Hi
Just wondering about my dosage of Bisoprol. When I read related posts on here, most people seem to be on a maximum of 5mg. I’m on 12.5 which I take at night. At my most recent appointment with my cardiologist in March, I asked if it could be reduced as I get so tired on an afternoon and I often have brain fog. He said no. I have had persistent AFib for a year now and I’m due to have my first cardioversion in August.
That's certainly a hefty dose of Bisoprolol. What is your heart rate on that amount?
Jean
I think the problem was that it took such a long time to get my heart rate down after I was diagnosed with AFib last July. I was taken into hospital in late August and between then and early September the Bisoprolol was gradually increased to 12.5. My heart rate on this dosage tends to be around 80 bpm x
Sadly it sounds as as though you need that high dose. There are other medications you could try though.
I take Metoprolol which is a pretty effective drug for me but there are lots of others. I think you need to say outright to your cardiologist that you want to try another drug.
Jean
Thank you. Will mention it when I am in for my cardioversion next month x
Good luck with the cardioversion!
Thank you. I know that it often only works for a short while but worth giving it a go x
If after the cardioversion your heart goes back to it's normal rate I'm sure they will reduce your Bisoprolol dose drastically.
That would be excellent x
Hi
And why not a CCB like Diliazem.
It worked wonders in contrast with the BBs not doing much to control my rapid H/Rate.
cherio JOY
Thank you x
Hi,
Just guessing here but I don't think hospital used all their resources to get your heart rate down quick enough. Probably explains why you are on such a hefty whack of Bisoprolol.
When I was diagnosed with AF and admitted to A & E the duty Dr administered a drip of Amiodrone directly in the back of my hand and I had the pleasure of watching my HR drop right down - slowly at first, then more rapidly until it got down to just above 100. I was then kept in Cardiac Ward for another 5 days for a wide range of tests. My HR eventually stabilised at high 50's - low 60's on 5mg Bisoprolol.
After some 12 years I developed side effects with Bisoprolol and was moved to 5 mg Nebivolol and then in April 2024 I was switched to Sotalol ( 40mg morning and night ). No problems apart from ongoing overwhelming tiredness.
John
Your last sentence brought a small smile to my face, John - even though a wry one. I hope you cope well enough with your tiredness. My days are spent feeling that way but owing to insomnia rather than bisoprolol (which I take at 1.25mg only currently).
Steve
Hi
Not the Billy Goat Gruff! AWWWWW.
I was kept on Metoprolol and a heart rate of 185 for 1 year 4 months. A 24hr H/Monitor showed this and 2 sec pauses at night. I never wanted it in the first place after STROKE with Rapid and Persistent AF. 4 days into it plus Papillary Thyroid Cancer.
I asked for a Heart Specialist who changed me to Bisoprolol - better for AFers.
Although another 24hr Heart Monitor showed H/Rate at 156 and still not controlled she ignored me on q.o.life.
Now 2 years 3 months uncontrolled my Locum said go see this recommended Heart Specialist.
He introduced CCB Diltiazem 180 1/2 dose. Within 2 hours I dropped down to 51. Scary.
The next day and three I liaised with NZ Healthline Dr and NZ Heart Foundation.
My regime for the past 2.1/2 years is:
Diltiazem 120mg CD AM for H/Rate control.
Bisoprolol 2.5mg PM for BP control.
= 120-130 / 77-80 60s Day and 47 avg Night (my normal).
I'm happy being controlled. Had 3 ops and on PRADAXA 110mg x twice of course.
Why don't medics use CCB Diltiazem to bring down heart rate. I know that if one has Ventricle function trouble it should not be used. I have severe left atrium dilation but ventricles are functioning normally.
cheri JOY. 75. (NZ)
Thanks for this x
Thank you. What you say is very interesting. Food for thought x
I take 10mg daily Bisoporal and okish
I’m on 11.25. 10mg in the morning then 1.25 before bed.
are there 2 types a slow release which you take once a day and the other you take twice a day in other words the twice a day is 5mg each and the slow release 10mg once a day?
I take 10mg each morning and was told this could not be increased. I’ve been told digoxin would be required on top of this if needed. I have been ok so far on Bisoprolol.
This was started on 5mg, then 7.5 mg and now 10 mg as I got breathless prior to each increase.
Good luck with cardio version. I’m still waiting to see a cardiologist (from March) in Scotland.
I take digoxin too. 3.25 mg x
I take 10 mgs a day, but split into morning and evening doses. I understand that some people are prescribed up to 20 mgs, but I am pretty sure that is for blood pressure. Maybe if you split the dose you would feel less zapped out ? Having said that, I do feel like a nap after lunch if I don’t ’get going’ pretty sharpish. It’s difficult to know if my dose of Bisoprolol is what makes me tired, or whether it’s just my age ( nearly 73 ) or just plain laziness 😄. My cardiologist said it was likely to be caused by the Afib itself.
Annie
What is wrong with a nap after lunch? This was standard practice in large swathes of the world (siesta ) . At 73 why the need to push yourself to " get going ". By this age we have earned the right to a bit of laziness. There is far too much push these days for constant activity and so called acheivement. I have a nap most days in the afternoon and have for many years. It's good for you and I don't feel in the least bit guilty about it!
Good for you !
