I have been on Bisoprolol for nearly 2 years. 3.75 mg in the morning and 1.25mg at night. I'm exhausted all the time . Not sleeping very well as having to get up for a wee every 1.5 / 2 hours, then having a nap in the day. Others on the forum have written about the brands. Mine is 3.75 made by Medreich and the 1.25 is by Hillcross.
Does anybody know which is the actual genuine BRAND rather than the generic which I presume I am on. Also has anybody swopped from a generic to an actual brand with good results. I am finding it very hard to exist in this constant state of exhaustion so I need to try something else in the bisoprolol family.
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Rosie0202
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It was my decision and agreed upon that I split the dose . This was to give me some protection in the early hours of the morning at a lower dose because I typically had the worse symptoms around 5am. Then the higher dose was to compensate for the extra burden on the heart rate during the daytime hours. My question was about the brand names and not the dosage but thanks for your response.
Bisoprolol is Bisoprolol whoever makes it. Sometimes it is called Bisoprolol Fumarate. Just look at what the leaflet says it is. There are people on this forum that are sure that Bisoprolol made by some companies do have an unwelcome effect on them. In this case ( and possibly your case ) there is a minuscule chance that it is what the active ingredient is mixed with to form the tablet that has the effect. If this is the case, you may find other tablets do the same - for instance : do you notice a difference between a generic paracetamol tablet and a Panadol tablet ? Paracetamol is the drug, Panadol is the brand, which contains paracetamol. They are exactly the same thing, but there may be a subtle difference in the ‘binders’. All the feelings you are experiencing are common with Bisoprolol, as many people on this forum say, and I myself suffer them too, but I would rather those feelings than the Afib sensations. Don’t forget also that Afib itself commonly causes those washed out feelings, plus depression and inability to cope, fatigue, frequent urination and poor sleep. I have also read on this forum that sometimes the Bisoprolol works better once the body has become used to it.
The effects from drugs made by different manufacturers is a very real problem for some people, there are differences in fillers and binders used and even the slightest change can cause problems.
I am aware that it is the binders that might be different amongst the Bisoprolol family. However, I am also aware that the brand is less likely to be affected by this than the generic. I am just trying to find out if anybody has taken a generic and a brand for comparison. Bisoprolol is doing a good job for me although I am paying a heavy price to achieve rate control. I appreciate that AF has an adverse impact on wellbeing. I want to avoid having a cardioversion and ablation for as long as possible.
I too am trying to keep to medication, rather than resort to ablation etc. I guess there is a lot of trial and error. My cardiologist said he could always change my Bisoprolol to Sotalol if needed, but I understand the Bisoprolol is more for rate control and Sotalol for rythmn control. For me, it’s the fast heart rate that makes me feel wretched so I continue with Bisoprolol. It’s certainly worth you asking if you can change as there are various medications out there, as you will know. But it is all such an effort when you are feeling rubbish isn’t it.
I'm seeing the cardiologist at the end of September and I have requested further tests. A repeat of the Echo, plus the results of the perfusion scan which was promising in not showing any significant calcification. At this point, I will make a further judgement about where to go to next.
The person to ask about an actual brand name is your pharmacist. Bisopralol made me like a zombie no matter what brand it was. Perhaps your GP could change it to a similar but different drug. I react extremely badly to generic meds but the reactions are not the tiredness that bisopralol gives me, it's usually rashes or stomach upsets or shakiness. I've never been able to isolate the specific filer, binder or colouring that does it. \Some people simply can't tolerate beta blockers.
I couldn't tolerate Bisoprolol at all - it made me feel far worse than my AF. I tried other types of beta blockers, calcium channel blockers rate and rhythm control medications and various combinations of them over about a year but in the end as it took my heart rate way to low sometimes as low as 43 or once 36 I stopped them altogether on the advice of my Cardiologist and later EP. It may be worth you talking to your EP to see if it is worth trying a different medication or slowly changing the dose. As I was diagnosed with lower rate persistent AF and had 3 successful cardioversions which kept me in NSR for 3 out of 4 years I asked to be put on the ablation list because I couldn't tolerate any of these medications. the ablation was unfortunately cancelled twice during Covid lockdowns and eventually after all that in 2022 had to have all the scans and tests etc again to see if I could go on with my ablation and found that my heart had remodelled itself so any further intervention such as ablation or more cardioversions would not work so I am now in permanent low rate AF and just taking apixaban. These symptoms and how the medication acts on you really need to be discussed with your EP.
I have lower rate persistent AF too. I refused to go onto rhthym control Amiodarone because I was unhappy about the side effects but I do take an anticoagulent Eliquis. I am 2 years into the more or less permanent AF. Why does remodelling preclude cardioversion and ablation and what does remodelling involve. Cheers.
