Newly diagnosed and just been to see a GP to collect bisoprolol. He's put me on 2 x1.25mg but suggested I start with just one a day. I've read horror stories about side effects, and as a busy person (I teach) I can't be laid low!
I think I'm most vulnerable to AF / higher heart rate in the morning, so wondering when is best to take them? Would bedtime be better so it's in my system by morning? Also worried about BP and HR going too low overnight - they are usually in the normal range.
What is your current resting heart rate. 2.5 mgs bisoprolol reduces my resting heart rate by 8 bpm. The half life of bisoprolol is about 12 hours. It will take about 4 days to reach steady state serum levels. To my mind it is the tachycardia that can come with afib that is the primary factor which can negatively affect the long term health of the heart. Rate control is definitely helpful. Alot of people experience afib during their sleep, they wake up in afib.
Accirding to my smartwatch, my resting heart rate averages 63bpm. However it has been higher recently because I've been so anxious about all this!
63 is a good HR.Is that with 1.25mg Bisoprolol per day?
How long have you been on it?
I would suggest you ask your GP to have you not take the other side.
Might be worthwhile getting a session with a Cardiologist.
I take it at night to reduce possible fatique.
I haven't started bisoprolol yet- 63 is my normal average resting HR when in sinus. I've only had one documented episode of AF so far. Blood pressure average 123/75
Hi
She/he hasn't started meds yet, She is offered to start with 1.25mg.
We can't get 1.25mg Bisoprolol here in NZ. We need to half the 2.5mg.
cheri JOY
Hope your's are larger than ours. I had to ask my 5mg to be cut in half.
Hi
I thought it would be difficult the white 2.5mg.
Look for the line, hold pill firm. Try foreword but I think it breaks going back.
I do 5 at a time but of course I'm luck if I get an exact 1/2. I put the 1/2s in a differeny container marked with a 1/2.
I use my old synthyroid bottles which have a 'moisture' pallet inside.
cheri JOY
1.25mg bisoprolol is only a tiny dose so don't worry too much . You may well not notice any difference.
Years ago when I was on the cardiac ward and taking 1.25 bisop, I recall the young doc being quite amused at such a low dose and saying that I may as well just put it on the table and look at it for all the good it would do! I disagreed with him as I felt it was helping a bit at that time. No undesirable effects at that dose.
Well 1.25 of Bisoprolol, made me unable to function, dropped my heart rate too low,
We are all different in our reaction to drugs.
Absolutely. I certainly can't function with 5mg whereas others are fine taking 10mg daily.
Yup, it did the same to me. Couldn't get out of bed. Bradycardia.
It slows the HR, that’s all. You can fearmonger yourself into AF and develop health anxiety by “reading horror stories”. A high HR when in fast AF isn’t good for your heart, but if you want to read horror stories I recommend going to the library. I’m sure you’ll find a horror section there. Bisoprolol can lower your BP, so that may be a consideration but you can monitor that at home. Low BP is less than 90/60.
Yes I was a teacher and bisoprolol was better at night for me, on Dr's advice. I was fine on 1.25mg daily.Not on it any more due to a successful AFlutter ablation 2022.
Bisoprolol is a rate control drug BTW . Do you have high rate AF?
If its not and your problem is weird fluctuations ( palpitations)then you need a plan of treatment to tackle that.
Who diagnosed you?
GPs are not necessarily well placed to direct your treatment.
An Electrophysiologist (EP).is the best option.
X
Hi
Um Electrophysiologist will push ablation.
A cardiologist is an all rounder. He will check via an ECHO to make sure you can have a cardioversion, ablation and/or arrythmic med.
I can't have any of the above as I have a severely dilated left atrium.
BBs and Bisoprolol didn't work as a rate control. 156 to high. Under 100 is control.
It works as a BO contrl.
cheri JOY
Exact. EP’s sell ablations. More profit than prescribing medication.
I live in the UK so will only see the Arrhythmia nurse for now. I could pay to see a private EP or cardiologist- might well do that in future. I couldn't afford a privately funded ablation though.
I, for myself, would not consider an ablation, unless I would become so symptomatic that AF made my life really miserable.
It still is an invasive procedure with considerable possible risks and side effects, a less than stellar success rate and a serious dose of harmful radiation.
You have the right to a referral to a specialist of your choice in the NHS. Your GP can refer you. If you decide to refer yourself,it costs about £250and after initial consultation ( about half an hour of time well spent) They can transfer you to their NHS list for further investigation or treatment plan.
Hi
Um.
Too many 0s Wilsond.
