reducing Bisoprolol to 1.25

[Crumbling]

I’m currently on 2.5 Bisoprolol but find I feel very drained of energy, it’s like walking through treacle especially in the mornings, I’ve asked to reduce to 1.25 but now I’m feeling a bit scared that my paroxysmal AF might start again. Has anyone reduced to this low dose and found it OK. I take other meds for high blood pressure.

[Popepaul]

Yes. I reduced my bisoprolol dosage from 2.5 mgs to 1.25mgs once per day. I did so because the drug appeared to to alter my blood sugar levels. I experienced no ill effects from the reduction. I take an extra 2.5mgs as a PiP if/when I go into AF, which is infrequent. I am able to walk cycle and go to the gym without issue. Obviously things may change as I age and the condition progresses.

[Oldforge73]

Hi, I had to reduce from 5mg to 1.25mg in stages, GP wanted me off it altogether but I couldn’t face try another BB so gave it a try. With low heart rate AFib it is perfect for me, I have episodes once or twice a week

but heart rate stays at average 75 bmp, if it went over 100 bpm I could just take another dose. Give it a try,

[Bunnyuk]

You might want to try another betablocker. I switched from bisoprolol to nebivolol because of similar issues.

[Crumbling in reply to Bunnyuk]

The cardiologist did say I could try Nebivolol, if the 1.25 doesn’t work, I suppose it’s best to see what happens first before swapping.

[Promised]

I was feeling pretty much the same with fatigue. I went to my GP thinking she might reduce Bisoprolol 5mg to maybe 2.5 mg but she increased it to 7.5mg . I now feel great surprisingly. Think it’s all down to tweaking the dosages

[Crumbling in reply to Promised]

mmm it’s confusing isn’t it, I’m not sure if I’ve done the right thing now!

[JOY2THEWORLD49]

Hi

Take the 1.25mg but have an ECG within fortnight.

I tried from 2.5m.g but I couldn't as ECG shows wasn't controlling my BP.

cheri JOY. 75. (NZ)

[Crumbling in reply to JOY2THEWORLD49]

Thank you, I keep a close check on my BP and my pulse so I’ll know if they change for the worst.

[Ppiman]

I would ask your GP about this. Even on 10mg bisoprolol, back in 2019, I didn't have the feelings you describe. Have you considered asking about, say, switching to a different beta-blocker, such as nebivolol, or a calcium channel blocker as alternatives, if it is the bisprolol causing it (that would be one way to test if it is the drug itself)?

I doubled my dose to 2.5mg bisoprolol a fortnight ago and initially felt my increased palpitations were rather better, but no, they are the same, and I had an episode of AF on Tuesday lasting a few hours, peaking at 140bpm, maybe, with few important symptoms. It seems the extra dose is doing nothing useful and I am thinking of asking to reduce it back down.

The only side effects I have noticed are vivid and negative dreams and cold toes in bed - and others here have reported similar, if I recall. I am wondering whether to reduce the dose as it doesn't seem to be doing anything useful apart from lowering my daily heart rate to under 50 at times.

Steve

[Maria1263]

Yes i take 1.25mg of Bisoprolol.Im fine with it.

[Drone01]

I may be untypical cos my very occasional bouts of PAF never last more than 30-45 minutes. I’m currently taking 1.25mg bisoprolol (was originally prescribed 2.5mg) but have decided to stop any beta blocker altogether because I am not satisfied that rate control is necessary and am prepared to put up with occasional racing heart (heart is itself in good shape). Have agreed with cardiologist to dispense with beta blocker, restore normal resting heart rate to 60bpm (it was sinking below 50), and try an ACE inhibitor for blood pressure control instead.

[Auriculaire in reply to Drone01]

You could ask cardiologist if you can have a prescription of Bisoprolol to use as PIP for afib episodes just in case your heart rate goes over100bpm.

[Drone01 in reply to Auriculaire]

Thanks for the suggestion. As it is, I deliberately take my heart rate up to 150bpm in the gym doing aerobic exercise. My PAF before medicating would be around 200bpm. Bisoprolol 1.25mg brought that down to 170.

[JOY2THEWORLD49 in reply to Drone01]

Hi

With ACE watch out for the irritating cough!

cheri JOY. 75. (NZ)

[Vonnegut]

The lowest dose of 1.25 mg a day was too much for me to take as it brought my heart rate down too low! And anyway that’s all it does. Bisoprolol reduces the heart rate but not the irregularity which is the main part of our problem- it’s an occasional fast and irregular heart rate. I take 100mg twice daily now and haven’t had an episode for well over a year now ( the last one arriving around the time I must have been infected with covid ( no other symptoms but a positive test) when an extra pill stopped it in a few hours. So I am definitely having the “spring” booster in a few days time as I haven’t had any I’ll effects previously.

[wischo]

Yes I reduced from 2.5mg to 1.25mg due to low heart rate and I use the pill in the pocket on the odd occasion I feel any palpitations. Never had a problem with reducing.

[TracyAdmin Partner]

Thank you for your message, please ensure you contact your doctor for advice before adjusting any dosage of any prescribed medications.

Kind regards

Tracy

[Crumbling in reply to TracyAdmin]

Thank you, yes I have consulted my cardiologist

[OzJames]

I’m taking metoprolol so I will convert dosage to Biso so you can get an idea. I started on 5mg which was far too much for me and soon changed to 2.5 that too was too high as my normal resting HR was around 60-65 so cardiologist reduced to 1.25 twice a day. I experimented down to around .7 and about 2 months later went into AF. I now have been on about 1mg for last 3 months and doing fine. I guess I weighed up my HR in AF is only in the 80-90 range at rest so my body didn’t need much to find a balance between staying out of AF and feeling good. I was also using Flecainide as a PIP but am now trying it on very low dose of 20mg twice a day. Of course this is all discussed and agreed by cardiologist as a reasonable plan going forward.

[momist]

If you are taking 2.5mg once a day, an alternative approach may be to switch to 1.25mg twice a day. I found the once a day approach left me without the energy to climb the stairs, and switched to twice a day lower dose and have been fine on that ever since.

[Crumbling in reply to momist]

Thank you, I did suggest that to the pharmacist but he wasn’t keen, not sure why!

[momist in reply to Crumbling]

I suspect the prescribing doctor would have to approve the change. You can ask your GP for that.