Gosh good question someone better than me would have to answer that. I just know it to be true the heart as a muscle, exercises itself differently over time in arrythmia and so will alter itself and re model - it's like exercising at the gym to get a 6 pack or taught stomach muscles. Sure someone will be able to explain that better than me.
If you are in low rate persistent AF I would question whether you actually need bisoprolol or any of the rate/rhythm control medication as I eventually did. My wife actually called my cardio EP on a Saturday morning as she rang the hospital and my EP was on duty and he said I must stop it if I felt so unwell. It was another day when I actually couldn't walk down stairs and was sat exhausted on a chair at the top of the stairs having walked from the bedroom to the bathroom and then collapsed into the chair.
Have you been offered a cardioversion - I would certainly ask for one as you seem to be having difficulty with bisoprolol. If the cardioversion is successful and you attain NSR - even for a few hours/days then it suggests that an ablation would also work for you. My first CV kept me in NSR for 13 months when I had been put onto digoxin by a new cardiologist to see if that helped I eventually got down tot he lower dose of digoxin and that seemed to be OK but the higher dose still lowered my HR too much but because of the successful Cardioversion stopped taking them and despite going back into AF twice after that was never put back on them. My second CV kept me in NSR for 6 months and the third - just before lockdown and upcoming ablation (had the CV in Feb 2020 and was due the ablation in March 2020) kept me in NSR for 15 months.
Before starting on Bisoprolol for rate control, I wasn't taking anything at all except my usual long term BP medication. Losartan and Indapamide. At that time my intervals between AF were very infrequent ie. 6 months was the shortest time gap. The AF was a quick 4 hour burst and back into NSR without intervention. During those episodes I had a rapidly fluctuating heart rate between 60 bpm - 136 bpm (within seconds). Hence the Bisoprolol. Following that, AF episodes became more frequent but with lower variations in heart rate and generally more tolerable. When AF became regular at shorter intervals, rhythym control was suggested followed by cardioversion then presumably ablation. Both were not to my approval as it involved Amiodarone.
I took amiodorone for 3 months around the time of my second cardioversion. Usually first cardioversions are done without amiodorone. and second Cv's with as it sshould keep you in NSR for longer - as it happened for me it didn't as it was the shortest I stayed in NSR after a CV. I had blood tests every month and the medication would have been stopped had there been any problem as it happened it was the blood test I had at the hospital at the end of the course when I was due to stop the amiodorone that showed a slight rise in thyroid hormone. I stopped taking the amiodorone as I would have done anyway and had another blood test within 6 weeks and the thyroid hormone was back to normal. I would ask for a cardioversion without amiodorone and explain why. I would definitely ask about whether or not with low rate persistent AF - likely to become permanent low rate AF if you are not found suitable for CV or ablation then why take bisoprolol or any beta blocker, calcium channel blocker or rate/rhythm control drug anyway. At the very least a change of dose or medication might make you feel better but definitely discuss all options with your EP. Mine was loathe to stop control and eventually got onto low dose digoxin which didn't seem to cause low heart rate but was only on it for about 5 weeks prior to first successful cardioversion and never put back onto it. Usually, when they tried me on the beta blockers, calcium channel blockers and rate/rhythm control medication I was Ok but not good for about 3 weeks and then the severe fatigue breathlessness and dreadful feeling of not being able to do anything would start and continue for as along as I was on the medication.
One thing to be aware of is that you should not come off Bisoprolol but lower the dose over a few weeks. Although I came off "cold turkey" and had no problems - I jsut felt so much better to be off the darn things. They are the first medication most of us are put on along with anticoagulants but it's amazing how many of us just don't get on with them as you will see on this forum.
I am quite well controlled with Bisoprolol in terms of heart rate. Not quite there with my BP though as I keep getting episodes of very high readings. My question was about the Bisoprolol brand versus the generic in terms of side effects. By the way I can't take Diltiazem.
In NZ my Bisoprolol canged from being grey in foil pop out pills to white with a line down middle, The new manufacture is IPCA Pharma Manufacture. All our meds have to pass Medsafe. I haven't noticed any difference.
Why couldn't you take Diltiazem? Do you know that Diltiazem and Bisoprolol should NOT be taken together. CCB AM best and BB PM as the spike in BP is early morning.
Trying to support one another, we like to know your trouble. You say your BP is not controlled by Bisoprolol. What is it BP and how much med do you take.
It was the heart rate with me that made me a zombie plus Metapolol leaving me rapid AF.
Hi there. Having worked for many years in the pharmaceutical industry, I can confidently assure you that excepting in the rarest of circumstances, generic drugs are the equal of the original brand (in the case of bisoprolol, I think, it was originally made by Sandoz, Switzerland, which, unusually, mine still is).
