I have been on Bisoprolol for a couple of weeks but I haven’t felt great. I felt tired and foggy most of the time, struggled to get my breath and my feet were freezing. I have spoken to the pharmacist at our surgery and he has changed my medication to Atenolol even though he said Bisoprolol was the preferred choice. Does anyone have any experience with this medication who could offer some advice. I had my second AFib episode 2 weeks ago and was treated in hospital but I still haven’t seen a GP about it. I had a 24 hour ECG yesterday but, unfortunately, one of the leads came off in the night and I had no idea until I got up. I feel so stressed about it all and would welcome any advice. Thank you.
change of medication to Atenolol from... - Atrial Fibrillati...
change of medication to Atenolol from Bisoprolol
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Wilky57
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66 Replies
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My mum was on atenolol for over 20 years,she had no problems with it. I'm considering asking to be changed over,even on 1.25 bisoprolol I can often get very tired and breathless for no apparent reason !
Thank you so much for your reply. I asked if I could reduce the dose of Bisoprolol but he said 2x2.5mg was the lowest dose I could have. I don’t have high blood pressure and I’ve only had 2 episodes of AFib. It all seems so overwhelming. You have made me feel better.
• in reply toWilky57
Bisoprolol is available as a 1.25 mg tablet. I didn’t tolerate Bisoprolol very well but have been better on Nebivolol
That's nonsense. 5mg a day is often the standard dose prescribed but for some people it is far too much. If your heart rate when in NSR is low normal then having it lowered too much will make you feel sluggish. It won't even necessarily stop further afib attacks. Many people here take 1.25mg. Women seem to be more affected by the nasty side effects of Bisoprolol. I take Nebivolol which I find better than Bisoprolol.
I had more frequent episodes of AF and was prescribed 1.25 mg. Even that was a problem with side effects. Glad to get off it. No experience of Atenonol I'm afraid.
Can I ask you how you got off it? I would love not to have to take this medication
I recall sitting in my Cardiologist's office and explaining the side effects of Bisopropolol. I also showed him an Excel spreadsheet (which is essential in my view) of my AF episodes. Dates, starts,stops etc.Most of my episodes started at 2am because the drug lowered my heart rate to less than 40 bpm.
About 15 months later I had an ablation and have never looked back.
Now it's just Rivoroxaban and my blood pressure meds.
Good Luck!
I can’t tolerate beta blockers and had big problems weaning off 1-25 Bisoprolol awful symptoms . So they changed me to Atenolol because they said it crossed the blood brain barrier less, I did tolerate it better and was able to get off
You have been very unlucky. I had hoped to go from 2.5mg to a lower dose but was told that was the lowest. I know from here that that isn’t so but I’m going to have a try at Atenolol and see how I go. I’m really bothered about putting on weight as I am already extremely big and have been trying to address it.
Sorry to hear of your discomfort. I’ve been prescribed different beta blockers on my now 4 year AF journey. I’m best on Bisoprolol. Atenolol made me very tired and I felt constrained when I walked up stairs and similar. Every person is different; so, not wishing to state the obvious, it’s important that you keep an open line to your doctor and work together to find the meds and dosage that actually suit you best. It can take a couple of go’s. Best wishes.
Wilky57• in reply to
Thank you for your advice. I have been so lucky up to now so I don’t know the doctors at our surgery. I’m seeing a GP on Thursday and I’m hoping he’s going to be brilliant! I have been very anxious since my hospital stay with AF but this forum has really helped me see things in perspective
I find Bisoprolol can also be manufacturer dependant on the effects you get my supply changed to Noumed and they are awful on 2.5 mg . And yes i get muggy head and brain fog. I just put on with it still working at 66.
Thank you for your reply. I suppose it’s all about getting to know your options
You're right. It is manufacturer dependent. Some use different ingredients to propel the beta blocker and this can affect breathing. I had to build it up from a quarter of a tablet to a full 2.5 over several weeks. I felt as if I was suffocating with the full tablet at first.
Wife was on Bisoprolol for years but eventually she developed persistent AF so switched to Atenalol. Switch was easy but didn't help control her rate so eventually she ended up on Nebivolol which is working vat keeping her rate under control.
Thank you. Does your wife see a specialist who keeps an eye on her and her medication. Hopefully I will soon be in the system.
