I only had just over a week on bisoprolol 5mgs after coming out the hospital after fast afib episode. I felt breathless and nauseated. I have no follow up at the hospital, they just said gp to review so last week the gp did agree reluctantly to go down to 3.75mgs which I've taken for nearly a week but I don't feel any better. They have only offered a review next month by a pharmacist. Not sure whether to contact gp again to try and go down to 2.5 or do you think I'm not giving it long enough? I hate feeling like this, breathless most of the time, tired and sometimes nauseated. HR has been mostly in 50s but has dropped to 42.
Bisoprolol: I only had just over a week... - Atrial Fibrillati...
Bisoprolol
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Exhiker
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I've had a lot of experience with Bisoprolol. It makes me feel breathless and exhausted if I attempt to do anything at all. It is however the default drug should you present at A& E with fast AF.
I would not put up with what you are experiencing. Get back to your GP and relate what you have said here, particularly your low heart rate.
I've also been getting stomach issues like bloating and abdo pain, not sure if that's connected as well.
I haven't experienced that. However do mention it when you speak to your GP
Have you been given an anticoagulant as well? These can cause bloating and abdominal discomfort. Women seem to tolerate Bisoprolol less well than men . I felt like a zombie on 5mg and even on 1.25 mg had side effects. I now take Nebivolol which is better but for me does not control the heart rate as well during an afib episode. Giving 5mg of Bisiprolol seems to be a standard response by hospital doctors - it's happened to me twice . I think you should tell your GP that you are not prepared to feel so bad on a daily basis and you want to try the lowest dose to see if you can tolerate that and if you can't you want to try something else - either Nebivolol or a different class of drugs from beta blockers. Remember nobody can force you to take a drug at a dose that is making you feel bad. In the end your body belongs to you not the doctors.
I am on rivaroxaban, that is what could be causing the bloating.
I am on Apixaban. It definitely gives me bloating , some reflux and abdominal discomfort - pain is too strong a word to describe it. Worse it worsens my skeletal pain.
It is. Well known to cause digestive issues, stomach bloating and constipation. You can ameliorate those effects with adjusting your diet but it depends whether you can tolerate the Bisoprolol at all. It didn't make me breathless but it did make me very tired. I also ached even when walking up a flight of stairs, which made me feel decrepit! When I switched to an anti arrhythmic I felt much better. You're entitled to see a cardiologist- get your GP to find out if you're in the pipeline.
I have been on bisoprolol (5 mg) for about a week and I have occasional side effects -- fatigue, insomnia, headache, flutters, etc. I am taking this in stride. My cardiologist advises that it will take a few weeks for my body to adjust. On the plus side, my heart rate is not scooting up into the 100s for no reason and my gym routine has not been affected at all. For me, I am giving it a chance and relying on the expertise of my doctors. (Full disclosure: I have a good number of family members who are doctors and I have personally seen the level of training and knowledge they have.)
I think we do have to try and persevere with this drug, as it is in my non-medical opinion the best drug for rate control . Having started on 2.5mg, I now find 1.25 keeps me at an average early sixties and my heart seems happy with that!. Verapamil is a non-starter for me.!
Hi
It is basically a BP med. Control Blood Pressure.
At 156bpm Bisoprolol did not control my Rapid Heart Rate. It did slightly better than Metoprolol at 186!
It was CCB Diltiazem low dose 120mg AM which controls my H/Rate. Within 2 hours of its introduction it took from 156 to 51 on 180mg 1/2 dose. 120mg better to take me down to 60s.
cheri JOY
Most of the meds used for rate control are primarily BP medications. Diltiazem is a CCB. I suppose it is a question basically of finding the one that suits you best, and that is the challenge, I'm pleased that you found yours !
Did nothing for my BP. I consider it primarily a rate controller.
it can definitely make you feel rough unfortunately.!! Iv been on it for years. I’m on 11.25mg daily and could sleep on washing line sometimes.?
Ask your GP if there is anything else he can try you on.?👍
Hi
Wow.
11.25mg!
If this for your rapid H/Rate.
Get your H/Specialist to introduce CCB Diltiazem. Which is for Rate control.
With a low dose of Diltiazem AM 120mg and Bisoprolol 2.5mg PM both H/Rate and BP are controlled.
cheri JOY.
