Bisoprolol and Mechanism of Action- Breathlessness

[MeganMN]

So I am on a tiny, baby dose of Bisporolol (1.25mg) after taking 2.5/made me dizzy and have pauses after PACs. I am getting this weird breathlessness. It is so hard to explain. I hiked a trail in our woods today with ko problem, but then sat on the couch and watched a movie and felt like I couldnt get air. What is that? I genuinely literally felt like I had air hunger, with no explanation other than new Bisoprolol.

[mikecrouch]

This sounds very much like my experience, I was sent home from hospital after having 2x stents fitted with 2.5mg of Bisoprolol, within minutes of taking my first tablet I became breathless but only sitting very still or trying to sleep, once I move around this seems to disappear, this was a couple of days ago, I haven't taken any since, I am still experiencing bouts of breathless but not so frequently, I am speaking to my doctor tomorrow.

[MeganMN in reply to mikecrouch]

What did your doctor have to say?

[JOY2THEWORLD49 in reply to mikecrouch]

Hi

Simply AF can make you breathless but when Metoprolol was changed to Bisoprolol it disappeared along with the pauses at night.

If you have asthma or in your family you may have a tendancy to BBs.

I cannot take Inhibrace an Ace med either.

When I bend over I find my heart squeezed or something and on rising can feel air pushed out.

cheers JOY. 75 (NZ)

[CDreamer]

Yep, that’s the delights of Bisoprolol. I couldn’t tolerate it at all.

Are you still experiencing pauses? The Action - Beta blockers block the affect of adrenaline and cause the heart to beat slower and with less force. I also found that it reduces the rate of metabolism and causes weight gain which I never have been able to lose.

Speak to your Doctor.

[MeganMN]

Thank you for the replies. I was wondering if anyone had had a doctor explain to them why it causes breathlessness. It just seems short odd. I can exercise and feel fine but get breathless when I am just hanging out. Super weird. CDreamer I am not getting the awful pauses on the lower dose, so the dizziness has passed, but the weird breathlessness is still around and I feel super tired and lazy. Ugh. My heart rate isn't quite as slow on the lower dose either. We will see. I will give it another week and/or ask about Nebevilol.

Pauses from PACs/Bisoprolol

[Qualipop in reply to MeganMN]

I only took bisopralol for a week and it dropped my heart rate so low I slept almost 24 hours a day and was stopped/ However after my heart attack, ticagrelor caused exactly what you describe. My oxygen level was always absolutely fine, just a sudden feeling that I couldn't get any air in. It stopped completely once I was changed to clopidogrel

[ETHEL103]

Yes I can identify with the air hunger thing.I tried a few beta blockers but I felt the same.I read they can affect your lungs but I was switched to verapimil and breathing went back to normal. Speak to a health advisor is my advice.

[Fullofheart]

WI couldn't tolerate bisoprolol at all, even the 1.25 dose.I wouldn't have managed a hike. Found it hard to breathe just sitting, like you describe.

My partner is on them currently with no problem at all.

I think it varies person to person.

They prescribed me with an asthma pump when they put me on bisoprolol and I had to use it quite a bit.

Hadn't used an asthma pump previously for over 25 years.

It wasnt sustainable so I came off it.

[Ppiman]

Hi Megan. I wouldn't call 1.25mg of bisoprolol a tiny dose. The response varies between people, I gather, and the dose response has been shown not to be linear, too. I found that 1.25mg has almost the same impact as 2.5mg, for example. It's a potent beta-blocker.

I, too, get what you call air hunger, which, for me, is a feeling that a deep breath is needed, but without being puffed out at all, or short of breath. I'm not sure whether it is linked to taking bisoprolol, or something else, since my brother describes the same sensation and he has no known heart issues. I wonder, too, if there isn't some link to anxiety? I find it an odd thing, and it isn't always present by any means. I found it was worse after my ablation, if I recall (in 2019, for atrial flutter) and I have written about it here more than once about it.

I have read that beta-blockers do affect more than just the heart as there are beta receptors in many organs, including the lungs and brain. Bisoprolol is very specific to those in the heart, however, similar to nebivolol, although that works differently. Changing to nebivolol might help but changing to a calcium antagonist, such as diltiazem, is another idea as the action is different. I wonder whether the cause doesn't lie with the condition itself rather than its treatment? I just had the sensation as I was writing this.

