I have been on Bisoprolol, 1.25, for a couple of years but found it difficult to tolerate (nausea and fatigue).
I have paroxysmal AF since July 2023 and a history of Tachycardia before that. On Flecainide 2x100, Apixaban, and since last week no longer on Bisoprolol but Veramapil, 2x40.
After 3 uneventful days, I today suddenly have episodes of raised BPM at night, and a higher Resting Heart Beat. Mein Heart rate goes quickly now into 100-120 bpm and I feel unwell.
I suspect this is the consequence of stopping Bisoprolol.
Has anyone experienced a similar scenario and how long did it last? Not sure if I should go back to Bisoprolol or riding it out. Needless to say the anxiety that a higher Heart rate will lead into AF again has resurfaced.
Are these common consequences of stopping Bisoprolol? Any suggestions how to cope with this unsettling development are greatly appreciated!
Written by
elkewilliams
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Some people have problems withdrawing from Bisoprolol so need to titrate down very, very slowly over quite a long period of time. Did you stop cold turkey? If so, you might want to go back to taking a vert small dose at night and then try withdrawing very slowly so that you end up taking it every other day, then one in three etc until your symptoms subside.
Could your GP prescribe another HR control drug if the Veramapil isn’t working for you?
You might do a search for withdrawing Bisoprolol as I remember quite a few threads talking about this issue, not everyone seems to have withdrawal problems but a significant number do and purely my observation, this seems to affect females more than males.
I had to stop it suddenly but to be hones I had much greater problems at the time so raised HR and anxiety were least of my concerns. All I can say is that when taking Bisoprolol I felt, like you, dreadful ALL of the time so I was much happier the day I stopped taking it. I will never, ever take it again and as far as I am concerned it’s the devils spawn.
Increase of anxiety is a problem on withdrawing from Beta Blockers and all I can say is relaxation techniques, self talk - ie: repeated note to self that the symptoms are just that, physical phenomena which are nothing to worry about, breath work will help IF practiced daily and distraction doing things you enjoy so the endorphins kick in are very effective = having a good laugh, listening to music, good book/film etc.
I don't know if the brands would be the same, as I am given a generic one, but I've found I can quarter the 1.25mg tablets. They end up a bit uneven, but I hope it won't matter too much with the smaller dose.
Strangely I've found my slightly blunter pull cutter seems to work better than a sharper one for these tablets, so it is worth experimenting with different ways of cutting them.
I don't know what shape your tablets are. I live in South Africa and the lowest dose available of Biso is 2.5mg. and the tablets are heart shaped. I started off with 2,5mg and reduced to 1.25mg, and then the Cardio said I could use it on a PIP basis if my HR went up. The hearts were easy to haldf because they have a deeep score, but I have put myself on a quarter heart daily to acustom myself to just the PIP - it's a bit tricky, but I thought maybe you would would find splitting a larger dose tablet into quarters would be easier.
Yes I had proble to went down from 2.5 mg bisoprolol as horrendous side effects then down to 1.25 mg same issues cardio then swapped me over to verapamil 125 mg all went wrong within 2 days had no rate control so after a week they put me on digoxin horrendous so I came off all 3 days later back to 1.25 mg bisoprolol which I seem to be tolerate better still tried and a few eptoics awaiting ablation now but 2 nd attempt on bisoprolol for me was my only option it's a difficult dilemma but we will get through that's afib as the do keep saying
I ONLY TAKE BISOPROLOL WHEN I NEED TO. I could have written Aprilla12345's post as I have had exactly the same reactions to the same drugs. My cardiologist's are at a loss to understand my problems and have attempted to apply several labels to my condition over the last 10 years. Significantly, GTN spay has no effect on me, I have no blocked arteries according to an angiogram and I have passed the nuclear mycardial persusion scan (the cheese sandwich test). The only drugs that have had a significant reduction on my (angina type) symptoms have been Dapagliflozin and Ranolazine. Although I can't tolerate Bisoprolol when it builds up in my system, I have found that when I do get AF and/or palpatations, I can simply take 1.25mg and the AF disappears within a few hours - When I do this, I also lie down for a couple of hours and I'm back to normal a few hours after that.
