AF with Bisoprolol

[DE-AF]

I have been switched from Disopyramide to Bisoprolol because Disopyramide was out of stock. I am now in AF and while Bisoprolol seems to be constraining my Heart Rate, I have been in AF nearly all day, and it’s not great. With Disopyramide twice a day, the next dose would resolve any AF, the Bisoprolol is a once a day, so I am going to have to wait until tomorrow. What do others do when taking Bisoprolol? Wait and hope?

[mav7]

Best to discuss with your doctor.

Not familiar with Disopyramide (Norpace) so I googled. It is an antiarrythmic medication while Bisoprolol is a beta blocker.

Was it discussed to not prescribe another antiarrythmic medication ?

[DE-AF in reply to mav7]

On my notes it mentions Flecanaide, but the nurse was adamant that Bisoprolol is the ‘Gold Standard’, so that was that. I did see it n one post that GPs cannot prescribe anti-arrhythmics, I wonder if that has anything to do with the preference for beta blockers?

[Crystamycin in reply to mav7]

Hello ~ I’m on Disopyramide and managed to stay on it until supplies came into UK. I’ve had to change strength of this drug but in keeping with daily dose. Disopyramide 100mgs in capsule format have been in stock since mid January with the 250mgs tablet form hopefully coming soon. I hope this helps. Unfortunately this is an expensive drug and although Community Pharmacy England had made provisions for Disopyramide, along with some other drugs to be accessed from the EU, this can be difficult to obtain. Pharmacies do their best to obtain what they call ‘Special prescriptions’ from abroad. Fortunately for them, my drug came into stock, as it is even much more expensive obtaining from EU or USA for example. Also Dispyramide is not a general drug in use that is automatically stocked in hospitals and pharmacies apparently. However, it does suit me best and the alternative is not as good for me and so I strive to stay on it as long as possible. Your Cardiologist would be able to prescribe a suitable antiarrhythmic drug.

[hausjac in reply to Crystamycin]

Interesting. When it goes out of production - not unusual as it's an old drug - I scan my scrip to my friends in Nice and their pharmacy just provides it! Last time I got it back in November from them (I was meeting my friends in Florence luckily) it cost 30 euros for six boxes which I wouldn't say is that expensive. Compare that to Apixaban which is gold bars worth! Also in recent years I've reduced from 500mg to 300mg/day although scrip stays the same so I stockpile. Crazy but there you are! Have just done it again although its available here at the moment and will collect it from their son when he's back in London so more to stockpile!

[BenHall1]

What were your doses, i.e 5 mg of both or of Bisoprolol or what ? When do you take the Bisoprolol ? morning or night ? Who prescribed .... GP, Cardiac consultant or EP ?

[DE-AF in reply to BenHall1]

It’s 5mg prescribed by the cardiac nurse. Once a day in the morning. Still AF, so this is 24 hrs plus now.

[BenHall1 in reply to DE-AF]

Thanks. I asked because when I was put on Bisoprolol 5 mg I was told to take it in the morning. Initially, no problem but after some months I started to experience weird side effects, like, random and full flow nose bleeds. I saw my GP and although she expressed surprised she told me to take it at night with my bedtime meds. Never had a nosebleed after that .... ever !

I have stayed on Bisoprolol 5mg ( at night ) until August 2023 when I began to feel more and more like the Zombie from the Land of the Living Dead. I was then switched from Bisoprolol 5mg to Nebivolol 3.75mg. No sweat, back to normal.

Maybe talk to your prescriber about switching to taking Bisoprolol at night ?

[wilsond in reply to BenHall1]

Me too

[Tykelady in reply to DE-AF]

I was put on Bisoprolol last summer 5mg morning and evening. I have never found any problems but understand this is the highrst dose prescribed.

[DE-AF in reply to Tykelady]

do you find you still get AF even on the high dose of Bisoprolol? I would be wary of increasing my dosage as I was getting HR < 50 on the 5mg...

[Tykelady in reply to DE-AF]

I was getting low BP and pulse rate but cardac nurse assured me it would be okay.

[hausjac]

Disopyramide is now in stock I just got mine which was prescribed back in September! I take Bisoprolol 7,5 mg as well and have been on this regime for over 35 years. Never heard that Bisoprolol a substitute for Disopyramide but as a complementary drug.

[DE-AF in reply to hausjac]

That’s interesting, I was given the impression it was one or the other……

[hausjac in reply to DE-AF]

Yes because one is an anti-arrhythmic and one a beta blocker. I was prescribed these as I have SVTs caused by an accessory pathway in my heart and the two medications have also helped apparently for my paroxysmal AF as I'm asymptomatic thank goodness and long may that last!

[opal11uk]

I completely sympathise with you, I too have this problem, Disopyramide being out of manufacture, I had been taking it for 20 years, and I was put on Propanafol instead as I already take Bisoporal but I'm pleased to say that there has been no problem with the combination as I separate the times I take them and think that helps.. I am given to understand that Disopyramide is back in production so might be worth having a word with your medics.

[Still_Breathing]

I'm on Bisoporol and digoxin. 1st for the rate, 2nd for the afib.

I would ask to speak to a consultant if I was you.

[Vonnegut]

The lowest dose of Bisoprolol was too much for me to take - it brought my heart rate down too low! It doesn’t deal with the irregularity either- Flecainide does that.

[Cb999]

hi i was taking flecanaide for several years but the EP stopped it and changed to bisoprolol due to also being diagnosed with angina. Flecanaide is not safe to take with Angina apparently. Anyway, I agree with you, the Bisoprolol kept my heartbeat low and not tachycardic but did not regulate my AF at all and I had 8 weeks of hell, waiting for my ablation. I was getting 5 to 10 heavy AF episodes every day. My own experience is, ask for an ablation as it has completely cured my AF, totally successful although I appreciate it only has around a 66% success rate.

[Ersilia2]

I’ve only just started Bisoprolol and I’ve been thinking the same as you,we have to wait, doesn’t make any sense.

[DE-AF in reply to Ersilia2]

It makes no sense at all, I have been in AF now for over 48hrs, I contacted the surgery yesterday afternoon and they sent me to A&E. A&E were great, lots of questions, ECG taken, but despite being in AF I wasn't 'an Emergency' so today I am back to trying to see my GP. Today will be the 3rd consecutive day in AF. I have a few Disopyramide left, so will suggest I use those to get back into rhythm, and see what happens from there.