Steve

[Vonnegut]

As I’ve posted here before, the lowest dose of Bisoprolol, 1.25mg, was too much for me to take daily as it brought my heart rate down too low and it sounds like it’s the same for you! The doc who prescribed them didn’t even arrange a follow- up appointment and only agreed to the low dose after I had pointed out how sensitive I am to drugs but the pharmacist said he’d phone me to check how I was getting on or I should pop in if I had problems. So I did after three days- he took my pulse and told me to stop taking it and a different doc at the surgery agreed! The surgery didn’t come up with anything else which is how I went to see a private EP who after he’d introduced me to having a smart phone and Kardia and I’d sent him a reading of my heart in AF, sent a prescription for Flecainide to my surgery for me. I took it as a PIP at first and since I have been taking it regularly twice daily I have not had an episode for well over a year. Good luck finding what works for you.

[mikecrouch]

OK, I have an update, spoken to my cardiac doctor and she thinks the most likely culprit for my breathlessness is another drug I am taking called "ticagrelor" which is described as an "antiplatelet" it too has breathlessness as a side effect particularly when resting and is usually temporary apparently, ive to restart my Bisoprolol in a couple of days and make a note of any breathlessness. Hope this helps, will update if needs be, take care and good luck.

[MeganMN]

Wow, so many different responses to the same medicine! I think it is difficult because I,have tried SO MANY medications and had problems with almost all of them, but the beta blockers seem the best at stopping my crazy rhythms. I really wanted to give this a go. I'll call today and update them and see about switching to something else. I may suggest Nevebilol first as he wanted to try Verapamil next but the antiarrhythmics have been even worse for me with side effects.

[Cavalierrubie]

l couldn’t tolerate Bisoprolol, not even the lower dose. I felt like l was in outer space and my heart felt like it was in a vice and restricted. It also gave me extremely low blood pressure and l always have a low read to start off with. Have you checked your HR and BP? It can play havoc with your numbers. Horrible drug for some of us. See your GP/Cardiologist.

[MeganMN]

Oh goodness. I have a call in to the EP and feel it is time to try a different med. I was thinking I should try to taper off and have been on 2.5 for one week and 1.25 for one week. Even after such a short time, coming off seems like it is going to be horrible. I feel awful 😒. Heart racing, nauseated, feeling like death... How long did most of you take to wean off? I am already breaking the tabs into quarters to get the 1.25. Should I break the tiny 1.25 into even smaller bits? I skipped it this evening and that was a huge mistake. Just took a tiny bit to stop my racing heart.

[Cavalierrubie in reply to MeganMN]

I wouldn’t do anything drastic like stopping your drugs until you see your EP.

[MeganMN in reply to Cavalierrubie]

Thanks. We have tried so many meds now that my EP has planned that we try for a week or two at most and stop if not working or terrible side effects.

[Cavalierrubie in reply to MeganMN]

Oh that’s ok. I was a bit worried about you stopping without medical supervision. I cannot tolerate the drugs not even the new anticoagulants. As a last resort l had to have Warfarin, but even that makes me tired. It took me ages to get stabilised and it was trial and error. Whilst trying each drug for a fortnight at least, l was sick for a long time. For me personally the drugs are worse than the condition.

[MeganMN in reply to Cavalierrubie]

I completely agree. I have had a terrible time with the meds. I just want to feel normal again! I had one med that wasn't awful and then it stopped working. I have failed so many, but the last two ablations they couldn't induce, so here I am. Thanks for the reply!

[Cavalierrubie in reply to MeganMN]

Well l wish you well. You will get there in the end and hope that is soon. We are all so different with our reactions. Take care.

[MeganMN]

Sounds like my hospital does Pharmacogenetic testing! I am going to speak with the Pharmacist tomorrow about getting tested for the various cardiac meds! Woohoo! Hoping that will provide some direction!

[2learn]

Hi, for Biso my GP recommends taking at bedtime to reduce side effects.

As for breathlessness when not moving, my personal thoughts and I'm not a doc, would be check your BP and HR at this time and also when you exercise. Perhaps when your heart working, exercising it, Biso helps, but when resting the Biso is too effective and brings it down too much. And as others say talk to your doc.