Bisoprolol and PIP

[Rhoded]

Hi, I unfortunately had a 14 hr A and E visit on Friday. I stated early evening. I am on 60mg of bisoprolol and 1.25 of Bisoprolol. So took another 1.25 and after a few hours still in AF so had to go. I have asthma and I have felt that lately I thought the Bisoprolol was to blame for more shortness of breath. When I got seen in A and E the Af had stopped!!!! Typical I explained about my shortness of breath. It was decided that the Bisoprolol had to be stopped. I now have a PIP flecainide 300mg and diltiazem 60mg to take when I have another A F episode. What others thoughts on the PIP ?

[BobD Volunteer]

Beta blockers are never a good idea if you have asthma so flecianide and a calcium chanel blocker would seem far more appropriate.

[Rhoded in reply to BobD]

Thanks BobD

[TopBiscuit]

I take Flecainide as PiP. I take 200 mgs and it (so far, except when I had covid) works well and stops the AF in an hour to two hours.

[Rhoded in reply to TopBiscuit]

Thank you

[bassets]

I was told I should never take a beta blocker when first diagnosed with AF because of my asthma. Hopefully you will feel much better with dilitiazem which I take now.

[Rhoded in reply to bassets]

Thank you yes have been changed to 60mg of diltiazem once a day and breathing much better. Edexoban 60mg and a PIP flecainide 300mg. 300 Seems a lot to me though !! Never had it before. ! All scary

[bassets in reply to Rhoded]

Glad you are feeling more like yourself. I always make a point of saying I have asthma whenever I go to hospital or see an unknown GP now. Best of luck

[Rhoded in reply to bassets]

Thank you 😊

[pusillanimous in reply to bassets]

How long ago was this, because the Beta Blocker/Asthma saga seems to be controversial.? I have mild adult onset Asthma (diagnosed via a spirometer reading), never serious enough to cause problems. When first diagnosed with Afib, I was prescribed the usual Biso, and then started reading it was contraindicated for Asthmatics. By then, my initial Cardio had moved, so I went to a new one, who said it was not a problem (my dose is 1.25mg). I moved from him because he over-booked himself, to a highly regarded specialist, who spaces his patients sensibly. Anyhow, I saw him again yesterday and again asked the Beta Blocker /Asthma question. (makes him the 3rd Cardio I have asked !)He said that the one I am taking (Cardicor by Merk) is a third generation BB and recent studies have shown that this third generation of BBs are quite safe with lung problems. Having got used to it, I like it and recently have (and he agrees) gone back to my original dose of 2,5mg, but splitting into morning and evening to control my raised systolic BP as well as my HR as the other BP medications now give me strange side effects. It's hard to know what to believe anymore as far as medication is concerned!

[bassets in reply to pusillanimous]

Good grief, you're right. It's difficult to get a sensible answer these days. I'm sticking to dilitiazem as it seems to suit me. Like you I have late-onset asthma but it did cause me to have to give up work. I think you should find what suits you and leave it at that. Anyway good luck with it

[Rhoded in reply to bassets]

Thank you now on 60mg of diltiazem and no bisoprolol. Breathing much improved

[bassets in reply to Rhoded]

Excellent - long may it continue

[Rhoded in reply to pusillanimous]

So very confusing but I knew my breathing difficulties was NOT asthma. The consultant I saw in A and E rang the cardiologist and he took me off it and put me on 60mg of diltiazem. Only been off bio 4 days and breathing much improved !

[pusillanimous in reply to Rhoded]

Yes it is - I think different things affect different people ways, so really, generalisation is hard, I think we must go with what suits us as individuals. I live in South Africa and so could say it's South African thinking, but it can't be, because all the Cardios I have seen have done their post graduate training abroad, either in the Uk or America, the current one in Edinburgh !

[Vonnegut]

That seems an awful lot to take as a PIP- it’s the maximum daily amount! When I took it as a PIP it was 100mg and got things back to normal in a few hours with an added 1.25 mg of Busoprolol if heart rate exceeded 140 twenty minutes after taking the flecainide which rarely occurred. Now I take 100mg morning and evening and only get incredibly rare episodes (like when I had covid with no other symptoms) which can be stopped with an additional 100mg! Of course we are all different so perhaps it will be ok for you!

[Rhoded in reply to Vonnegut]

Hi thank you. Yes I must admit 300 seems a lot to me too. Never had it before ! So bit scared. Am now on diltiazem 60mg instead of bisoprolol and breathing so much better thank goodness.

[Vonnegut in reply to Rhoded]

That’s good!

I am sitting by the beach at Clevedon on the nicest day of our belated summer! Just met a nice woman from Hungary and bemoaned Brexit together!!

[Rhoded in reply to Vonnegut]

Enjoy

[Teresa156]

300 mg was prescribed to me initially as a PIP and I’d never taken it either up to that point, i have only taken that amount once and I didn’t like taking it. I was told to take 150, then another 150 half an hour later. I lived to tell the tale though…

I’ve seen another EP since who told me to take 100mg and then, if not subsided, to take another 100 a few hours later. They all have different views.

I think there’s also a weight limit to 300 mg of not being below 11 st, and I’m just over 10 st, but the original cardiologist told me not to worry about that either ? (But I did).

I presume this was prescribed by a cardiologist and they would know what’s best for you.

[Rhoded]

Well I am bellow 11 stone definitely and I have not ever seen a cardiologist it's just phone calls from gps to cardiologist. Nightmare. It's very hard to get to see a cardiologist even though I was in A and E they said I would see one but never did !!

[Teresa156]

Hi Rhoded,

So was it A&E that prescribed you the fleconaide? ? It must have been a cardiologist if so, within A&E who did so - they must have done an echocardiogram when you were there? ( a scan?) or you’ve had one in the past? As I say, things may have changed.

It’s normally only ever prescribed if it’s known your heart is structurally sound - but things might have changed. I know a GP cannot initially prescribe it. I’m sure it’s fine and they know that they’re doing.

[Rhoded in reply to Teresa156]

It was a doctor who spoke to a cardiologist. The doctor then prescribed it. I had an ultrasound of the heart about a yr ago. So yes let's hope they do know!!!

[Teresa156 in reply to Rhoded]

I’m glad you had an ultrasound 😊 yes, I’m sure it’ll be fine. When I took 300 , my HR went back into rhythm within 2 hrs, so hopefully the same, or quicker for you 🤞

[Rhoded in reply to Teresa156]

🤞🤞

[jwsonoma]

As Afib is progressive my cardiologist leans more to preventing Afib. I am on 75mg Flec 2x day and can take another 150mg as a PIP. That has happened once in 6 years.

He said with medical advancements in ablation the longer you postpone an ablation the more effective and safer it is. It is like sea sickness or a migraine. It is substantially easier to prevent afib (especially early on) than stop it.

[Rhoded in reply to jwsonoma]

Yes I see that. Thank you.