splitting the dose of bisoprolol?

[Scrabblefiend]

I am just wondering, as I’m continuing to feel pretty comatose on this, whether it’s worth asking the doc if I could split the dose and take it morning and evening rather than having it all in the morning? Anyone tried this?? Thanks!

[Paulbounce]

I know the answer Scrabble but I'm not a doctor - he/she is the best person to ask. I think you will get the answer you want and I know what I would do

Paul

PS. To slow down the rate of how quickly your body aborbs the medication, take it after food. Again check with your medic.

[jeanjeannie50]

What dose of Bisoprolol are you taking?

[Scrabblefiend in reply to jeanjeannie50]

Quite small 2.5 a day. Started on 1.25 and then it was increased

[jeanjeannie50 in reply to Scrabblefiend]

I know a lot of members here change taking their Bisoprolol to night time. I'd ask your GP if it would be ok for you to do that.

[Scrabblefiend in reply to jeanjeannie50]

Thanks, good idea!

[BenHall1 in reply to Scrabblefiend]

15 years ago when originally prescribed Bisoprolol I was prescribed to taking it in the morning. All rather strange BUT some months after starting it I developed full flow, random nose bleeds which usually only occurred around mid morning, but not on a daily basis. I went and saw my GP and she looked up in her book of magic potions and brews ... and said take it at night which I did for the next 13 years without a problem. I am now on quite a different beta blocker - (Sotalol 80mgs) BUT - I now split that as prescribed by my new Cardiac Consultant. 40mg in morning and 40mg at night. No sweat there. If you can't get anywhere with your GP at this time of year you could try checking with your prescribing pharmacist I suppose.

[OzJames]

are you on a slow release so hence one a day. I take metoprolol which is not slow release and hence take 2 lower doses a day

[mesally]

My pharmacist recommended the twice a day approach, am and pm, to minimise these side effects

[Ewloe]

the doctors are happy with me taking 2.5mg bisoprolol once in the morning and then again at bedtime. It gives even coverage over 24hours and 5mg in one hit was lowering my blood pressure to silly figures. I definitely feel better doing it like this.

[30912]

I was given the choice when discharged from hospital in August. 5mg a day either in the morning or half twice a day if you find that it causes any issues taking it all at once. I chose the latter although switched to Sotolol later under the advice of a cardiologist.

[JOY2THEWORLD49]

Hi

Have you got low blood pressure??

I was on 2.5mg PM with CCB Diltiazem AM 120mgCD.

I had trouble with waiting for vision to return after picking up ping pong ball and closing my eyes and getting 1/2 vertigo. Also stopping during walk as it felt energy draining.

When I kept an eye on BP ot was going low.

Eventually I 1/2ed it and had that for a week. Still kept going low so I stopped it.

It's quite a 'heavy' drug. It didn't control my heart rate 156 avg day.

Maybe you only need 1/2 the dose.

CCB Diltiazem controls both my heart rate dramatically and some BP.

cherio JOY. 75. (NZ)

[Scrabblefiend in reply to JOY2THEWORLD49]

Hello Joy, I suppose it all depends what counts as low BP. Alongside bisoprolol I am on ramipril to reduce it and that seems to work, bringing it to the 120/75 zone. Your stopping on a walk because you feel drained of energy is just where I am now! The bisoprolol has reduced my HR very effectively, steadily low 50s.

[JOY2THEWORLD49 in reply to Scrabblefiend]

Hi there

If you have any sort of Asthma or ecezma in your ancestory it would be the biso,, or ramipril. The ramipril is an ACE blocker. Any coughing? I started with an ACE in 2008 but was changed to a beta blocker.

HR @ low 50s is over the top for a start,

You have in fact both types of blockers working on BP and H/R.

I agree definitely use your own persuasion or Dr to reduce Biso... again but then get an ECG.

Why was your Biso... increased?

Sometimes it is trial and error. But your H/R is too low DAY.

cheri JOY. 75. (NZ)

[Ducky2003]

I felt dreadful on Bisoprolol, breathless and lethargic. Even climbing the stairs felt like climbing the North face of the Eiger. Pharmacist recommended asking consultant to change me to Diltiazem which, thankfully, he did.

Some of us just can't tolerate Bisoprolol as it attaches to receptors in the lungs as well as the heart.

[Redactrice in reply to Ducky2003]

Yes, it had the same effect on me. I somehow persevered for six weeks while waiting to see a cardiologist, who immediately agreed with me that it did not suit me and I needed a different drug. Metoprolol is not great but it's less extreme; on bisoprolol I could barely get out of bed.

[Ducky2003 in reply to Redactrice]

I was stuck with it for 3 months and it was only a casual conversation with the pharmacist, that produced this information about the receptors in the lungs.It was a random cardiologist I had the appointment with and dont think he was impressed at me telling him I wanted off Bisoprolol and Diltiazem instead........ he actually said "what do you know about it?" I soon set him straight, he shut up and gave me the Diltiazem. 😊

[Redactrice in reply to Ducky2003]

Well done for standing your ground. I have had one or two similar experiences. Not all cardiologists are experts in arrhythmia, much less the medics in A&E. Few have been as patronizing to me as the random cardiologist you saw. I got that vibe from the first one I saw, who was meant to be in charge of my case. After three appointments I requested a different one.

