Bisaprolol Advice

[alpha666]

Hi all 69 year old male had AF for a couple of years, prior to this i was diagnosed with high BP by my GP and was on medication Atenolol and Amlodipine, was on this for few years and was fine, then a couple of years ago i started to get very short of breath, GP diagnosed AF, to cut a long story short i paid private to see a Consultant Cardiololgist who changed my meds to Bisoprolol 5mg twice daily,Entresto 24/26 twice daily, Apixaban 5mg twice daily, Dapagliflozin 10mg once daily and Furosemide 40mg once daily. He also recommended a Cardio which was successful but only lasted a couple of weeks before i slipped back into AF.

However on these meds i was much improved and the Ejection Fraction rose from 30% to 45% and he told me the best thing i could do was lose weight, always been on the large side and weighed in originally at 122kgs, so went onto a calorie controlled diet with daily exercise steady walking doing 8-10k steps and over a 6 month period my weight has now reduced to 101kgs so a 21 kg loss.

However recently i am suffering dizzy spells on and off for about 6 hours after taking my morning meds, i think its the Bisoprolol that is causing my issue. Using a bit of logic now i am about just over 3 stones lighter and clearly my heart is now not working so hard to carry my bulk around is the medication too much for my new lower weight, and would it possible to only have 5mg of Bisoprolol a day instead of 10mg ? as i have read 5mg twice daily is a high dosage, any thoughts much appreciated.

[Omniscient1]

This I a known side effect I think. There are certainly lower doses of biso available (down to 1.25mg) but check with your Dr. Your weight loss may be a factor with regards to the dosage, well done by the way!

[2learn]

Hi, 10mg biso is high, what's your resting HR. If its regularly below 60 you may be taking too much which can cause the dizziness. Talk to your Doc about dosage and whether you can reduce and take it at night.

[alpha666 in reply to 2learn]

Hi thanks for the reply, have a digital BP monitor with cuff that i use most days to check my pressure which also gives me HR, when resting this is usually below 60 bpm some days its about 45 which is probably to low, i tend to think its the Biso dosage that maybe too high.

[alpha666]

Sorry forgot to say Blood Pressure is always good, i key the figures into the NHS blood pressure tool and its always in the blue section which is healthy, so the Biso is working for that but i think its slowing my heart rate a bit too much.

[JOY2THEWORLD49]

Hi

The best thing is for someone to prescribe An ECG and 24hr Heart Monitor. It is a true picture of what your meds are doing through day and night.

In 2021 I had 3!

Why because the specialist wanted to see what Metoprolol was doing. Breathless H/Rate Day 186 Day 47avg Night. Pauses at night. I couldn't exert myself. Fatigued and in trouble.

Changed to Bisoprolol. 156 Day, 47avg Night no breathlessness no pauses at night. Improved exertion.

Changed to CCB Diltiazem settled on 120mg AM. Controlled down to 86-96 Day, 47avg Night, lost 5 kgs settled at 60s Day, 47avg Night.

2.5mg Bisoprolol for BP control.

10mg Bisoprolol did not change my rapid Heart rate.

I've been on the above regime of meds for 2 years 6 months. It took a Private Heart Specialist to get me right. Diltiazem works like an antiarrhymic med but safe to use on atrium dilation not like Flec... which is a NO NO along with cardioversion and ablation.

cheri JOY. 75. (NZ)

[Tellingfibs]

I am on 10 mgs Bisoprolol daily, with a weight of around 64 kgs. I don’t think weight is a factor with the dosage. The doctors are pleased my HR is around 60, but it does drop to the low 50s sometimes. I think you should mention the dizziness though. It might be a couple of your meds are interacting. You are on quite a cocktail, and doctors aren’t the experts when it comes to drugs - you need a pharmacist’s advice. If your doctors practice has one, so much the better. Good luck.

Annie

[maurice2]

Yes, ask your doctor to let you go down to 5mg (or 2x2.5) a day so you can see if this improves things. I've dumped the biso altogether and just take an anti-coag (for a mild arrhythmia). I didn't get on with it, left me feeling like I was only partially there.

[Desanthony]

It seems time to have your medication/dosage reviewed in view of your weight loss.