As her persistent AF us treated by medication only (2 failed CVs) she is supposed to be seen every 6 months by the NHS arythmia nurse.
I was prescribed Bisopropol when first diagnosed couple of years ago but didn't tolerate it, upset stomach, GP switched it to Atenolol, been OK since, haven't noticed obvious side effects.
I was only on the lowest dose of Bisoprolol for three days! The doc who wanted to put me on a higher dose didn’t even arrange a follow up appointment but the pharmacist said he’d ring me in a week to see how I was getting on and that I should pop in to see him before that if I had any problems. After three days I was feeling more tired than usual so I popped in to see him. He took my pulse and told me to stop taking them immediately and a different doc agreed! As they didn’t come up with anything else we went to see a private EP and after he’d introduced me to having a smartphone and a Kardia and I’d sent him a reading of my heart in AF he sent a prescription for Flecainide to my surgery for me. At first I took it as a PIP but now I’m on 100mg twice daily, I haven’t had an AF episode for well over a year. Hope you find something that works for you!
Thanks for your reply. It’s all very hit and miss, isn’t it. I think my problem is because I have had to wait so long to see a doctor. My heart rate is much higher than it used to be before the 2 episodes of AF and, I’m guessing, that’s because of the medication. I’ve felt in limbo because of my GP wait. This forum has been invaluable for me.
We found the EP through the AFA website and it was definitely worth what we paid when we received his bill several months later! I had been going to our surgery for some time after fainting etc and they’d just take a blood test and say there was nothing wrong with me!! I’d still have been waiting for a diagnosis if I hadn’t joined my daughter at Bath Spa for her birthday when the paramedics diagnosed me with paroxysmal AF on the way to the main hospital where I spent possibly the worst night in my life!
Sorry to hear your story. I will look on here for an EP. Will I need my doctor to refer me? Is an EP better than seeing a private cardiologist? Sorry to be so thick
Hi I found breathlessness a problem on Bisoprolol so changed to Atenolol. Both had awful side effects for about 6 weeks, dizziness and weird feelings in my head. Seemed better for a few weeks then the breathlessness again. So was then changed over to Propranalol, again better for a while once the awful side effects had got a bit more tolerable then the breathlessness started again. All of them have been the lowest dose available. I don't do well on any medication, I sometimes think meds can be worse than the condition!
Thanks for your reply. Are you still on medication? I wonder if I would be better without the beta blockers because I still have an irregular heart beat but feel ill as well now. I’m so used to being healthy and it seems so extreme to have to take something that makes you feel so ill. I’m still waiting to see a doctor,2 weeks after coming out of hospital. I’m really hoping he’ll say to just take the blood thinners. It’s completely thrown me.
It seems to be accepted that anything under 100 beats per minute resting heart rate is fine when in atrial fibrillation. Do you know what yours was when you were in hospital before they started you on beta blockers? Have they told you what rate they are trying to achieve with Bisoprolol? In AF the heart has to compensate in ways it doesn’t have to when in sinus rhythm to allow the body to function well so it naturally beats faster. If the rate is suppressed too much, down to what would be an ideal rate in someone without AF then it will often leave people feeling exhausted all the time. My resting heart rate in sinus rhythm was always around 60, sometimes dipping into the 50s at night. In AF, without Bisoprolol it sits at about 85 - 90 but I feel the palpitations so I take a small dose of Bisoprolol (1.25 to 3.75 mg depending on activity levels) which manages to reduce rate to between 70 & 80 & keep the palpitations at bay. Sorry - that’s basically a long way of saying ask your doctor what he/she is trying to achieve with beta blockers?
I'm still taking the lowest dose of Propranalol...I'm trying to cut it down, withdrawal effects even on that low dose are horrendous. Have got as far as cutting 1 tab in half in the evening. It does help keep the HR in the 70's. That's high for me it used to be in the 50's before afib. I get no help from Docs over meds, they don't seem to believe me re the side effects and treat me like an hysterical old woman. When I do get to see a cardiologist which is difficult given the extremely long waiting times on the NHS I find they are more understanding but still expect one to carry on taking these chemicals as they can offer no alternative.
