As I am having sleeping problem with Bisoprolol, It is suggested me to try Diltiazem , anyone is and are taken it at what dose level and what kind of side effects they have . It is for my information only before I ask the GP to change it or he suggested to me . I do not want to jump from one problem to others , If anyone has tried other alternative to Bisoprolol.
please share your experience
Thank you
I was on 120 mg (sustained release version) prior to my recent ablation and 60 mg after (along with Flecainide after). I get bad asthma with Bisoprolol but not with Diltiazem, and it slows my heart rate a little, rather than the huge slowing with Bisoprolol. The only side effect I get is swollen feet and ankles, and I will ask my EP if I could change to Verapamil. No sleep problems with either, but my Bisoprolol dose was low (1.25mg).
Thanks sharing your experience,how bad are your feet , does it stop you the long walk as I am a keen walker , also how often you get feet problem and how you deal with them
The feet aren't too bad, thanks. I'm also on Epleronone which as a diuretic keeps the swelling down. My left is worst as that's the leg they took a vein from for my bypass, the right is rarely a problem. I really only get a problem if the Epleronone is overdoing it on my BP and I have to back off. Walking is great to help prevent foot swelling in the first plave, or to resolve it, the muscle use helps pump the excess fluid away. If my feet have blown up a bit, I get them back under control by walking, elevation, and the Epleronone. Tightening my boot laces for walking also helps a bit!
Hello Cliff just seen your post and interested to read about your asthma response to bisoprolol I have had asthma symptoms ever since my bisoprolol was increased a few months ago but gp dismissed it until I had him split my 10mg dose to 2, 5mg daily and I isolated these from my other meds (digoxin, furosemide and edoxaban) about 55 minutes after taking bisoprolol my throat got tight and coughing started could not hold a conversation, it passed off a few hours after the morning dose and then started again after the evening dose I kept a chart for 2 weeks and my gp has finally agreed that bisoprolol was closing airways, never had asthma in my life now on Friday had to stop digoxin as it can't be taken with dilitazem that day took 2 days of bisoprolol and started dilitazem on Monday been given an inhaler but been off bisoprolol 2 days now but still breathing problems is this the kind of thing you had on bisoprolol please?
I'm quite surprised ypur GP didn't acknowledge the chance of Bisoprolol causing asthma, it's well known.
All through my early years of AF I was always kept away from beta blockers for this reason (I have allergic asthma in contact with cats etc). After I had my dissection I was put on Metoprolol, which was abroad so they didn't have my history. I seemed to manage this ok, though I did need daily inhalers, later changed to bisporolol. But I stopped it after 18 months as it was really slowing me down, heavy legs etc. Much later I tried it again for my AF, as I thought the inhalers would be enough. No chance. Within 3 days my chest was really tight and I was changed to Diltiazem. It took a couple of weeks to get rid of the bad asthma, but it's still there in the background, worst lying down.
Thank you for your reply this has been all new to me as never had allergies or asthma in my life before I am hoping this settles down as the bisoprolol comes out of my system really concerned I am going to be left with it permanently. When this started could not find anything on the forum relating to this problem so that's why I picked up on your post thanks again
I went back to Bisoprolol after trying Diltiazem as it made my heart race.
That is interesting , as currently my sitting HR is ~71 but it race to 100 just going up stairs,
So Diltiazem may not be good alternative .
Diltiazem shouldn't make the heart race, this may have been a contrast between (perhaps a fair dose of?) Bisoprolol and Diltiazem. Not a reason to not try Diltiazem, in my view.
Nope it made my heart race, I was on 1.25 Bisoprolol and rate fine at 60-70 Diltiazem took it over 100 and it didn’t settle. Confirmed and agreed by cardiologist, it can happen but everyone is different so have to try it.
Diltiazem reduces heart rate and I don't think 100 is that high when climbing stairs.I took Diltiazem 180 mg for 6-7 years as the only med other than anti coagulant for my AF.
Yes I possibly had some slight ankle swelling but not a major problem.
I am now in NSR and no longer take the Diltiazem.
I could never cope with Beta blockers as slowed me down too much.
Hi papillone, I take Diltiazem it was prescribed for me last December after 16 months on Bisoprolol in varying doses. The side effects were few, maybe some indigestion at first and probably a few withdrawal symptoms as I adjusted to this new drug. I was started on 60mg modified release once or twice a day depending on my Afib which is paroxysmal. The plus side for me was it dropped my blood pressure to normal levels, the Bisoprolol caused me a lot of health issues, I could only manage to tolerate 1.25mg after being on 5mg. Even on such a low dose I had sleepless nights, maybe once a week, not at the level you are at. How is your heart rate, has it come down to an acceptable BPM? On 5mg I ended up in hospital with syncope caused through bradycardia and postural hypotension, I was told the dose was too high and adjusted down to 1.25mg. Is it possible for you to be able to adjust the dose but still achieve a lower heart rate? I certainly do not feel the Diltiazem has affected my sleep unlike the Bisoprolol so I am quite happy so far. Regards Kathleen
Thank you for your response
My BP is most of the time OK 124/75 HR is ~ 72 as I mentioned before I live walking so the with Diltiazem is swelling do you this if so how bad is
ho
No swelling at all, I had an allergic reaction for a few days but just took antihistamines and it went away and ok since, just my body getting used to a calcium channel blocker. I too love walking with my husband and can report no adverse issues with this drug, it seems to be a lot kinder to me than Bisoprolol. There are other beta blockers you know that may suit you better, it is all trial and error until we find the right treatment. If sleeping at night is difficult is it possible for you to nap through the day? Regards Kathleen
Thank you
I take 120 mg of extended-release diltiazem once a day for the management of paroxysmal AFl/AF. This medication has not affected my sleep, but it has lowered my blood pressure though I do not experience symptoms like faintness. The first month taking it I did feel tired but after this my body became use to it and that disappeared. The medication has effectively helped keep my heart rate in sync. And thankfully has not caused any swelling in my ankles and I walk for miles. Though, I know that for some people it's dependent on the dose and 120 diltiazem ER is a lower dose. Plus other medical conditions you have or medications you take can also influence how it affects you.
