too much bisoprolol

[Iainzzz]

upped my bioprolol from 7.5 mg to 15 mg Now even more breathless aching and tired. What is happening?

[BobD Volunteer]

The more you take the worse you will feel. No doubt it is the drug causing your tiredness. 15mg is a very high dose. Who told you to take that much?

[Iainzzz in reply to BobD]

Hospital upped it and stopped digoxin as heart rate wouldn’t come down

[wilsond in reply to Iainzzz]

When you say 'hospital' was this A n E,or Cardiology? Do you see an Electrophysiologist ( better option for our condition)What were your heart rate recordings?

[Buzby62]

That’s an exceptional amount of Bisoprolol, I’m sure I’ve read that 10mg is the usual highest dose but can go up to 20mg in exceptional circumstances. Are you in persistent AF and need to keep the rate down or is that medication to manage episodes of PAF I wonder.

I see you’re a new member, I’ll add a link to all the patient resources, read as much as you can.

heartrhythmalliance.org/afa...

I would start with the AF fact file, Beta blocker info sheet and AF drug information sheets.

Best wishes

[Jetcat in reply to Buzby62]

I’m on 10 mg daily but sometimes have to take an extra 1.25 before bed if Iv had ectopics etc throughout the day.!! The cardiologist said it’s rare that people need more than 10mg daily but it’s not unheard of.👍

[Autumn_Leaves]

You need to be guided by your hospital on this one. If 15mg works in a short term emergency, that’s good, it has done its job. However, 15mg may not be sustainable long term given the side effects but you’ll need to report this and discuss whether tapering the dose whilst keeping an eye on your HR is an option. It’s not possible for anyone to say how much to take because we don’t know your history and what other conditions you might have, what other medications you take, and so on.

[jeanjeannie50]

Do you have something that you can record what your heart rate and BP is right now and let us know? That is a very large dose of bisoprolol to be taking.

Don't forget there is always the NHS 111 number you can ring at any time for advice.

Jean

[Cliff_G]

You need a thorough meds (and arrhythmia) review. I've never been able to stand the slightest dose of BBs. Diltiazem is my far preferred rate controller.

BBs are safe and cheap and always (it seems) a first line approach, but I've lost count of the number of people who have had serious problems with them. They're not even very effective at controlling arrhythmias, a mainstay of the rate control method.

[Jalia]

I'm not surprised that you feel like that. It's a pretty hefty dose. Do take on board the comments made by others , as I'm sure you will.

[wilsond]

Wow! 15mg is really high. Are you meant to take it as a very short term ?Ive never known anyone on 15mg.

No wonder you feel off ! Doubling the dose.

I would be querying this,and reporting the effect ASAP. X

[Bubum in reply to wilsond]

I have persistent AF(100% burden), I’ve been on 15mg/day bisoprolol for 2 years and apart from my fair share of fatigue my heart behaves itself quite well, I have a good cardiologist who I trust…..maybe we should let the experts do their job and stop worrying people…..

[wilsond in reply to Bubum]

I didn't question any professional . I responded to a post asking if anyone had had similar experience and is this commonplace on the dosage prescribed. I suggested querying it for reassurance and also asked which had prescribed it.It is a an unusually high dose.

In my own experience, I have been given medication in error once in hospital, by.a cardiologist which caused another heart arrthymia and had to be corrected a week later by an Electrophysiologist in another hospital after a very bad episode.

EPs are far more appropriate in dealing with arrthymia which is why I suggested it might be helpful .

I think its always best to be as informed as possible about our treatment and be our own advocate if necessary.

I'm glad you are stable now

[Bubum in reply to wilsond]

It’s not an unusually high dose…a high dose granted.

Most of us don’t feel the need to complain about the side effects….more understand the payoff.

If I was not “held back” by my meds then I would cardiac arrest frequently and I don’t want that……

[wilsond in reply to Bubum]

Many do on this forum and have found that switching to another rate control is better possible and after discussing with their specialist. One type of medication doesn't fit all. To just put up with significant side effects can be as bad as the original problem. Obviously if there is absolutely no choice and your condition is as serious as your that's different.

I took bisoprolol (2.5 then 1.25 reduced due to severe breathlessness)for several years to try to correct the mistake made and to work alongside my other arrythmia drug. Once the Flutter was abated I came off gradually .

I have rarely seen other forum members report taking 15mg as a permanent daily dose, and have been on here many years, as others have commented on this post.

[Bubum in reply to wilsond]

You’re missing my point and also assuming that I haven’t “shopped” around for the meds I take, I can’t tolerate Entresto or any arb’s for example ….. I am really not interested in who’s been where for the longest but having things in perspective is important and scaremongering from a non qualified person is not fair….

[wilsond in reply to Bubum]

I merely meant that after quite a long time on here,I've rarely seen such a continously high dose.I am not scaremongering but trying to suggest to a clearly worried oerson the solutions that could be helpful.

Over and out on thus discussion

[Bubum in reply to wilsond]

You’re not qualified to allay people’s worries……over and out as you say, you’ll be telling me you’ve been in the services next 😌

[Goosebumps in reply to Bubum]

You are being offensive towards a long standing contributor on this forum who is trying to support the original poster by explaining their experience of the medication in question.

On the basis of your last statement no one is qualified to even be on this forum or respond to any question so we might as well shut the forum down.

Luckily, most people understand the value of the support given and the intentions of responders.

[Bubum in reply to Goosebumps]

Not meant as offence, just a different perspective….rather than worrying people about a decision taken by a qualified professional regarding their particular circumstances…..

