Tiredness

[mikefff]

Hi All,My first question here! , probably an obvious answer. Who else gets extreme evening tiredness on apixaban and bisiprolol. Is it the apixaban causing it. Cheers.

[Ppiman]

I would say it isn't related to apixaban, Mike. Welcome to the forum, by the way. It's full of kindly people and useful advice (especially if you use the search function, too).

If you are sleeping normally and feel excessively tired, it will be difficult to work out the cause, I expect. Tiredness can be thyroid or diabetes related, for example, but you likely know it isn't these. Bisoprolol might be a contributory factor, especially with higher doses. You might find your heart rate drops of an evening because of it, perhaps a little too far for your body's requirements and this could cause the tiredness.

As well as the atrial issues that cause my arrhythmia (ectopics and AF), I also have a thing called "Left branch bundle block" (LBBB) and when this kicks in, I can suddenly feel extra tired and evenings can be a time when I notice this. Many have these bundle blocks when 60+ years, I gather, but you don't give your age, so it might not apply. If you have a home ECG device perhaps an Apple Watch, Wellue, Emay or Kardia, it will show this as a widening of the big "R wave" peaks on the tracing, sometimes showing an odd "M" blip shape at the very top.

Steve

[mikefff in reply to Ppiman]

Cheers Steve yes I can check in my smart watch will do that.

[Ppiman in reply to mikefff]

Here’s a “wide QRS” ECG trace caused by LBBB on my Apple Watch.

Steve

Apple ECG trace showing wide QRS

[Rainfern]

Hi Mike, and welcome. I’ve not experienced tiredness with Apixaban which is the only medication I’m on, but Ive read several posts that associate bisoprolol with tiredness, especially when the dose isn’t quite right. We all respond or react differently to different medications, so it’s something to discuss with your GP or cardio team. I found AF exhausting enough without further side effects! Let us know how you get on.

[mikefff in reply to Rainfern]

Thanks I'll discuss with doctor, good idea. Cheers.

[Desanthony]

I had bad fatigue and breathlessness on Bisoprolol - they tried various dosages and it made no difference. Tried other beta blockers, calcium channel blockers and various rate/rhythm control medication and within about a month they all brought on these side effects. At one time bisoprolol brought my HR down to 36 and I had to call the paramedics out as I felt so unwell. It may be that you need a review of your dosage or a change of medication as you go on. So speak to your EP about this.

[mikefff in reply to Desanthony]

Thanks I'll check in with the doc.

[Cavalierrubie]

Bisoprolol is notoriously known for tiredness and not a good drug for some of us. It lowers my blood pressure too much. I have a friend who recently had to take Apixaban for a blood clot in her leg. She felt very tired whilst taking it. Her clot dispersed, and she was able to stop the drug, and she felt much better and had more energy. We all have different reactions and side effects from drugs, but there are many others to try if you think they are making you this way.

[mikefff]

Thanks Caval so could be either that's affecting me possibly, I'll chat to doctor I think. Cheers.

[Cavalierrubie in reply to mikefff]

I think that’s a good idea. We are all so different and one size doesn’t fit all. The aim is to have a good quality of life as is possible and sometimes trial and error with these drugs is necessary. I don’t get on at all well with taking drugs. I take bisoprolol as a PIP (pill in the pocket for when l have an attack of AF). It works for me. Hope you soon feel better.

[Ducky2003]

I lasted 3 months on Bisoprolol before demanding to come off it, as the fatigue and breathlessness were dreadful.My pharmacist explained that it attaches to receptors in the lungs as well as the heart so recommended a calcium channel blocker instead.

Told the next cardiologist I saw that I wanted to be put on Diltiazem instead and no issue since.

Very unlikely to be Apixaban related.

[mikefff in reply to Ducky2003]

That's great info thanks. My asthma has increased also. Cheers. So diltiazam does same thing as bisiprolol I presume I. E. Reduces heart rate

[Ducky2003 in reply to mikefff]

That could be a reason for problems with your asthma. Yes, they both keep the heart rate in check, just by different mechanisms. 😊

[Sylviep7 in reply to mikefff]

If you have asthma that is a contraindication for taking betablockers as they can make it worse! I'm surprised the Doctor prescribed them however, in my experience ,a lot of Doctors have little knowledge re side effects.