You need to get a Kardia so as to check your rate when you are in afib . The beta blocker is to lower your heart rate not to stop the arrythmia. For that you need an anti arrythmic or an ablation . GPs cannot prescribe anti arrythmics so you should get a referral to an EP( electrophysiologist )- a type of cardiologist who specialises in the electrics of the heart. If your rate in afib is higher than the normal range then you need to take a rate lowering drug but beta blockers are not the only type of drug which will lower rate. Often people have to try different doses or different meds till they find a regime that works for them.
They send everyone out of hospital on beta blockers and anti coagulants . After my first bad experience they tried to send me out on beta blockers and I said to the consultant I have normal BP and resting HR of around 60 give or take a few beats there was a two and a half year gap between AF episodes , why should I take a drug everyday that really disagrees with me when I may not have an episode for another two and a half years (14 months and counting). She said fair enough that was the end of the beta blocker conversation. It’s now on my notes I must not be given beta blockers thanks to consultant letter
• in reply toSylviep7
Atenolol is available as 25 mg tablet
Bisoprolol and Nebivolol 1.25 mgs
Propranolol 10 mgs
Source British National Formulary BNF
Don’t know if that helps.
Sylviep7• in reply to
I think your comment may be in reply to someone else?
• in reply toSylviep7
Not so. You mentioned you are on the lowest dose of Propranolol and cutting it in half. Are you saying you have problems with Propanolol 5 mgs?
My experience is that my cardiologists have dismissed very low dosage of beta blockers as ineffective. Many of us wouldn’t agree.
Sylviep7• in reply to
I don't know why you replied with a list of betablockers? As I said I've been on lowest dose of all of them. I think there is a misunderstanding...I am cutting the Propranolol down gradually as there are horrible withdrawal symptoms and it is not advisable to stop cold turkey. I take 10 mg morning and lunch time then 1/2 tab evening. It took a while of shaving bits off the evening dose to get it down to half as the withdrawal symptoms were so bad. Next I shall start shaving tiny bits off the morning dose...it's going to take a fair while to get off it totally.
• in reply toSylviep7
I understand now. Thank you.
I have been on Bisoprolol for 8 years on 7.5mg to treat AF. They kept putting the dose up.. I have had no side effects at all and it's been a great drug for me. I hope you get settled on your new medication.
Have you made an appointment to see your GP? Maybe it would be best if you did and ask for a referral to see an electrophysiologist (EP). I couldn't get on with any beta blockers at all - they all made me feel worse than AF.
I’ve been waiting to see a GP. It will be almost 3 weeks by the time I see him. I will make a list of questions and I will definitely ask to see an EP. Do you still take beta blockers? I have never had to take medication long term and have been lucky enough to manage with only the odd paracetamol until now. Thanks for your help.
No. I didn't get on with any beta blockers, calcium channel blockers,or any rate or rhythm control medication - they all made me feel worse than the AF. Just on anticoagulants. Just remember that dosage and medication can always be changed so if when you are on medication you have side effects you cannot cope with ask for a change in either dosage or medication as necessary.
• in reply toWilky57
My GP told me I would probably be dead before I got to see the local EP on the NHS (ok so a little poetic licence there).
He said I should see an EP privately for one off advice and it was £200 well spent.
I think it’s important to research your EP carefully particularly if ablation is advised at any point. The number of procedures done, how many a week, complication rates (tread very carefully).
You can be referred anywhere in the country on the NHS. The best EPs are generally found in the large teaching hospitals. If you have some names, you could ask members here for an opinion.
Wilky57• in reply to
Thank you so much. I will start my research. I had never even heard of an EP u til today. I live in Lancashire so perhaps I should start looking in the Manchester area as there are probably bigger hospitals there.
Iam on bisoprolol. I was feeling really tired all the time .I started taking it before bed instead of morning. I feel more awake. I feel so much better. Hope this helps
l can’t tolerate Bisoprolol. Horrible side effects for some of us. You are taking a high dose. I would try an alternative if l felt like yourself. We are all different, but medication should help to make you better not worse, so don’t suffer in silence.
Thats a really good point. I need to follow what I'm told to do but, at the moment, I'm very much in limbo. It should all come clear on Thursday. Thanks for your help
I did mean via your GP/Cardiologist regarding trying an alternative. I can’t tolerate most drugs, just have pip plus anticoagulant. I hope you eventually find the correct combination of drugs that suit you, and you get stabilised and feel much better.
