Stopping Bisoprolol & ramipril - Atrial Fibrillati...

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Stopping Bisoprolol & ramipril

GM1987 profile image
26 Replies

Long story short! I’ve been on 2.5 of each now for over two years & im over 18months clear in sinus rhythm after a successful ablation in feb 22 I’ve recently had an eco which shows heart in full health, I’ve been through the genetics route which concluded no heart disease or family history to worry about, the cause for my af & what they believe to be mild cardiomyopathy at the time was in fact myocarditis which caused the damage to the left electrical pulse which in turn started the paroxysmal AF. Anyway all is clear for now & they have informed me to stop all meds & wait 6 month for my mri to clarify that my heart is back as strong as it can be with scar tissue & the lbb present, this will give them a clear view that it was a case of Covid causing the viral damage. I’m nervous to just stop & feel a bit crap after one day? Anyone got any tips on how I go about this?

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GM1987
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26 Replies
Desanthony profile image
Desanthony

You have to come of bisoprolol slowly so if you just came off "cold turkey" that could be why you were not feeling so well.

Teresa156 profile image
Teresa156

it’s a shame that they didn’t help you or advise you about tapering off - Bisoprolol especially, as you really must do that, especially as you have been taking it for 2 years and are on 2.5 mg. I know they think it’s a small dose, but it really isn’t to just stop taking. If it’s only been a day since you stopped, I am not sure what is best to advise you as I am not medical, but I know you perhaps need to decide quite quickly.

There are various ways to reduce and people do many different things and some much slower than others. If I was in your position right now, I might seriously consider taking it again ( so you’ve only missed a day) then the following day after, cut the 2.5 in half and then half one of the halves so you take approx 1.75. After a few days, or even a week is best , reduce to 1.25. Then after a week half again to .65 roughly. After a week and if you feel ok, either stop, if you feel brave enough, or half again then stop after a few days. I would really consider going to those lengths as I’ve experienced it and you do not want your heart to protest.

If you have 1.25 pills, obviously you can take those and they do cut in half with pill cutters ( I got mine cheaply from Amazon), I need to point out I’m really not supposed to offer medical advice, but just want to try and help you as I know what it feels like, coming off Bisoprolol too quickly ( I failed).

I don’t know about ramipril. You might need to Google that or perhaps others may be able to help you there.

GM1987 profile image
GM1987 in reply to Teresa156

Thanks for the reply, back in April 2022 after 2 months with the ablation i was told to stop them as my sinus rhythm & eco was clear but the rebound was awful I had awful palpitations & thought i was back in AF again! I was told that was because it was still the 3 months blanking period after the ablation, I didn’t care I asked to start them again straight away & they disappeared. However now I’m obviously nervous & don’t want to abruptly stop which I asked can I not ween down to 1.25 & as told it’s already such a low dose it won’t make a difference? I think I will just cut them in half & so that for a few weeks & break myself in 👍🏽 as for the ramipril I think I’m fine to just stop them.

Ppiman profile image
Ppiman in reply to GM1987

I have read that bisoprolol is the safest to stop taking owing to the long half life and other metabolic reasons, so I don't think the advice you were given was bad from what I know. If you have withdrawal symptoms, however, perhaps ask your GP if you can take 1.25mg bisoprolol on an "as need" basis (the drug takes around an hour to work), then slowly stopping them altogether? I used to take the drug this way.

I also have LBBB and lots of AF-like palpitations with increasing but still occasional AF. My GP thinks the bundle block is the cause of them. Have you been told anything? I'm down to see a cardiologist shortly.

Steve

GM1987 profile image
GM1987 in reply to Ppiman

Thanks Steve, I never thought that the ectopics are now obviously more frequent due to the lbb I’ve kind of forgot about that with everything else, even tho they say my hearts fine & pump is back normal & im sinus rhythm my head still worries about the palpitations! I guess it’s kind of normal now with that branch block present.

Ppiman profile image
Ppiman in reply to GM1987

I’ll let you know what I’m told next week. Initially (2019-2021) I was told these bundle blocks are unlikely ever to be important in a heart that is otherwise healthy (which mine is said to be). And yet now I’m told by my GP that the wide QRS the block causes might be related to these issues.

It does seem that LBBB can cause the heart output to be rather on the lower side of “normal” (mine was in the low fifties), so any ectopics might reduce that yet more perhaps leading to mild symptoms.