[Hanibal]

Hi,

For me it was the bisoprolol.

I was on up to 7.5mg a day for a year and it absolutely floored me. Could barely walk to the end of my drive and my HR was a constant 50bpm in all situations so not enough blood got to my legs when walking. I finally got my GP to reduce the dose and my energy came back immediately. My dose is now 1.25mg/day without any noticeable effect apart from a much faster HR which stays within the 60/100 bpm even when in arrhythmia.

I also take Apixaban for blood control without issues.

Hope you sort it out.

[mikefff in reply to Hanibal]

Cheers, that's really useful to know, some great info for me.

[maurice2]

I'm just on apixaban for arrhythmia. It hasn't made be feel especially tired. I stopped the biso because I made me feel like doing nothing for hours. I do quite a lot of walking on the apixaban especially on weekends, six miles on Saturday, eight yesterday. Sometimes i feel a bit tired after the exercise 😅

[Tapanac]

I’ve never known Apixaban to cause tiredness and I’ve been on it for approx 8 years, it's more likely your afib or bisoprolol. You don’t say how high is the dosage? Everyone is different though so perhaps you could have a word with your GP or cardiologist or EP

All the best and welcome to the forum

[mikefff in reply to Tapanac]

Hi it's 5mg.

[Tapanac in reply to mikefff]

Yes I know that’s not massively high (some on here up to 10mgs) but after my pacemaker snd because of covid my heart rate kept going high I was put up to 2.5 but had to go back to 1.25 as not only did it lower my BP too much but I felt like I was walking through treacle dragging myself around

I doubt if it is the apixabsn

[Auriculaire in reply to mikefff]

I felt like a zombie on 5mg.

[Jetcat]

hi Mike. I’d say it was the bisoprolol causing tiredness. It’s pretty well known for it in some people including myself.!!

[Vonnegut]

I should think it’s the Bisoprolol. Even the lowest dose of that was too much for me to take daily as I felt tired and the pharmacist took my pulse and told me to stop taking it after just three days and a doc at the surgery agreed!

[RoyMacDonald]

It's the Bisoprol. I came off it for that reason.

All the best.

Roy

[southkorea]

I feel very tired ever since I have been on ax

[southkorea]

I have been extremely tired most of the day since I have been on apixiban!

[southkorea]

just to add! I have been on bisoprolol for years with no ill effects . It is only since I have been on apixiban that I have felt very tired!

[BillCook]

We are all individuals, with differing responses to medication.

In my case, I was switched from warfarin to apixaban and noticed no change whatsoever in how I was feeling.

Bisoprolol was a different beast altogether for me. I was put on it whilst waiting for a cardioversion to treat persistent AF. I felt pretty grotty, but my sysmptoms were quite similar to the effect the AF was having on me, and I therefore did not suspect the bisoprolol. I only discovered the magnitude of the effect when I accidentally ran out of bisoprolol. I discovered my error on a Friday so couldn't get a top-up immediately. By the Sunday I felt wonderful (at least in comparison with how I had been feeling!) My wife said it was like having a different person in the house.

I know some people tolerate bisoprolol with no problems at all. I didn't, and I believe I must be unusually sensitive to it. But extreme tiredness was a definite side-effect for me, so it could possibly be having a similar effect on you.

[Grmdwnsth]

Since fairly recent diagnosis of AFib I’d just been continually exhausted. I didn’t know if it was the AFib itself or the meds that had me napping by lunchtime, feeling dizzy every time I got up, and forgetting what I’d discussed only hours earlier due to brain fog.

NHS / GP busy and seemed happy to just keep me on meds for a few more months. So saw a private cardiologist and the first thing he did was instruct GP to switch me off the 2.5mg of Bisoprolol onto some calcium blockers . Three days later I was a different person. More energy / clarity of thought - just felt like me again.

Hope you find an answer. Via medical professionals of course! All the best.