Yes, I do often have a nap. the brain fog that is more of a nuisance x
I will have another chat about the tiredness when I have my cardioversion. It’s the brain fog that’s more of a nuisance. I sometimes feel as if I’m zoned out x
I also had brain fog and general apathy on biso but was only able to cut down on it (and cut it out in the end) AFTER a successful cardioversion (electric variety). So I wouldn't change the dose until you get a green light from the medics.
Hi
If rapid persistent AF (High pulse rate) I found any BBs Beta Blockers weren't helping and so all Drs did was raise my Bisoprolol.
Eventually uncontrolled I went to a private Heart Specialist. On Bisoprolol my H/Rate was 156 Day. My normal Night was 47bpm.
He introduced CCB Diltiazem 180mg. H/Rate dropped within 2 hours to 51. Too drastic. A bit light headed, wouldn't be able to drive.
Between NZ Healthline's Dr and NZ Heart Foundation/s Nurse my med regime for the last 2.1/2 years is
120mg Diltiazem CB 120mg AM to control H/RATE.
2.5mg Bisoprolol PM to control BP.
Levels are 120/79. 60s day and my normal 47avg bpm Night.
110mg PRADAXA x twice.
125mg Synthroid daily - Thyroid cancer. REMOVED total Thyroidectomy + 12lymphs + 2 affected with dissection.
No swelling ankles, I have to keep up with healthy food and kiwi, or fig, or prunes etc.
I'm happily controlled.
Yes, what is the point if Bisoprolol is not controlling your H/Rate/BP etc.
cherio JOY 75 (NZ)
So pleased that you are doing ok. Will have another discussion with my cardiologist when I get the chance x
My experience has been similar to yours. Was in persistent AF and was on 15mg of Bisoprolol daily until my cardioversion last December, which is still successful so far, fingers crossed ! Post cardioversion the dose was reduced to 10mg per day, and am now on 5mg per day.Am also on Flecainide 50mg twice daily, and of course Rivaroxaban. Best of luck with the cardioversion . The magic seemed to work for me. (Am on the waiting list for an ablation now ).
Because I have AV re-entrant tachycardia I took Bisoprolol 10mg for nearly 35 years along with an anti-arrythmic. I actually reduced it to 7.5mg about three years ago after getting my cardio's approval because of lack of energy now I'm in my late 70s. These two medications apparently help my PAF diagnosed 4 years ago as I'm asymptomatic and was only diagnosed by accident, and only Apixaban was added because of stroke risk. It's a good drug if one can persevere with it. I do remember when I first started it that I struggled but now wouldn't be without it
I have a maximum of 10mg when in rapid AF and considerably less when I'm in NSR. Even the smaller dose affects me badly the 10mg is awful - weight gain, more sleep disturbances, dreadful tiredness, brain fog, colder extremeties, etc. I dont know if the maximum dose is weight, heart rate or some other metric related. I know when monitored in hospital they give me more than 10mg at times so reckon it's related to how low your heart rate may go if you suddenly revert to NSR which could be dangerous if too low.
I was told that they needed to keep upping it as my heart rate wasn’t coming down. They also introduced digoxin. It’s seems to be controlled now but the brain fog and the weird dreams/ sleep disturbances are the worst problem. It could be that the culprit is not getting a good night’s sleep x
I'm in a similar position, although the digoxin didn't seen to do a lot re. bringing my heart rate down by anything more than 5 or 6 bpm and gave me rampant diarrhea every 3-4 weeks until I took a break from it! My cardiologist (EP) has now said that if my heart rate can be kept under 150bpm its OK to lower my bisoprolol dose as I need to lose weight which I totally agree with. I've lost 9lbs in a month and a bit through dropping my bisoprolol to 2 x 1.25mg per day rather than 2 x 5mg per day. How long this can go on I'm unsure of as my heart still has periods of misbehavior which can be worrying at times. Hopefully I can continue losing weight foe a while before it worsens.
My sleep disruption is a little better on the lower dose but still problematic which doesn't help with tiredness, brain fog or weight loss!
Fortunately, I have dropped two dress sizes over the last year despite the Bisoprolol. My BMI is more or less ok now. This is largely because of not drinking alcohol and trying to eat more healthily with smaller portions. It’s been relatively easy to do this as my appetite isn’t what it was (maybe because of the meds?).
The sleep disruption is a complete nuisance and, as you say, doesn’t help with the tiredness and brain fog x
Hello
AF is a condition that can affect many in different ways, all treatment options are based upon your personal circumstances. The medication will have been prescribed to help manage your symptoms, if you find episodes change or you experience anything new, please do not hesitate to contact your GP for advice.
Kind regards
TracyAdmin
Thank you x
I take 5mg morning and 5mg evening.
I am in permanent AF I started on 3.75 but then increased to 7mgs but it made me ill. My cardiologist reduced it to 5mgs but I also take digoxin. I had fast AF so that maybe reason for digoxin. Ask your cardiologist if there is an alternative, there are similar alternatives with lesser side effects. I have your symptoms on 5mgs. So I empathise with you
I was on 10mg which my consultant said was the maximum dose. It seemed to age me by a good 10 years so I asked if I could reduce to 5mg which he agreed and I feel a lot better. I do not have permanent AF. I have just had an ablation to the right hand atrium (they could not get through to the left) and that on its own had made a big improvement.
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