I don’t exactly know why I’m on it.?? It was originally prescribed for palpitations 20+ years ago. Since then i developed AFIB and Iv had 3 ablations.!! I think it could be because my BP readings are always high in the surgery but spot on at home.!!
Hello , I have had same problem regarding bisoprolol. My gp changed it to Nebivolol. I feel much better . Bisoprololl well known for strong side effects . Hope you find you pill !!!
Hi. I was also given Bisoprolol after a stay in hospital. I couldn’t take it as it made me feel so ill. I tried something else, after phoning the GP and that wasn’t much better so I phoned again and was given Carvedilol, which has been fine for me. I have never been a pushy person but, I’ve realised, you’ve got to get the best for yourself if, unfortunately, we are going to have a good quality of life with AF. Good luck.
you will get used to it!! I have been on 2.5 for years and take 5 occasionally when stressed will no ill effect. But if you are unhappy go and see the doctor again!
HiDo you see a cardiologist? If not, I suggest you are referred. If you can afford it see one privately.
I am on 1.25mg Bisoprolol. I was on 2.5mg but it dropped my heart rate far too much into 30s/40s.
Now at rest HR is 40s/50s. The cardiologist assures me that this is safe as long as I don't collapse or pass out. My GP wonders if I should just use bisoprolol as a PIP ( pill in the pocket) to take when I start in AF but my understanding is that bisoprolol is to prevent AF by keeping heart im sinus rhythm.
I feel tired all the time. Really have to push myself to do anything but feel better when I do.
I do still get AF. My triggers are coffee and wine. I have really cut down.
Hope you get the right advice and help soon. You would probably feel more reassured by a cardiologist.
Bisoprolol is a rate control drug not an anti arrythmic. It might help people stay in NSR by preventing runs of tachycardia that can turn to afib but it is not much use for those whose afib starts when they are relaxed and their heart rate is already slow . For such people using it as a PIP can work well especially if afib episodes are not very frequent. Why feel bad all the time when in NSR? Especially if breakthrough episodes are still happening.
I have also been on that road not a lot of help from some areas I came out after afib 178bpm put on to 5mg bisoprolol and told be on them for life after a week had a few blackouts and could not function spoke to doctors they then dropped at night and feel tired it to 2.5mg all went well no issues 2 weeks later tired and ectopic beats and triples dropped down to 1.25 and told after 2 weeks to stop and use it as a pill in the pocket that didn't work at all so then on to verapamil 1200 that didn't control my rate of bpm so 2 weeks later put on digoxin 3 days later back on to digoxin and 1.25 mg bisoprolol low heart bpm about 48 to 60 resting a few minor palpitations occasionally and now referring to cardio for ablation it is a process sometimes its a combo just keep pestering cardio doctors still have some problems ie the odd wet legs at night that leaves to a awakening bpm to about 110 but easily controlled by breathing slow you will get through but it's a process and sometimes worrying but we will get there keep going
Hi
Are you asthmatic?
Cause if you are or have a tendency get excema etc it could be a no no for you.
Why were in hospital?
Your Heart rate is too low during day at rest.
Strangely ACE Blocker products and Metroprolol a BB Blocker made me breathless.
But I found Beta Blockers did nothing for my Rapid Heart Rate Day at rest. 185 with Metoprolol and 165 with Bisoprolol.
A private interested H/Specialist introduced CCB Calcium Channel Blocker Diltiazem. Low dose 120mg AM brought H/Rate into 60s.
Careful not to interfere with low H/Rate Night asleep average 47bpm.
So PM I take 2.5mg to keep BP controlled.
132/69. 60s Rest Day. 47avge PM.
Proved by 3 x 24 hr heart monitor with each change of meds the above showed how a CCB low dose AM was my med for control rapid H/Rate. And a low dose of Bisoprolol PM (separate) to control BP.
When CCB introduced I arrived at my low doses with the help of our NZ Healthline and on a week day a nurse at NZ Heart Foundation. To arrive at my above regime it took 2 years 3 months and an interested Heart Specialist whom I was so grateful to. Drs were just putting up my Bisoprolol and prior, lowering my Metoprolol.
I doubt whether life will change on staying on a 'breathless' med but lowering it could make all the difference.
You know your symptoms. You need to be comfortable with quality of life.
Only stopping it altogether could have a detrimental reaction.
Up to you.