[bantam12 in reply to Bubum]

You are lucky you have “ good cardiologist who I trust” many are not so lucky myself included “ let the experts do their job” if only they did !

[Bubum in reply to bantam12]

Change him/her if you are not comfortable….it’s about you not them…not meaning to be dismissive 😊

[bantam12 in reply to Bubum]

Oh believe me cardiologists are changing all the time in my hospital, never see the same one twice. Unfortunately being a women we are dismissed and not taken seriously but that’s a whole new story.

[Bubum in reply to bantam12]

Hardly a new story, with respect, but I do find it alarming that in this day and age sexism should exist in this environment ☹️

[bantam12 in reply to Bubum]

Indeed, new was the wrong word, I should have said different story, been dealing with the gender bias for years, despite it now being acknowledged nothing changes.

[Bubum in reply to bantam12]

Society makes me shudder sometimes …..😌

[Bubum]

hi

I’ve been on 15mg/day bisoprolol for 2 years now. During this time I have had no “events”, and I’ve had a few. Although I do feel the fatigue, I do have quite an active life, I travel a lot and spend a lot of time in Morocco (a million stairs wherever you go), and as I say I do feel the fatigue…but I have adjusted and work through it and lead a full life and I’m happy with that.

I trust my cardiologist, who said to me “everything I prescribe you has a side effect, what you have to weigh up is whether that side effect is better than the consequences of not taking what I prescribe”

It’s always your choice….please don’t be distracted by comments from non professionals but do listen to your body and your cardiologist…. It’s always your choice.

[Vonnegut in reply to Bubum]

But cardiologists deal with plumbing problems in the heart and ours is an electrical problem so we need the advice of an electrophysiologist. That’s how I was introduced to Flecainide which does keep my heart in order very well.

[Bubum in reply to Vonnegut]

And if you have a combination of the two ?

Trust me I have been up and down every avenue, with due respect

[Vonnegut in reply to Bubum]

Poor you! But, as we know we are all different and I hope you find what works for you as I have. Now the only problem I have is persuading the repeat prescription system to work!

[JOY2THEWORLD49]

Hi

Sounds like you shouldn't be on it. BBs well Metoprolol made me breathless, are well known to make some breathless. M. also proved 186 H/R Day and pauses at night on my normal 47avg bpm.

Introduced to Bisoprolol still no control of H/R.

Introduced to CCB Calcium Channel Blocker Diltiazem 120mg CD great contrlled my H.R day and leaves 47 at night. Kept with Biso... 2.5 at Night but recently BP low so carefully reduced to 1.2 and now No MORE.

An improvement in energy. GEE YES.

Fatigue and energy restoring itself. Some is an improvement for QOL.

I don't know why Drs just increase it.

Take it back and reduce other way and have a 24hr Heart Monitor and an appointment with your cardiologist.

Dr can't give you CCB it needs a cardiologist.

Care as you find the right one for you. I found D.. instant relieve.

cheri JOY. 75. (NZ)

[Fannyphasbees]

I was told 10mg was the highest dose!!

[Dastardly]

I agree with Cliff_G. I had problems with breathlessness when I started on Bisoprolol and was changed to Diltiazem. I recently saw a Cardiologist who informed me that my AF was now permanent, but that the Diltiazem was doing a good job keeping it in check, as well as controlling by BP. Bisoprolol is the standard of care for AF, but some healthcare providers seem reluctant to change away from it.

[Vonnegut]

Bisoprolol does nothing to stop the irregularity in heart rate and 15mg is an amazingly high dose! I had to stop taking 1.25mg daily ( the lowest dose) after just three days as it brought my heat rate down to the low 40s! Have you checked your pulse?

[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 as 3 months on Bisoprolol was horrendous.Some of us just can't tolerate Bisoprolol as it attaches to receptors in the lungs as well as the heart.

[Ppiman]

I guess this will be an attempt to "see what happens" as the doctors try to achieve an optimum result. All will depend upon how symptomatic you feel with the arrhythmia compared with the treatment. It will always be a balance. There are drugs that can suppress the arrhythmia directly, the most common being flecainide, but heart tests are needed before these can be given, and only a specialist can start them. They are generally safe but have more dangerous potential side effects than any beta blocker such as the one you have been given.

I think it's fair to say that bisoprolol is one of the safest drugs to try out when arrhythmias start, but, as you are finding, it can bring side effects its train. The maximum dose for AF is usually 10mg, but 20mg can be given for other illnesses from what I read. The most common dosage, I would guess, is 5mg, and with many on 2.5mg or even 1.25mg (i.e. yours truly).

I seem to recall taking the dosage you are on for a small time when I had atrial flutter. This arrhythmia, originating in the right atrium, is hard to control with drugs but digoxin, and then ablation, came to the rescue (but only for left-sided problems, including AF, to develop later). I can never separate the problems I had with the AFl and the side effects I had from high doses of bisoprolol.

Steve

[violconsort]

My cardiac consultant advised me a number of years ago that 10mg was the maximum dosage within a 24-hour period when taking bisoprolol. Currently, my daily intake is 7.5mg, keeping the extra 2.5mg in reserve should I suffer an AFib episode. Indeed, I experienced such an episode within the last few days, took the extra tablet, and my pulse had returned to normal within 18 hours. Normally, I don't have an issue with tiredness when taking my regular dosage. Given that most people on here agree with 10mg as a maximum, I think it would be wise not to exceed this figure. Hope this helps.