[Ducky2003 in reply to Redactrice]

That was in the early days of AF (8.5 years ago). Fortunately, since then, I've been under a great team with a fantastic EP.😊

[Rosie0202 in reply to Ducky2003]

Hi

I too get very tired and breathless on exertion and have been taking Bisoprolol for about 3 years now. With my GP's consent my current dose is 3.75mg in the morning and 1.25mg at night. I chose this because my episodes of AF usually started very early morning (around 5am) so I wanted some overnight protection. My AF is now persistent and I don't think I'm ever in normal sinus rhythym as a result. My heart has enlarged during that time and I have some fluid around the heart. Nothing major. I am interested in the comment about receptors in thelungs. Can you elaborate please as I now have some lung problems and not sure if it's related to bisoprolol.

[Ducky2003 in reply to Rosie0202]

My pharmacist told me that with beta blockers, some are cardiac specific and others can interfere with lung function so, folk with asthma have to take cardiac specific ones.Bisoprolol is supposed to be cardiac specific but, with some of us, it does attach to lung receptors as well.

I now have an enlarged heart and awaiting mitral valve repair surgery as a result, but my problem with Bisoprolol was 8 years ago and fortunately, I only ended up taking it for 3 months. I take my Diltiazem twice daily and its a slow release version.

That's what was explained to me so maybe gave a chat with your pharmacist if you want something more in depth. Better to speak to them than GP as they know the medications better.

[Magson in reply to Ducky2003]

I was stuck with Bisopropol for about 18 months and it was a small dose of 1.25g per day. Plenty of tiredness, lethargy and slow heartbeats. Glad to get rid of it!

[Vonnegut]

You don’t mention the dose of Bisoprolol you are on but I only took the lowest dose of 1.25mg for three days before I popped in to see the pharmacist who had told me to do so if I had any concerns. He took my pulse and told me to stop taking it and a doctor at the surgery agreed! They didn’t come up with anything else which is how I came to consult the lovely EP privately, who, having introduced me to having a smartphone and a Kardia and having seen the reading of my heart in AF, sent a prescription for Flecainide to my surgery for me, to take as a PiP, when it stopped episodes in a few hours. Now that I take it regularly, it has virtually put an end to episodes and I have managed to reduce the first dose of the day to 50mg keeping 100mg in the evening. And the phone is a great companion too but thanks for reminding me of Scrabble which we haven’t played for ages and it’s that time of year.

[Tapanac]

I had a call from consultant yesterday as they wanted to up my bisoprolol and he suggested splitting the dose morning and night.

I was on 1.25 but they wanted to change to 2.5 that’s when consultant said 1.25 morning and night as I was feeling lethargic snd legs were like walking through treacle even though that is still a very low dose

No problem

Xx

[KiriKaboom]

I was recently diagnosed with AF and started on 1.25mg Bisoprolol in the morning. This has since been increased twice to 2.5mg then 3.75mg taken in the morning. I began to have some palpitations in the early hours of the morning and at a medication review with my GP we agreed to split the newly increased dose and I now take 2.5mg at 9am and 9pm. This has worked really well for me and I no longer suffer the side effects I had when first taking Bisoprolol and have very few episodes of palpitations and none at night. To me, splitting the dose makes sense because Bisoprolol has a half life of approximately 10 hours.

Please see your GP before you make any changes to your meds!

[Redactrice]

Yes, talk to your cardiologist, who may switch you to something else entirely, as mine did because even the 1.25 dose of bisoprolol twice a day made me a zombie.

[Swamps]

after bouts of AF and Tachycardia I was placed on Bisoprolol and took it for a few days but my pulse at night was going as low as 28 BPM 35 - 45 daytime and I was absolutely exhausted all the time

I visited the GP Who agreed I had done the right thing and that I was a bit of an anomaly

Hence me being moved up the ablation list from which I have fortunately not looked back from in 10 years

That said my point is go back to the GP They prescribed me in good faith but were happy to admit it’s not right for everyone….

Some trial and error is obviously involved

And check your pulse it should be around 70BPM but down to 55/60 is OK

If it’s low 50’s or into the 40’s that could be the tiredness issue

I’m not a Dr just someone who has had Bisoprolol cause me more issues than what it was treating

So don’t do anything without consulting your GP

Good luck

[Efka]

Use split dose here, only on 1.25 so have to cut the pills in half so take 0.625 morning and night with the ok of the cardiologist.

[Manycrafts]

I've been taking 5mg Bisoprolol for 10 years. Mine was not for AFIB but for Sinus Node Tachycardia which occured in a panic attack, when my heart rate didn't go back to normal again. The medication was to slow my heart rate in my case. I started by taking the whole dose in the mornings, but found at night I was waking on what felt like the brink of another panic attack and I was also feeling quite dizzy and nauseous a little while after taking it. For the first 12 months I slept sitting up which helped. Anyway, after a few months taking it, a locum doctor suggested that, as I was getting panic symptoms at night, it might help to take 2.5 in the morning and 2.5 at night, which is what I have done for the past 10 years. I have had no problems and find that any dizziness and nauseousness are much less and very infrequent now.

[Scrabblefiend]

so I saw my GP today and have the green light to split the Bisoprolol dose and take half (1.25 mg) in the morning and half in the evening. If that doesn’t address the lethargy then we’ll try reducing to just 1.25 mg per day but as he wisely says “Baby steps “. Thanks all for engaging!