[DoggieMum]

Yes it's a problem. I find I am tired pretty much all the time. I have just been prescribed another drug Flecainide which I am told will help, but I only started taking it yesterday so I'll have to wait and see

[Qualipop]

I had awful tiredness on bisopralol; felt like a zombie and just slept all day. It had to be changed. Do you check your bP and oxygen levels? Bisop was dropping my BP much too low.

[Snowgirl65]

I take my Xarelto, an anticoagulant, at dinnertime and it makes me sleepy about an hour later -- which is fine with me, as it's nearing bedtime. Then I take my Metoprolol around 8 p.m. which also gets me sleepy, so I end up with a very good night's sleep. I'm going with your Apixaban instead of the Bisoprolol causing your tiredness. Just my personal opinion, of course!

[Bluetonic]

Most likely the bisoprolol especially on higher doses. I was on 12.5mg/day at one point and could not function. I later discovered that I am highly susceptible to bisoprolol as even on 0.625 mg/day my HR was in the low 30s and I was exhausted. It took 2 attempts to wean myself off it as I had terrible palpitations and headaches when reducing the dose.

I wouldn't discount Apixaban either, we are all different . Rivaoxaban made me feel awful and put me in hospital with anaphylactic shock

[DiyChas]

I was on 5mg bisoprolol at the beginning as HR was slightly over 100 at rest.Caused significant tiredness.

Reduced it to 2.5mg and reduced tiredness significantly and HR was still around 80.

Talk with your cardio or EP.

Maybe bisoprolol should be replaced.

[mikefff]

Yes cheers!

[JOY2THEWORLD49]

Hi

I reckon it's not your anticoagulant.

AF causes tiredness and probably bisoprolol may relax you more.

For instance I drove 2 hours non stop from my place To Whangarei. Slept 6.30-11.45 then after an hour slept until 7am.

The following day I drove 3.5 hrs Whangarei - Auckland Browns Bay on the Northshore. Slept 6am - 3am and then 1.5 resting and went back to sleep 7.30am.

Returning Auckland to Whangarei - 6am - 10.45 then 12 - 7.30am. Turning towel rail on 8pm - 12 turning heat off.

Arriving home 6pm. Slept 12.30 - 6.00am and back to sleep turning towel rail on until 8.30am.

So concentration and/or exertion gets you tired. I take 2.5mg at night.

Bisoprolol is a beta blocker and stops adrenaline from entering the heart. My dose is 2.5mg. I also take CCB Calcium Channel Blocker Diltiazem 120mg that on introduction reduced my 156 heart rate to 51 on 180mg. This was reduced.

Breathlessness came with Metoprolol and the monitor showed pauses at night. This stops on Bisoprolol. With a high blood rate I couldn't exert myself.

But I was reminded I needed to exert myself so the muscles in my heart would remain strengthened.

I suggest that your heart specialist or Dr refers you to have a 24hr heart monitor fitted. It is accurate and your report will be interesting. You should be given the avge heart beat at night and during the day. Plus BP.

Always take the least dose of each med. Before and after each change of med I had the heart monitor. 3 in 10 months. But I have settled and taken the above for 2.5 years.

60s H/Rate Day and my normal 47bpm Night.

BP 120-130. /. 69 -79 .

I still stop my exertion when energy? is failing. My Dr says it is your blood circulating - it is not even. I also had thyroid cancer which caused the stroke through AF.

I'm sure you will improve with slowly advancing your exertion. Walk, work, go about your day. Rest when you need to.

cherio JOY 75. (NZ)

[mikefff in reply to JOY2THEWORLD49]

Fantastic huge thanks for your extensive info. Cheers. Mike

[JOY2THEWORLD49 in reply to mikefff]

Hi

You are most welcome.

Happy to be of help.

That's what we joined this group to help others on their journey and getting our own help if we need it too.

You take care of No.1 - YOU.

cherio JOY

[JOY2THEWORLD49]

Hi

Also get a blood test for B12, Magnesium, Potassium, Iron, Your throid TSH, T3 and T4.

Cholesterol and Triglycerides. Anything else the Dr needs there are heart levels too.

The Journey is interesting.

cherio JOY. 75. (NZ)

[BaileyC57]

I am on a different beta blocker and I AM tired all the time! I have been on other name brands beta blocker I was tired on them too! All of those pills make you tired and having AFIB does not help!