I take 5 mgs of Bisoprolol morning and night. Unfortunately I have missed this morning’s dose somehow. I know this drug is sensitive to reduction in dose, so would you advise me to miss this mornings dose altogether and take this evenings as usual, or take the missed dose now and take this evenings quite a bit later ?
Annie
There should be advice on the paper in the packet which covers this. My view is don't worry about it, DO NOT PLAY CATCH UPS, just take the night dose as normal , keep calm and just carry on. Don't do it again 😂😂.
I think the sensitivity you refer to relates to stopping Bisoprolol altogether. In which case you wean yourself off it very very gradually.
John
Thank you John. I thought I would leave it but then take evening dose s bit earlier. I think I have omitted the odd dose before over the years, when I had to miss out my Warfarin. As I take them together, I just didn’t take either in that instance. Makes me sound a bit ditzy doesn’t it 😄.
Annie
Annie, ( a.k.a. Ditzy ) 😂😂😂
I've done it often over the years ... including my Warfarin. I figure I'm so loaded with all these sorts of drugs now ( after 14 years) that it doesn't matter and I just give myself a slapped hand and carry on. I've even had to stop Warfarin at times when under going a range of different medical procedures at different times. I just stop, restart again and carry on. I guess I do have the advantage of my paroxysmal AF being highly controlled and nowadays AF events can be months or even years apart. So its not as if i were in persistent or permanent AF.
Thank you Pussycat 😄. I am not heavily burdened with Afib. I get episodes several times a week but they don’t last long. The Bisoprolol is to keep the HR down - I don’t think it’s an anti Arrythmia drug - and although I get ectopics all the time, my HR is almost always around 60. I guess my missed dose won’t alter that. I was only a bit anxious about side effects of the missed dose, but I think it’s me being fussy and worrying over much. Thanks for responding. All replies always help somehow in these situations.
‘Ditzy’ 😉
Personally I wouldn’t worry about it, I sometimes forget and it hasn’t caused me any problems.
Thank you bantam12. That’s reassuring. It’s such a large dose that I take, I don’t want to risk taking more than prescribed in 24 hours - better to have slightly less. And thinking about it, as my dose is split in two, if I forget about this mornings dose, I’m only really reducing todays dose by half aren’t I.
Annie
As others have said, nothing to get too worried over. It's mainly patients who take their meds anytime they think of it , and sometimes not at all on a regular basis that cause themselves problems.
There should be advice on the packaging and there will be online, my personal advice, unqualified is no, take your next one as usual and buy a daily pill distribution box to help with your doses etcx.
Yes, all the advice is geared to a ‘once a day ‘ regime, so to be told ‘ take the missed dose when you can and your normal dose the next day ‘ wouldn’t work for me. I missed the dose in the end, and then took my evening pill a bit earlier. As several people here suggested, I felt no side effects. Thanks for replying.
Annie.
if you've been taking it a while then there should be some in your system, i've forgotten too and nothing happened just relax
Thanks for the reassurance. I missed the dose and all was well after all. I am a worrier ! 🙄
Annie
I believe that bisoprolol, owing to its half life in the body, is one of those drugs that reaches a "steady state" in the bloodstream, regardless of when it is taken, or how the doses are divided.
The reason the doses are divided is, so far as I can see, questionable scientifically, but it seems some doctors prefer it that way, and, even more confusing, it genuinely reduces side effects for some patients, thus proving that science only provides a partial answer for some (whose metabolism might be unique to them).
If that is so, then you can take it once daily, with your doctor's approval, and shouldn't notice a change. And that would mean that, yes, you can take the extra dose of a split-dose regimen at a different time.
The answer lies with your doctor, however. I would call them today.
Steve
Thank you Steve. Wise words, as ever. In fact I decided not to catch up with my missed dose, but just took my evening dose a little earlier, which suited me anyway, and I will continue taking it at that time. I felt no ill effects of the missed dose so what you say about half life of the drug must have had something to do with it. I can’t fathom the difference between a long half life and a short half life. It’s gobbledegook to me ! 🙄
Thank you! Half life is a measure of the average length of time it takes the body (often the liver or kidneys) to either remove or “neutralise” 50% of a drug so that only half of the initial dose remains. I’m not sure why “half” really matters though. Also, with some drugs, what remains can be active so further complicating. In fact, with codeine, it is only the metabolite (which surprised me to learn is morphine) that is active.
The term “steady state” confuses me but it seems the body will create a smooth concentration of certain drugs without peaks and troughs.
The half life of bisoprolol is quite long (hence the usual once daily dosage), so it’s possible you’ll feel some small impact later on but it’s equally possible (I suppose) that you don’t need to take the dose you are on?
My wife has just loaded up my weekly pill box. You would think I were at death’s door with that lot! And it seems nothing like a week has passed since I filled it last.
Steve
Thanks for the explanation ! And yes, those pill boxes empty at an alarming rate - I am sure time goes faster with every passing year 😄
Hi
A bit late but just received your post.
As you can take 10mg Bisoprolol I would take it now.
5mg at night.
In actual fact the night one is most important to get through those early morning spikes.
cherio jOY. 75. (NZ)
Thank you Joy 👍
I take 7.5mg at night and have been known to occasionally forget. However I don't catch up I just take the next dose on time. It's never been a problem. However. if say, you missed two doses then your heart rate might start to get tachycardic,
Thank you for responding !
I took 2.5 in the mornings and had to stop. It wiped me out. I’m now taking just 1.25 at night. For some reason I can’t keep my eyes open
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