Cheri JOY
I take this give it time it will pass
I wouldn't take less without medical advice. I have taken 7.5mgs of Bisoprolol for 7 years now, and I have had no side effects whatsoever. In the beginning, I can not remember any significant side effects either. I think most pharmacists would say you've not given your body long enough to adjust. Can you not stick with it and go to your review and see what the experts say? Best of luck.
Personal experiences and scientific opinions on the benefits of bisoprolol are very varied with a recent paper concluding that, in the absence of significant heart failure (ejection fraction less than 50%), appropriate calcium channel blockers are a better option.In my own case, I found that bisoprolol did lower my ventricular rate a little but even moderate exertion caused significant breathless as the heart rate wasn't able to respond to the demand. A switch to verapamil turned out to be a better option for me although at the expense of a little peripheral edema and constipation. Ventricular heart rate was lowered by 10 compared with bisoprolol and exercise tolerance was much improved. The afib is still there but the ventricals do seem to be resisting the influence of the frisky atrials to some extent.
Everybody is different!
Malcolm
I have the same concern with my bisoprolol. HR and BP are normal but I get breathless with any physical activity (even walking up stairs).Will check on verapamil with my cardiologist at next visit.
Hi I find betablockers make me breathless - I've tried Bisoprolol for several months and the breathlessness got worse and worse. Then switched to Atenolol and for a short while breathlessness went only to creep back after a couple of months. Then changed to propranalol lowest dose. Same pattern, improved breathing for a couple of months now can't even go upstairs without getting breathless. It's a well know side effect of betablockers.
A week might be a long time in politics, but it isn't in medicine! Also, taking bisoprolol is generally to help with symptoms, so its uses rather depends upon what the fast AF did to you and whether you'd want to experience those symptoms again. Did you have an echocardiogram, for example, to determine the overall state of your heart and especially left ventricle? The bisoprolol isn't directly going to stop the AF, but it seems for many that slowing the heart is a) a good thing in the long term, b) reduces the frequency of AF episodes and c) slows the rate during an episode, which is helpful to the heart output (and how we feel with this), the operation of the valves and ventricles.
Beta-blockers are the safest first line treatment for AF, and they are all similar (note that one called nebivolol has a somewhat different mode of action so is worth a trial if bisoprolol side effects don't settle down for you, as they often do). Alongside beta blockers are drugs called calcium channel blockers that might be an alternative if you don't eventually get used to the beta-blocker; beyond both are anti-arrhythmic drugs such as stall and flecainide, but both need hospital prescription and are less safe, so reserved for symptomatic cases.
I have myself, after an ablation for atrial flutter in 2019, gone from using bisoprolol 1.25mg as needed, to, a year ago, taking it daily, and more recently to 2.5mg daily. I get many more ectopic beats (palpitations arising from the atria) than AF itself, which seems to come once or twice a month and is not too bad in its effects. I am noticing what might be side effects from the increased bisoprolol but which might also be effects from my increased palpitation level. I see my doctor next week and will be asking him. I don't get nauseous, thank the lord (I have had that from my acid stomach issues and hate it with a vengeance), but I do get the feeling of needing to breathe in deeply, rather than "breathless" as you describe it. I don't feel great doing energetic things but press on with daily stuff regardless and enjoy walking. I don't go to a gym or similar so have no idea what I'd feel like there.
Since increasing to 2.5mg I get a heart rate usually in the 50s but which can drop to low 40s (although my Apple Watch seems to have "blips" at both low and high rates so I never can be sure). A 48-hour monitor showed some bradycardia but the specialist was okay with it. I see him again next Friday.
Overall, as I implied at the beginning, it's often more or less down to you (rather than down to medical need per se) as to whether the bisoprolol is useful and worth living with, but giving it much more than a week is likely needed for your heart and mind to adjust better.
Steve
when I was first diagnosed in 2020 with stable angina (I now have PAF too) I was given Bisoprolol too. It made me feel so tired and my pulse was very low. Doc told me it does not suit everyone and said I could stop taking. This was after about 10 days. She also said she couldn’t tolerate it. Bisoprolol doesn’t suit everyone!
i think you should be seen by a cardiologist, you should be able to ask your gp to refer you. I was seen in hospital within 2 weeks of diagnosis and they took me off bisoprolol straight away. Having said that my husband was diagnosed a few years before me and has only ever seen gp.