Steve

Auriculaire profile image
Auriculaire in reply to GM1987

Sorry what you have been told is not true. Some people can come off Bisoprolol cold turkey with no problems and others need to taper. Rate of tapering also varies for individuals . Neither yourself nor anybody else can possibly know which category you come into till you try . So the safest option is a slow taper. As you have been on it for a couple of years another few months will not make much difference. Going down from 2.5 mg to 1.25 mg is often easy and can be done over a week or so. If you feel fine at 1.25mg I would stay on that dose for3/4 weeks before lowering and then lower slowly staying on each new dose 3/4 weeks. Once you are down to .65 mg go to every other day then to every 3 days before stopping completely. Doing it like this can be fiddly and you don't get exact amounts when cutting up small tablets but I have found it does stop the heart from protesting. If your heart does protest go back up to the dose it was comfortable with and slow the taper.

GM1987 profile image
GM1987 in reply to Auriculaire

Thanks, I’ve just stopped the ramipril & the bisoprolol are now down to 1.25 I will slowly take it down the next coming weeks until is nothing. I just feel better knowing I’m doing it that way than just abruptly stopping it 👍🏽

Teresa156 profile image
Teresa156

You could try just taking 1.25 - I weaned to 1.25 very, very slowly though from 2.5 and although they still say 1.25 is a low dose and ‘does nothing’ ( which is so annoying, as it does do quite a lot! Don’t believe what they say!) I can tell you that my heart rate during the day, is virtually the same as it was when I was on 2.5 😳 the only difference I can see, is if I do go into afib, my HR raises more than it would on 2.5.

I’ve experienced what you have, but I went into Afib as soon as I came off 2.5 and I reduced straight to 1.25 for a week then stopped, on his advice. I had also only been on Bisoprolol for 7 weeks at that time. This is why I’d never do it again as it was awful. The adrenaline kicks in badly, as you’ve found. I even used jewellery scales when I was reducing to 1.25 and I did it over a few months. It was a complete faff, but I didn’t want to go through that again and my heart didn’t even notice the reductions.

It is up to you , I personally wouldn’t. I would still take a lot longer if I was you - and still do it gradually, it is very well known how hard it is to come off these and we’re not alone in this experience.

Good luck. Let us know how you get on. It may still take a few weeks after you eventually stop for you to feel normal again.

Teresa156 profile image
Teresa156

I was going to add too - I’m going to have an ablation in a couple of months approx and at some point I’ll have to try and come off 1.25 Bisoprolol & I’m dreading it. I intend to take about 4-6 weeks to do it.

GM1987 profile image
GM1987 in reply to Teresa156

Well good luck with the ablation, i hope it’s successful 🤞🏽 I’m going to call my cardiologist tomorrow & arrange the dosage change to 1.25 I did want that anyway & did put it to him but was told to stop all together. I feel more in control & less anxious if I do it that way. Thanks again for the help with your experience.

Buzby62 profile image
Buzby62

I’ve just updated my bio today

18th March 2024, 3 month review, stopped Bisoprolol and Apixaban, zero on Chads Vasc.

Excited and nervous to stop the meds, still have contact with EP team and next review December 2024.

I’ve been on bisop for 3 years at 1.25 and then 2 x 1.25, I took my last 1.25 yesterday morning and none since. I asked should I taper it off and answered no, it’s a small dose but I know it has a noticeable effect even at what they call a low dose. I don’t know if it’s the excitement, the dry weather (for a change) or the reduced bisop but I’ve felt really good today and more energy than usual. I hope it continues as is but I have them on standby and will introduce a taper if I need to.

Hope your withdrawal settles down for you, best wishes

GM1987 profile image
GM1987 in reply to Buzby62

Good luck with that, I hope them days long continue, I myself have been on them 3 years at 2.5mg & once did stop abruptly but felt dreadful for 5 days until I resorted back to them again. I’ve had 3 days in total without as I was sick last week & couldn’t take any! Today I feel less anxious & fatigued than usual but I have felt a little more of a racing heart without them as my job is very active. Time will only tell we are supposed to listen to the specialists but sometimes individuals know their own body & needs. I’m happy to test myself for a few more days & see how I cope I do also have my prescription on hand incase I need to intervene. Thanks again & All the best ❤️

Buzby62 profile image
Buzby62 in reply to GM1987

Still off the meds, I felt the benefits within a day or so, more energy and less breathless walking up hills. I didn’t really think I was breathless but I’ve noticed the difference. Withdrawal symptoms although relatively mild took a few more days, had an anxious day yesterday as I woke with raised HR in 70s at rest which is high for me and BP raised a bit too. Feel less anxious today and both HR and BP a bit lower than yesterday. Sticking with it for now 🤞

Best wishes

Snowdrops_17 profile image
Snowdrops_17

You can't just stop a medication you have been prescribed all of a sudden GM 👌When you take medication your body will take time to get used to them and do the job they prescribed to do so!