250.00 pounds I think.
I paid $350 to a Heart Specialist who gave me an hour.
Well known for his 'success' with AF and heart issues. Used to work for our base hospital.
Where hospital H/Specialists have failed.
Mine failed me and left me on Bisoprolol with a h/rate of 156. I even wrote to her after she had received a report of a 24hr heart monitor. My loctum referred me to a very interested Chinese H/Specialist.
I have never looked back after being introduced to CCB Ditiazem.
cheri JOY
Not true in the UK . The NHS doesn't charge for operations, and if over 60 all medication is free. I was never pushed into ablation route it was a two way decision after other options had been tried.Electrophysiologists are cardiologists with extra training in arrythmia, so Joy, with an EP you get the best of both worlds.
And the NHS is not charged for the procedure?? My best friend, a cardiologist, calls ablations ‘the cash cow of the cathlabs’. But we both agree that for some patients it may be a last resort solution, if their quality of life is terribly influenced by very symptomatic, permanent AF
I don't understand your question. The NHS provides funding for all health care, paid for by National Insurance contributions and also from central government. Consultants are paid under contract to the NHS. Not per operation/ procedure so there is no cash incentive. In other countries, and obviously here in the UK in private clinics, consultants earn their salary differently.
I had a long route to ablation for various reasons, and when AF and AFlutter impacted greatly, and suddenly got worse,decision was made. Its primarily QOL yes but sustained AF over time weakens and enlarges the ventricle and results in heart failure ( as fatally for my mum and Nanna, ablation not being offered so widely then)
It wasn't last chance saloon for me but as ablation for AFlutter is 95% success rate,no brainer and no AFl since . AF breakthrough counted on one hand since both done June 2022.
On anticoagulants still,as is protocol in the UK( thank god)
Not in the UK they don't. Funds too low and waiting lists too long 😉
Do EP’s perform ablations for free?
In the UK, yes. It's what the NHS is all about. Outcomes are important though, so they do screen by need and suitability. I've had 2 on the NHS and am very grateful for it!
May I find it extremely hard to believe that EP’s and cardiologists do not get paid for their work and that hospitals offer the use of their very expensive equipment for free?
Of course not. But we do not pay them directly. We pay our taxes and it is organised by the government. I can assure you I didn't pay for either of mine but it was funded by our National Health Service.
That’s my point. For EP’s and hospitals expensive procedures like stinting and ablations are real cash cows. No matter who pays it. The final bill is always paid by the tax payer, anyway.
Electrophysiologists are cardiologists with extra training so you get the best of both. They do not push ablation here as it is very expensive ( circa 15 to 20k) but free to us on the nhs,as is all medication after 60.EPs are heart experts and arrhythmia experts too,and very thorough.
Not in the UK, my EP wouldn't even do an ablation privately as he couldn't guarantee that it would be successful so I waited six months to have it done by the NHS completely free of charge. Good call by my EP, who incidentally I saw on the NHS as I was found to have atypical A Flutter and he was unable to do the usual ablation so I had a cardioversion instead. I'm always amazed to see the number of cardioversions and ablations that people are having, that just doesn't happen here. I'm on an 8 month waiting list for an AV Node ablation, I had the pacemaker fitted in May all foc. It's a very different system in the UK.
The cure for anxiety is the right amount of information not too little or too much.
I suspect you have too little at present, so book a prompt private appointment with a trusted cardiologist; write down your Q's (incl one on Flecainide) and the answers before leaving the consultation. Also best to keep an AF diary for the week before seeing him/her to form a basis of your discusssions.
Good luck and stay here as good balanced experiences.
Bisoprolol, some people take it and have no issues, some seem very sensitive to it.
I do think it saps my energy ( a little) and on occasions makes my momentarily woozy.
But the protection it gives outweighs the annoyance of it.
I keep as hydrated as possible.
Some find taking it at night before bed helps with the symptoms.
Once you are on bisoprolol it stays in the system for a few days ( I asked my cardiologist). He said take it morning or night but be consistent about when you take it.
Try it and if it doesn't suit you there are other alternative betablockers.
Hi
Bisoprolol better at night. They have a 1/2 day life. Chemist said.
I take CCB Diltiazem AM 120mgCD for heart rate control.
Bisoprolol PM for BP control.
cherio JOY 75 (NZ)
My very experienced AF nurse told me that Bisoprolol stays in the body for 24hrs and Metoprolol (which I take now) for 12 hrs.
Your dose of Bisoprolol is very low. I'd give it a try.
Hi
It's the other way, Jean.