Oh yeah same as they don't seem to be able to help or don't know mine seems to be a high bpm at most times when off meds the only reasonable comfortable place was when I split a 2.5 mg bisoprolol which ghen gave me a 10 percent lower dose which they laughed about bur didn't disagree trouble is I need to float between 2.25 and my 1.12 depending on how feel they are fully aw of what I am doing and leave it to me to sort with them watching I have flecainide as a back up but makes my ecg go all over the place to which they say see how you feel
That’s very interesting, haven’t heard anyone doing this - taking Bisoprolol when needed. I was told that you have to take it every day. My problem also was not tolerating it the longer I took it.
At the Royal Brompton (in London) they call taking an extra dose when you are having a bad episode of AF/Palpatations "Pill in the pocket". I used to use this technique often when I was on a regular daily dose of Bisoprolol. Without this I would have been in A&E every week. Several times before I was told to do this and I had to attend A&E, their default action was give me and ECG and then put me on a Bisoprolol drip anyway. I'm not proposing this will work for everybody in all situations, however, I know my body and personally, I would always try this technique first as it has never failed me over the years.
I take Bisoprolol when needed. My GP told me to do that as l can’t take it regularly as it lowers my blood pressure too much and gives me nasty side effects. It works for me and keeps my numbers low when having AF attack and helps stop the attack. I think there are others on here who do the same.
I am also on the waiting list for an ablation and because of the side effects of Bisoprolol I’d rather not be on it.
Thank you for your reply - it does help to read about others having similar problems. Not sure though how long I will be able to tolerate this situation. I read somewhere that the beta receptors are supposed to ‘calm’ down after stopping beta blockers - after 3 days! But not so sure if that applies to everyone.
Interesting to hear that. My cardiologist once mentioned that some people can be ultra sensitive towards stress hormones when Bisoprolol is withdrawn. Little did I imagine what he meant!
Sorry to hear your distress. I am on Metropolol which is related to Bisoprolol and when I try stopping taking it I experience similar issues such as the easily elevated heart rate. Not sure if and when it would go away, but so far I have stayed the course of the Metrolpolo, but i AM reducing it. I am prescrivbed 25mg which I now cut in half. Some days I am talking the 12.5mg dose and alternate every 1-2 days of not taking it to try to wean off of it.
It may have been better to ask for guidance from the cardiologist about weaning off, but because he sounded so matter of fact about switching from Bisoprolol to veramapil that made me unsure how to deal with the consequences. As I am switching from one rate control drug to the other I am not sure how to slowly reduce Bisoprolol and taking Veramapil at the same time.
Very little was said about possible withdrawal symptoms - do cardiologists really appreciate how different our experiences can be?
I was told to stop Bisoprolol because I couldn’t tolerate it, but I was given another Beta Blocker to start the next morning as a .Swap ‘ Talk to your Doctor and wishing you all the best
Tehre can be problems when stopping Bisoprolol and usually you are told to slowly wean yourself off them taking fewer tablets over a few weeks or so. However, my cardio/EP told me to stop straight away and I could with no problem - i was on lowest dose but I just couldn't get on with them or any other beta blocker, calcium channel blocker or any rate/rhythm control medication or any combinations of them - tried pretty much all of them over first year or so.
Wow! Sounds like a lot of changes! I am very wary now even doing a swap back. Can’t see that Verapamil is doing very much about keeping my heart rate down.
I was having stomach problems so my doctor allowed me to stop Bisoprolol which I did straightaway, however I also had stomach problems when taking Lansoprazole with Apixaban. As some people on the forum said they didn’t have problems with Apixaban, I stopped the Lansoprazole and am now happily back to normal.
I must admit that I have only been taking medication for a couple of months, as my AFib has not long been diagnosed, so this might explain how I was able to stop Bisoprolol without any ill effects. My doctor didn’t propose an alternative, even though these exist, considering that it was possible in my case. Let your doctor know about your increased heart beat if you still suffer from it. He or she may also propose an alternative to Bisoprolol that might suit you better.
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Are you taking BISOPROLOL for Heart Rate control? What are your experiences with the Pulse Rates on this drug.
Different brands of bisoprolol 
atrial fibrillation then high heart rate 
