How often and what time of day do you take Bisoprolol?

[kitenski]

I think I've been taking my dosage incorrectly, I've been taking it every 12 hours, vs everything I've read says once a day.

Just wondering what others do and if once a day do they take it at night or in the morning?

regards,

Greg

[bantam12]

I split my dose and take half AM and half PM, works better for me.

[BobD Volunteer]

Once a day is once every 24 hours , not once every 12 hours.

[kitenski in reply to BobD]

correct

[pip_pip]

Protocol says correctly every 12 hours . It might differ according to individual, with doctors support

Phil

[kitenski in reply to pip_pip]

What’s protocol please?

[pip_pip in reply to kitenski]

the official procedure or system (Online dictionary)

[kitenski in reply to pip_pip]

Do you have a link? Both NHS and drugs.com say once daily as does the patient leaflet within my packet.

[pip_pip in reply to kitenski]

Both my GP and my electro-physiologist told me twice a day every 12 hours as a stable dose. I don't have a link. My suggestion is to see your GP or cardiologist and discuss the issue.

Phil

[kitenski in reply to pip_pip]

thanks Phil, as you know I do like to question what the "experts" say, I find it interesting that the patient info leaflet in my box says once a day!

[Tapanac in reply to kitenski]

Once a day is every 24 hours

[Tomred in reply to kitenski]

Hi Kitenski, if Dr say once per day ,thats once in a 24 hr period.

[jeanjeannie50]

My AF nurse told me that Bisoprolol stays in the body for 24 hrs so it can be taken in one dose. However, it can make the person taking it feel tired and splitting it into one half strength tablet every 12 hrs can help prevent that tiredness.

Jean

[Tomred in reply to jeanjeannie50]

Problem Jean, i take 1.25 mg tablet and it is very hard to cut in two ,they are so small, any tips, lol.

[Borderterriorist]

I take mine according to the prescription, so I've taken it once daily (I take it in the morning) and twice daily, eg 5mg bd (am and pm) .

[kitenski in reply to Borderterriorist]

Do you know why the prescription changed?

[Borderterriorist in reply to kitenski]

Yes, unfortunately even on 10mg of bisoprolol taken in the morning, I still had a resting pulse rate of 130bpm, my prescription was changed to 7.5mg twice daily and I had slightly better control but still not good enough so now I'm on 5mg bisoprolol twice daily + digoxin which has improved things.

[Tplongy]

did your doctor or pharmacist not advise you how to take your medication Greg? I guess what other people do is irrelevant really if your own doctor or cardiologist told you to take it in a certain way ?

[kitenski in reply to Tplongy]

It's adapted over time and they've also let me experiment within some boundaries.... What I've found is taking 2.5mg twice a day then about every 2 months I get a funny spell, with ectopics, lots of Afib etc, if I drop down to 1.25 it seems to settle the same day!

Hence wondering about changing the frequency!

[pusillanimous in reply to kitenski]

My Cardiologist says I can take my 1.25mg dose when I feel I need it. So when I feel that my pulse is a little fast and I check it and it is in the 90s , I take my 1,25mg and it comes down rapidly. I'm happiest with a resting HR in the mid 60s to early 70s.

[opal11uk]

I take 10mg each morning around 8 am

[mesally]

I was advised to split the dose, half morning and half night, to minimise side effects. This was by the pharmacist

[LiliH]

10 mg 8 a.m. only

[Suesouth]

7.5 once a day with breakfast

[BrotherThomas]

3.75 mg around 8am

[Easternmost]

Split dose am and pm - for rate control and less drowsy side effect.

[Bladebabe1889]

Hi, when I was first diagnosed I was prescribed it once a day. After a failed cardio version and now in permanent afib I take it twice a day, morning and evening.

[NLGA]

I did use to take my 10mg in 2 lots 12 hours apart but I felt tired all day

Now I take 10mg at 10pm and find they work the same

[mbheart in reply to NLGA]

that's what I do too - 10 mg at 10 PM nightly

[30912]

Once daily for me in the morning as suggested by the hospital at the time of being prescribed it with the proviso that I could split it into two, half morning and the other half in the evening if I feel the effects of the morning dose proves problematic.

