, phones always busy or put on hold for ages. I have been on Nebivolol for 5 years (was on Bisoprolol) I have never heard of it being increased to bring a HR down in this situation. Good luck with getting sorted.