I'm exactly the same with medication. I rarely even need a paracetamol. I will talk to the GP on Thursday and try to find a private EP if I don't feel ok with things. It's all a mine field. Thanks very much
I was on Atenolol for years and it worked very well as a blood pressure medication with no apparent side effects. When I was diagnosed with AF it was changed to Bisoprolol as it was deemed a better drug. As a consequence my blood pressure went up and I felt a lot more lethargic
I just recently started Bisoprolol. I also have felt very tired and fuzzy. I am only taking 2.5 once a day and still feel gross! It does seem to help to take it at night, but I am getting terrible headaches and stomach upset. I think, for me, the issue is that it has dropped my heart rate so much. That would make most people tired! I will be anxious to hear more responses. There seems to be quite an individual variation in responses to beta blockers.
That’s a high dose to start off with. I was started on 1.25. It didn’t suit me so had to stop. Horrible side effects and lowered blood pressure too much.
Can't help with the atenolol but don't worry about the lead xcomin goff. Same happened to be last year but all b ut one of my leads came off. I just hoped they'd got enough to read. Turned out I should have just reattached them
I was on Atenolol for 3-4 years at a pretty low dosage. No noticeable side effects other than pretty low BP and it was hard to get my heart rate up during exercise. I had 3 afib episodes during that period that. All episodes converted within a few hours with Lopressor treatment. After my last while on Atenolol my new Cardiologist prescribed Multaq.
I’m happier on Multaq, except for the price. HR seems more natural and my heart responds quicker to activity. I’ve had one atrial flutter in the last 2.5 years while on Multaq. Converted almost immediately with a calcium blocker administered.
All this being said, I think the reduction in episodes may be as much exercise/lifestyle related than because of the med change. The Multaw may be a bit more effective, but not definitive.
This may be no help at all, but I was quite happy on Atenolol with little side effects.
What dose of Atenolol are you taking? I’ve been on it for 40 years and took 50 mg a day, until HR was down to 40 bpm, and doc changed it to 25 mg. Seem to be ok on that now. No problems on it at all, so good luck.
Years ago my EP told me to cut my meds in half and take them twice a day to reduce side effects. I still do that and it definitely helps. I also managed to cut down the dose quite a bit over that time.
Wish I could help but while one of my meds. Nebivolol was changed to Atenolol the overall side effects on me both remain unhelpful even if they do keep us alive.. Pity Pharma cannot improve their products to help improve quality of life.
I was on Bisoprolol for over a month and I had awful side effects with sickness and diarrhea for over a month, headaches cold feet and hands the shakes etc and my hospital was doing nothing about it until I had had enough of being ill and stopped it myself and sent an Email to my GP telling them how I was feeling and they changed it to Atenalol and been on it for nearly 4 years, No side effects whats so ever, the only problem I have is that my hair has thin out quite a lot.
Every time I go to the hospital and say that I'm taking Atenalol they are not happy. I now been given by the hospital Dapagliflozin 10mg and my GP reduced that to 5mg as I could not take the 10mg strength either. (The Dapagliflozing which is a diabetic drug, but apparently good for your heart has been added to my Atenolol)
I really hate going to the hospital as every time I go there there is more medication added, I got a feeling the nurses are working for the pharmaceutical companies Lol.
Thank you for your help. I feel you don't get treated as an individual when you need help. I am seeing g a doctor on Thursday and I'm hoping I could reduce/stop my Atenolol as my heart rate us a lot higher than it was without medication
The amount of stress I am going through you will not believe it. I had a pacemaker fitted on our first lock down of the C19 within a year the cardiologist told me I needed to have the pacemaker change to a CRT-P which it was arranged to have it done September 2022, went into theater to have it done and was opened up and after 2 hours of being plod about they closed me up and was told it could not go ahead and would need to go back and have it done through the right side of my chest.
1 year and a half has gone past not heard a word from hospital until I phoned up and asked what was going on, within an hour the hospital phone me up with an appointment for the 29th January 2024.
2 hours before I was due to go in I got a phone call saying it had been postpone and the hospital wanted me to have some check ups before the will go ahead with the op.
I have now had my pacemaker check and Saturday just gone I had the Eco-cardiogram done, but now I have to wait till August to see the Cardiologist? ( I'm not getting my hopes up at all)
The NHS is at an awful mess!!!
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