[Ppiman]

Each drug is cleared from the body, often by the liver and kidneys. The time it takes for this clearance to fall to 50% of the original dose is calculated for every drug, and is called its "half-life". This then determines the dosage frequency. For bisoprolol, the half-life is 10-12 hours, which translates to a once daily dosing regimen, which is the approved dosage. Also important is that a "stead state" concentration is reached for each drug after a certain time. For bisoprolol, this is five days. Thus, once daily dosing will, after five days, achieve a constant concentration of bisoprolol in the bloodstream.

Splitting the dose into two, and taking it twice a day is, therefore, not required and much less usual, and shouldn't make any difference whatsoever to the drug's effect. But... it is preferred by a few doctors and patients. I can't imagine why, but some of us do have different liver enzymes and kidney function, so perhaps it is helpful at times?

I take 1.25mg each morning, and an extra dose if my AF is fast and uncomfortable.

Steve

[Auriculaire in reply to Ppiman]

That accounts for why the nasty side effects I had on Bisoprolol didn't kick in till I had been on it for about a week. When they gave it me in the hospital I felt fine the first few days!

[Ppiman in reply to Auriculaire]

I wonder whether some of the side effects are more a result of the heart-rate and BP lowering effects of the drug? That's what seems to be the case with me.

I have bradycardia, probably from the bundle block I have (LBBB). I used to think that "bradycardia" meant only that my heart rate drops below 60 at times, which surely it does. However, I now think it is more insidious than that, and more to do with the rate being too low for what my body is "asking for", as it were, in terms of blood supply. I get "side effects" such as slight light-headedness, a "distanced" feeling and, of course, tiredness, but I suspect from the bradycardia rather than the bisoprolol.

How are all your ailments these days? You struggle with a lot of pain, I think?

Steve

[Auriculaire in reply to Ppiman]

Given that my resting heart rate in NSR is between 60 -70 bpm and my blood pressure has always been fine I do not see the interest in having either lowered by a drug. I also used to get bad pains in my legs on Bisoprolol. Jean mentioned those too. At the moment I feel I'm going through another floxing cycle. I optimistically thought they had stopped but all my old symptoms have come back. Awful rib pain , poorer digestion, neuropathy in my legs and feet. At least the episodes are much further apart now but it was foolish to think I might have healed even after 9 years. My afib is coming more frequently but is far less symptomatic . I don't really know what to do about it as it doesn't really bother me and I don't want an ablation. The only thing that bothers me is the Kardia giving the high heart rate even though I can't feel it. Nebivolol does not work very well at bringing it down. A friend died 10 days ago and it was his funeral last week. I was dreading the funeral but the afib struck the day after when I felt much more relaxed!

[kitenski in reply to Ppiman]

Steve,

With a 12 hour half life then potentially taking it every 12 hours means you have more in your system? Ie take 10mg 12 hours later you have 5mg ie half left in your system, so you take another 10mg and for a period you’d have 15mg in your body etc etc

[Ppiman in reply to kitenski]

Yes - I guess splitting the dose after the "steady state" forms in the system, will not be any different from taking the two in one go? I am guessing there might be something in splitting the dose as a few here do that, but it's hard to see what it can do.

You are right, though, in what you say - or it seems so. It seems not the best thing to do the more I think about it.

Steve

[LindyMc]

When I started taking it (because my resting pulse had dived bombed and I felt dreadful), I was prescribed 1 or 2 1.25 once or twice a day until I had sorted out what worked.

[OzJames]

i'm not sure if there are 2 types of Bisoprolol? I take metoprolol tartrate which is immediate release taken twice a day and there's another type Metoprolol succinate is slow release and taken once a day

[Ppiman in reply to OzJames]

No - bisoprolol has a longer half life that metoprolol, I gather, so to make it once-a-day, there is a sustained release version of that. In the USA, metoprolol seems the preferred beta-blocker for AF, whereas in Europe it is - mostly - bisoprolol.

Steve

[OzJames in reply to Ppiman]

Thanks for explaining Steve

[riverside22]

mine is twice, one with breakfast, and one at 7pm

[Vonnegut]

As I’ve written here before, I had to stop taking one of the lowest dose of Bisoprolol (1.25 mg) after only three days as it brought my heart rate down too low! We are all very different!

[hausjac]

I take my dose - 7.5mg - last thing at night so I don't get the beta blocker side effects

[iohnl]

3.75mg twice a day, 8am and 8pm.