I stopped Bisolprol without tapering off them! I was a kitchen porter and it's a busy job! I was forever tired when taking them!

When I stopped taking them I personally felt so much better and less tired!

Now I only take Aspirin, Ramipril and Ezetimibe! Heart attack was February 2019!

But slowly taper off Bisolprol GM 👌 everyone is different 👍

And with some medication it's better to taper off them slowly!👍

Good luck 🙏🥰

GM1987 profile image
GM1987 in reply to Snowdrops_17

Thanks, I myself was a hospital porter whilst at university so I know this busy you are! I still walk a lot more as a postie now tho! 😂 I have been very fatigued & brain fogged with increased anxiety whilst on bisoprolol so I’m happy to be feeling a little better from that side of them, I am slowly tapering now until it’s nothing. The ramipril is now finished.

Snowdrops_17 profile image
Snowdrops_17 in reply to GM1987

I am supposed to keep taking Ezetimibe for high Cholesterol but I will tell my doctor that after 1½ months my calfs are aching like mad again! As I have vascular problems in my legs this medication made it worse! Going for a blood test next week and tell the nurse about it 👍I didn't take it for 2 night and today my legs are less heavy altogether! So it improved vastly!

Medication GM hey, .... Pills we get prescribed at times some good some bad!

Well keep your fitness going and decreasing your meds slowly!

Tomorrow is a better day! And it will be Sunday and next week Easter Sunday 🌴🌿💐

Ewloe profile image
Ewloe

i was told to reduce my bisoprolol from 7.5 to 5. I did it slower than the gp said. I used a pill cutter and reduced a small amount each time. I took about 6 weeks to do it with no problems.

Sixtychick profile image
Sixtychick

Id been told to come off my Sotalol tablets, 5 months after my catheter ablation. I am doing it very slowly. I had been taking 80 mg twice a day, so cutting it down by 20mg every 2 weeks. I’m down to 40 mg now and been ok so far. Having been on these for many years, I was worried about stopping them. Slowly coming off them, is the way to do it.I have to continue with the anti coagulants for life though. Good luck, hope you come off your tablets with no problems.

GM1987 profile image
GM1987 in reply to Sixtychick

Thank you, I made the mistake of jumping off abruptly after 2 months after my ablation as requested by my cardiologist however it was the worst idea as my heart wasn’t happy with that! I was straight back on them! This is why I was anxious now to stop again, however at that time my heart was still in the blanking period after the ablation so palpitations was expected. I’m

Doing half of what I was on for a few week now until I can slowly take it to nothing. Good luck with your journey 👍🏽

Sixtychick profile image
Sixtychick in reply to GM1987

Thanks. Same to you. What a helpful site this is. I’ve always had answers to any questions I've put on here and I try to help people, if I can, in return.

Singwell profile image
Singwell

I agree with everyone here regarding slow titration off Bisoprolol. Ramipril is for your BP isn't it? I did come off mine cold turkey but that was because - at the time - I was changing my med routine from Bisoprolol and Ramipril to Flecainide and Diltiazem. It was also during the pandemic and I had no advice. I don't remember noticing a change with coming off the Ramipril so my advice would be to check your BP am and pm just to monitor what happens during the change. Keep a log for your next review. And congrats on having achieved this level of wellness

GM1987 profile image
GM1987 in reply to Singwell

I think I was put on it due to the first thought of mild cardiomyopathy to protect it incase it was overworking! I’ve never had blood pressure issues? I’ve stopped the ramipril anyway now so I will keep tabs on the BP just to be safe 👍🏽

Treetopp profile image
Treetopp

Just come off Lipitor

Treetopp profile image
Treetopp

Just came off Lipitor after two years. From time that I started on them I felt bad aches and pains.Also just started reading a book that a friend lent me called The great Cholesterol Con amazing which also

Very informative.

GM1987 profile image
GM1987 in reply to Treetopp

You mean the aches & pains after on whilst taking the meds? I will have a nosey at the book! 😎👍🏽

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