Bisoporol instead of Tildiem

[sharpedge]

Hoping for some advice. My wife has HCM and has had an ablation a few years ago. Her Afib seemed to calm down but recently it has increased dramatically. The ablation was carried out in London and appointments were not too difficult to obtain. We now live in Gloucestershire and it seems that getting to see a cardiologist is really difficult. She has been to A&E a number of times and all they did was to monitor her until the episode finished. A second ablation is planned but impossible to find out when. The most recent episode and visit to A&E was after a three day episode (always on a weekend). This time the doctor gave her a 2.5 Bisoporol which did the trick. He gave her a prescription for 28 tablets and said only to take if bpm goes above 110. A few episodes happened and the tab did the trick. We thought we would ask our surgery pharmacist for more tablets but she said can’t do as they might react with her heart medicine which is Tildiem Retard 180mg twice a day.

Despite phone calls and emails to our Glos cardiologist there is no reply. Have managed to get a telephone appointment with GP but not holding out much hope.

Does anyone know if it is okay to take Bisoporol with or without Tildiem.

Other than going private not sure what to do.

Would really appreciate some help.

[mjames1]

Tildiem Retard is one of many formulations of Diltiazem. I have been prescribed both Diltiazem and the beta blocker Metoprolol together. Metoprolol serves the same function as bisoprolol.

I found adding the Metropol, especially effective during an afib episode. This as needed approach seems to be what your cardiologist had in mind.

The pharmacist may be reticent because both of the drugs do essentially the same thing and the concern is your heart rate may go too low.

This has happened to me all the time when my cardiologist prescribed drugs that overlapped and function. The pharmacist is just doing their job, but they're not doctors nor are they familiar with your condition or medical history.

So in this case, your cardiologist knows best about adding a beta blocker to diltiazem. If you cannot persuade the pharmacist by explaining this is only an an "as needed" use, then have the doctor explain it to them.

Jim

[sharpedge in reply to mjames1]

Afternoon Jim

Thanks for your prompt and clear reply. My wife has her telephone appointment on Monday, I’ll let you know how it goes.

Kind regards

[Vonnegut]

I too live in Gloucestershire - have done now for well over half my life though I was a Londoner! After the lowest dose of Bisoprolol proved too much for me to take daily after only three days ( the doc hadn’t even arranged a follow up appointment but the pharmacist was concerned as I hadn’t taken anything like that before) we found a lovely EP in Bristol on the AFA website who we saw privately- I didn’t come across any through the NHS sadly. and haven’t been followed up much either in the five or so years since diagnosis. Good luck!

[sharpedge in reply to Vonnegut]

Morning Vonnegut

Thanks for that info, can you give me the name of your Bristol EP, recommendations are appreciated.

Kind regards

[Vonnegut in reply to sharpedge]

Jonathan Pitts Crick- he was at the Spire in Bristol at the time but I lost touch with him and it was five years ago now - or more! I have his mobile number though it might have changed now. You could try phoning the Spire. Good luck!

[sharpedge in reply to Vonnegut]

Thanks again, just checked and he is still in Bristol.

Kind regards

[Vonnegut in reply to sharpedge]

Good luck! I didn’t get his bill for ages but though it was large, it was definitely worth it. I wonder if he’d remember me!