[GettingTooOld]

1.25mg twice a day,

[GeordieBairn]

Hi I was on 10mg once a day but as my heart rate was higher on waking my cardiologist changed it to 5mg twice daily. I also take 2.50mg of digoxin in the morning as my afib is very hard to control. So I think it just depends on the patient

[Polomad]

I take it once a day in the morning. My cardiologist told me to avoid taking it within 2 hours of any blood pressure pills.

[Natali999]

Hi,

My mum takes a 5mg dosage of Bisop.

She takes 2.5mg in the morning and 2.5mg late afternoon.

I've not heard every 12 hours. What does your dosage box state?

[Pab1]

I was prescribed 5mg once a day in the morning and my AF and Aflutter were generally ok but found I was having a lot of PACs and PVCs and mostly at night while asleep. (Monitored using a Well heart monitor). So I split the dose t half morning and half at bed time. It made no real difference. I tried taking the full amount at bedtime but still had most PVCs and PACs at night and more in the day so I went back to 5mg each morning as PVCs and PACs do not cause me any problem whilst asleep. I just find it curious that I have most of my irregular heartbeats while asleep. If I drop off during the 6 pm news for example the same thing happens - strange!

[Tapanac]

depends on what your cardiologist or EP says and on your prescription

I take mine once a day in the morning as my heart rate went too low when I was asleep

All the best

[DiyChas]

I believe taking it in the morning made me lethargic and slightly dizzy when rising.After reducing intake and taking at night only, no lethargy and very little dizzyness.

But slight rise in heart rate (now ~80).

My cardiologist accept my changes.

Everyone is different. Consult your medical specialist.

[TracyAdmin Partner]

Hello and thank you for your message. I am pleased so many members have offered their advice about taking medication based upon their own experiences. It is important to take your medication at regular intervals each day. You need to find a time that suits you personally, if you have any questions regarding your medication, please check with a pharmacist as they are dealing with medications on a regular basis.

If you would like to contact the Patient Services Team for further advice, please contact us:

01789 867 502

[e-mail]

Kind regards

TracyAdmin

[Qualipop]

GP told me to take it at night. If I took it on a morning I was like a zombie but even at night, I struggled to wake up next day.

[Manycrafts]

Mine was prescribed due to my heart rate still staying high 24 hours after a panic attack. It was prescribed once a day at first in the mornings, but I was waking during the night on the verge of a panic attack with my heart rate beginning to climb so a locum doctor told me to split the dose and take half in the morning and half at bedtime. Thankfully this worked and so I have continued with twice a day, 12 hours apart since. It also reduced the tendency to indigestion after taking the full dose at once and sometimes slight dizziness an hour afterwards.

[Swimsyroke]

I take 1.25 in the morning as my EP Consultant said it's time life is 17 hrs

[Wilkie1]

I take 2.5 mg once daily. As stated elsewhere in the reponses Bisoprolol reaches steady-state concentrations within 5 days of administration so once daily is sufficient to keep concentrations in a therapeutic range. In terms of timing I used to take it in the mornings, which is stated as a preference in the information leaflet, however I have moved that to 8pm. My thinking behind that was that Bisoprolol reaches peak plasma concentrations within 2–4 hours and my Afib episodes were starting between 10pm and 9am so I decided to move the timing of medication to reflect the timing of the higher risk of Afib occurrence.

[Redders]

I take 2.5 mg once a day at anytime.

[JezzaJezza]

take it as per the prescribing doctor instructions. Beware of well meaning GPs - my cardiologist prescribed 2.5mg of bisoprolol to control palpitations and was extremely effective. My GP said my resting heart rate of 42 was too low (I have no symptoms of bradycardia) and she reduced it to 1.25mg. Within 2 days the palpitations were back. One week later I had a review with the cardiologist and she went MENTAL, she was really angry with the GP. I’m now back on 2.5mg and quelle surprise…..no more palpitations.

[Camelia23]

I've been prescribed 1.25 am and 2.5 pm

[Tellingfibs]

When I had a low dose of Bisoprolol I took it once a day, in the evenings ( although the leaflet in the packet says mornings. ) My GP said either was fine. When my dose increased, my cardiologist said to take half the dose in the morning and half the dose in the evening.

[Agent_47]

10mg, in the morning.Used to be evenings, but morning works better.