Thank you Steve. On the side of the packet of my 1.25mg box it says MA Holder. Sandoz Ltd and then gives a Surrey, United Kingdom address. On the front it says Bisoprolol Fumarate. On the 3.75mg box it says MA Holder. Medreich PLC. with a UK address. On the front it only says Bisoprolol Tablets. So can I assume that the 1.25mg box is the brand and the 3.75 mg is the generic. Incidentally I have no issues with the Eliquis, the brand name for (apixaban). (anti coagulant). However when I was given Apixaban (the generic), I had lots of pain in the stomach until I changed back when I discovered that Eliquis was the brand.
You are right on the bisoprolol. Sandoz has a large UK company but are originally Swiss. Many branded drugs are made and sold as generic tablets even by the brand’s owner, confusing the issue further. The company I worked for owned two generic manufacturers, for example.
It is always possible that one tablet or brand will react differently for an individual, but that would be very unusual. The main cause, I would guess, would be the way the tablet is compressed during manufacturing altering its release in the stomach or intestines. Sometimes different excipients (“fillers”) are allowed but these are inert substances (again - it’s possible an individual might react, but rare). If they are allowed, then that would apply to the branded version, too.
In the case of your problem with generic apixaban, whilst it’s most likely a quirk of circumstances, you might have been unlucky. You would have to do your own double blind test to be sure. 😳
Testing of drugs is strict and heavily controlled but these days - well, we all worry at the source of things. The world has changed significantly this past decade or so and drug supply is going through what seems to be a uniquely bad period.
Well I found a difference in the CCB Diltiazem wemt from original to generic ACCORD and it had not been passed as safe.
If we are offered a different med with differing manufacture and it is NOT passed by MEDSAFE we as patients need to sign a Rule 29. But that wasn't done. I just queried the different colour of the capsule. The original was by far superior. It got my heart rate down in the 60s. ACCORD 90s. Then back to original 60s Heart Rate again.
1.25 mg was too much for me to take daily. The doc had wanted me to take 2.5 mg but I pointed out that I was very sensitive to drugs so she agreed to the lower dose and didn’t even arrange a follow up appointment but the pharmacist said he wanted to check on me and to pop in if I had any problems before he rang. Three days later I popped into see him as I had been feeling more tired than usual. He took my pulse and told me to stop taking it and a different doc at the surgery agreed. It had brought my heart rate down to the low 40s! As they didn’t come up with anything else, I found an EP who I saw privately. Having introduced me to having a smart phone and a Kardia, and I’d sent him a reading of my heart in AF, he sent a prescription for Flecainide to my surgery for me to take as a PIP with an added Bisoprolol if my heart rate was over 140bpm twenty minutes after taking the Flecainide 100mg which it hardly ever was. We are all very different and hope you discover what works well for you.
That’s a pity. Now I take Flecainide regularly it has put an end to episodes for me and I now take 50mg early and 100mg at night - I suggested reducing the first dose from 100mg and a doc I spoke to on the phone agreed to let me try it as I could always take some more should I get an episode which I haven't so far. Though it works well at keeping my heart in order it might be increasing my fatigue and might affect my digestion but still here at 80 and haven’t had an AF episode for a year and a half and that last one came around the time I must have been infected with covid ( with no other symptoms but a positive test) and was ended in a few hours with an extra 100mg of Flecainide, the only time I reached the maximum daily dose!
It seems that a lot of people find bisoprolol to be not very effective and to cause unpleasant side effects. In my case I found that a dose sufficient to slow the heart rate down also prevented it from responding to the demands of exercise so that I'd be panting after very moderate exertion with a heart rate that barely changed. In the UK, bisoprolol is the first option that GP's go for on initial diagnosis of afib but after six months of bisoprolol I asked my GP to give calcium channel blockers a go. I'm now taking a fairly high dose of verapamil (360mg) which is a rather old drug but has been very effective both in controlling blood pressure and bring my average heart rate down to 70ppm (and gradually falling still) while allowing the heart rate to increase when exerting myself. There also seems to be signs of long term improvement as, after eleven months of persistent afib, I experienced a return to sinus rhythm for 36 hours.
There has been a downside though. Calcium channel blockers do disrupt the fluid balance in the body so that extremities can get a bit chubby at the end of the day, which is resistant to diuretics but does tend to dissipate overnight (which unfortunately means a trip to the loo two or three times a night).
Everybody is unique and will have different experiences with drugs but for me the change from beta blocker to calcium channel blocker (has to be verapamil or diltiazem to help with afib) has been worth doing
I took Sandoz Bisoprolol Fumarate at 2.5mcg dose and could not bear it, as the others say. The additives in the product info are as in the clip above in case that is any help.
Fortunately don't need it now but just keep in cupboard in case of a recurrence of Afib.
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