I am not really understanding exactly what you are concerned over, but all i will say is with all of us with AF initially the standard Bisoprolol and blood thinners are prescribed, then under care of our GP until our referral comes through for Cardiologist at hospital which can take a while, If you have any concerns please speak to your GP, one size does not fit all when it coms to medications, between my Cardio and myself we have worked out my best dose for Bisoprolol, mainly i dont take it except when in AF, then 2x 2.5 ones and sit and wait for it come down takes around 3 hours sometimes,but i luckily have the PAF type so infrequent (at the moment). i am 77 and had no heart issues whatsoever until last year. also my natural H.Rate is around 50, with half of a 2.5 bisoprolol = 1.75 grm. it does lower it to around 45 ish, but that is fine they dont worry abaout lower h.rates. the time to be concerned is if our hearts keep going into the high h.rates, this is why most are given Bisoprolol, and for them to give you 5mg, they must feel you need this higher dose, but speak to your medics and take their knowledge. kind regards
Perhaps you shouls have atayed longet on the 3.75mgs then you would know if its more or less that you need. I think you have to fo exactly drs orders orherwise you qill never find the right tablet and the right dosage. Ive been hoing down a similar path and looks like im running out of drug therapy options. All the best to you and your doc.
Also low hr maybe the reason for nausea. It was for me . I have a pacemaker now set at 60 and now no nausea in the early morning.
I took the lowest dose of 1.25 daily for only three days before the pharmacist took my pulse and told me to stop taking it and a doctor at the surgery agreed. Pharmacists know far more about drugs than doctors seem to do and more importantly, they realise that we are all different so require individual treatment. And I was around your age when that happened. As the NHS didn’t come up with anything else we saw a private EP who, after he’d introduced us to having smart phones and a Kardia, and I’d sent him a reading of my heart in AF, prescribed Flecainide to be take as a PIP at first with my low dose of Bisoprolol to be taken only on the very rare occasions when my heart rate exceeded 140 twenty minutes after taking the Flecainide, which rarely occurred. Now that I take it regularly it has virtually put an end to episodes though it may well have increased my fatigue but I am 80 now. Good luck finding what works for you.
My own experience is that I took Bisoprolol for 3 months when first diagnosed and it floored me completely. Breathlessness, fatigued and couldn't walk more than 50m without having to stop........ and don't mention trying to get upstairs.I mentioned this to my pharmacist, who explained that, although supposedly cardiac specific, Bisoprolol can attach to receptors in the lungs which mimic ones in the heart. This is what causes the problems.
Pharmacist suggested I spoke with the cardiologist about changing to Diltiazem, which I did (well, I told the cardiologist I wanted to change as I wasn't going to take Bisoprolol again) and have had no problems, medication wise, with that since. Bit of puffy ankles for a couple of weeks on a higher dosage but that's it.
Don't put up with feeling like this.
I went on 2.5 last November and looking back at the notes I keep had issues with lethargy, runny nose, the odd weird feeling and low heart rate but it seems to have bedded down now if that's any help
Do I ever hear you loud and clear. Struggled with shortness of breath for years from taking bisoprolol. But could never convince my my cardiologist how badly it effected me until I gave him my elevated sleep apnea numbers after an increase in bisoprolol. Short version of a long story I'm now on digoxin. Old medication and not usually prescribed, but it's working for me. Best of luck. Smile, breathe and go slow.
Everyone is different - for me Bisoprolol made me feel like I was dying! There are many others - I have tken Soltalol which was okay but I have just stopped that completely now too and feel so much better. Don't put up with it there will be one which doesn't make you feel so bad or something completely different, for me Digoxin works well, it's slightly more natural and has been around for many years.
my cardiologist charged me to Nebivolol. This has not made me breathless unlike bisoprolol.
Hello there,
Just my opinion but sounds like the meds are keeping your HR low… I would ask the doc if you could take it down more or go on another bp med. I’m on smallest dose of Metoprolol and Eliquis. There are so many different ones and we are all so different.
Best of luck to you!
my ep told me low and slow to begin with ,on bisoprolol.
Your heart rate sounds a bit low and biso will keep it down so tell you doc and they may be reduce it.
yes I’d ask for 2.5 it’s clearly getting the pulse lower
and actually I was in 2.5 and felt like I was walking in leaded boots and magic happened on goung down yo 1.25 it all stopped …takes time yo settle in system I think .
My cardio said there not much difference between 1.25 and 2.5 it still does the job , not sure exactly what he meant as it’s clearly a lower dose but I remember him saying that
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