I was talking to my Chemist today.
Bisoprolol covers 12 hours only.
Metoprolol 24 hours.
cherio JOY
half life is different to effectiveness, half life varies depending on the effectiveness of the patient's renal function so it's often longer for older people than for a fit young person. tbh I think you are both saying the same thing but in different ways. For most people a single dose daily is effective.
Have been on 1.25 Bisoprolol for 7 months all good feel better than I was also on edoxaban all good
Sometimes too much information that conflicts isn’t helpful, others experience will not be yours everyone is different. I would take the meds suggested by your doctor and then you will have your own experience to work with. I take 1.25 Bisop myself and have never noticed any negative experience and until you try you will not know. Best of luck with your treatment.
I couldn't function on bisoprolol at all and switched to metoprolol, which may be an option for you. It still slowed me down but it didn't make me non-functional (unable to get out of bed) the way bisoprolol did. Can you hold off on beginning the dose until it's school hols, so you have some time to adjust? Having said that -- even on metoprolol, my adjustment period was about six months, not a week or even six weeks.
When first diagnosed with paroxysmal AF I was automatically prescribed 2.5mg Biso by Cardiology, but didn’t take that dose. After talking to my GP I started instead on 1.25mg daily (using a pill splitter) that I took in the morning. It still reduced my resting heart rate into the 40s. Once I had had an Echo showing heart in good shape I stopped Biso altogether but started an ACE-inhibitor to keep my blood pressure down. I just put up with the infrequent brief AF episodes when they happen (at 180-200 bpm for under 30 mins) because thus far I revert to NSR without intervention.
Your BP and resting heart rate look great without any medication. You can experiment with Bisoprolol, but you need an echocardiogram (ultrasound) to check on structure and operation of the heart (ask to be referred). Once you know the results you and the medics can better decide whether your heart rate in AF needs controlling. Depends on how long your PAF episodes last, at what bpm, and what shape your heart is in. A number of us on here think that betablockers are handed out like sweeties to newly diagnosed AF sufferers who don’t need them (a bit like antibiotics used to be dispensed without knowing if they were really needed). They won’t do you any harm but might make you feel lethargic.
Good luck!
Welcome to the Forum - I am sure many of the members here will welcome you and offer advice based upon their own experiences.
AF affects everyone in different ways, this is also reflected in the medications to treat and help manage the symptoms: Bisoprolol is a beta blocker and often prescribed in the treatment of AF. Some of the well known common side effects of beta blockers, specifically Bisoprolol, can include:
Dizziness, weakness, drowsiness or fatigue and shortness of breath. There will be a list of side effects in your medication packet which you should read thoroughly before commencing. If you have any questions about your medication, please speak to the Pharmacist or your Doctor.
For further details about some of the medication for AF, please download: 'AF Drug Information' booklet
UK & International: api.heartrhythmalliance.org...
US: api.heartrhythmalliance.org...
Kind regards
TracyAdmin
My Bisoprolol 2.5mg new white pill and manufactured by IPCA comes in an OPENED plastic container with no paperwork.
This new one dissolves as soon as it hits the tongue.
On google it says you can dissolve it in water and add to food. Amother recommendaion says not to chew it!
Confused.
I've suddenly getting dizziness and its from the new Bisoprolol.
My BP goes down to 103/62! 2 out of 4 testings 10 minutes apart.
Dizziness picking up the TTennis ball. I have to wait 3-5 minutes.
My Special Nov last year said I could drop it when I cornered him about low heart rate.
But this is BP low .
cherio JOY. 75. (NZ)
Hello thank you for your message, I would not delay in contacting your doctor about the recent changes, please retain all the packaging etc to present if needed.
Kind regards
Tracy Admin
hi
I’m in 5mg morning and night
I have taken 10mg at night for weeks before as I didn’t get so tired in the day but advised to sit them by the AF nurse
Keep a close eye on your BP once you start and more importantly how you feel. My normal BP was mid 50’s and 2.5mg sent it down to 40’s and for me this felt bloody awful and literally like a zombie - spaced out and zero energy - no GP follow up after starting it so I finally managed to get an appt - advise was to drop it to 1.25mg. This helped a little but bit not enough but taking at night seemed to help a bit more through the day but HR still too low. post HA the hospital queried the Bisoprolol and said I shouldn’t be on it as brought HR too low- came off and made a massive difference to me - think it very much depends how you react to it so my advise it start it slowly, keep a close record of HR and how you feel - If you’re Ok and you might be all good but if you’re not feeling ok in it get back to GP
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