Hi Papillone, I was on metoprolol Succinate ER 25 mg for 8 years. Then in Sep. my blood pressure went really high . So I was placed on 50 mg of metoprolol . After a few days it started to flare up my asthma. So my pulmonologist said that sometimes higher doses of beta blockers can cause asthma flare ups. He suggested to talk to cardiologist to be put on a calcium channel blocker. . So I follwed up with cardio and we started the weaning process of the metoprolol and added Diltiazem ER 120. I also take losarten at night. After a week we stopped metoprolol and then upped the diltiazem ER to 180 mg. I felt better on it . I felt like I had more energy , but after a week my ankles swelled up and it also triggered my Gerd. So now I am in the process of going back down to 120 and added 25 metoprolol but my HR has gone down to the 50’s .And I have a dry cough not sure what’s causing that. When I was on the 180 it controlled my HR and my BP . My ankles have gotten better. Every body is different and maybe you will be fine. If it wasn’t because it swelled my ankles and the Gerd I really felt better. The only way you will know is to try. Best of luck to you !
I have fast AF and take 30mg Diltiazem. The conatiner tells me to take IN THE MORNING. It doesn't make me sleepy.
I couldn't tolerate diltiazem. My lower legs swelled up like tree trunks, and my face and upper arms flushed bright red. I stopped it after three days and went back to bisoprolol which is OK for me
I have been on this for 4cyearscor more. A slow release.90mg in morning and evening. No side affects so far.
I also had a racing heart with diltiazem. The first attack happened about a week after starting it and it was so bad I had to go to hospital. I had a second attack a week later and had to call an ambulance but didn't go to hospital. I was then put back on bisoprolol and the attacks began to reduce in intensity and frequency over the next couple of months.
I have not had any further recurrence for several years now.
I've been on Diltiazam 90 mgs twice a day for 3 weeks now after taking Bisoprolol for 3 years and I've had no side effects thankfully. It does control my heart rate better too when in AF ( every other day ) and it contains an anti arrythmic which also helps
It is pity that there is no guideline or data to suggest that who and under what conditions one drug prescribed over the other ( unless I am missing something) . Looks like it is an all matter of pot luck . Bisoprolol beta blocker or Diliazem calcium channel blocker .
Most of the time proscriptions are handed out by clinical nurses or GPs with little background knowledge. They will says try this and that and see how it works. I suppose this will be in my case too.
Thank you for sharing your experiences with these drugs , Am I right to say that experiences are. if you having the heart racing issue like jumping up on activities ( like in my case ~75 while sitting and going up on stairs to ~100 in seconds) then Diliazem may not be as effective as Bisoprolol) .
Very much appreciate your comments especially if have come across any study.
Thanks. Papillione
100bpm is perfectly fine if your heart is in good condition. You can expect it to rise from resting 70bpm to 100bpm or well above on exertion. Until you’ve had an echocardiogram you may not be sure, but do question whether you need a rate control drug at all. Bisprolol 2.5mg seems to be the standard response to a PAF diagnosis. I only took 1.25mg per day to start with and then abandoned it altogether once my echo showed good heart structure.
Thanks drone01, I think in my case the Eco showed some volvo leakage I do not how bad it is
I can’t advise you what to do, but I regularly take my bpm up to 140-150bpm whilst doing aerobic exercise at the gym (ie into the fat burn range). What you don’t want is a high bpm for an extended period as a result of AF. My own very occasional PAF episodes take me to 200bpm but fortunately revert to NSR in less than half an hour without intervention. I abandoned any rate control drug but take an ACE-inhibitor to keep my BP under control.
max dose of Diltiazem here…360mg slow release ones daily. No side effects whatsoever.
I am a quite active 70 year old, and I do medium weights 3 times a week weekly and cycle 3 days a week.
No other health issues.
180mg slow release daily, seems to affect circulation in legs a bit but not helped by my age and too much sitting around!
Hi. I'm on 300mg Diltiazem and was on 100mg Flecainide as a PIP. Had my first ablation in August 2023 and afterwards EP said to stop both. When I pointed out that I was taking 240mg Diltiazem for BP long before I developed AF, he said he would review this at the 3-month follow-up. However, the day after the ablation, I had a major AF episode and EP said I could go back on the Diltiazem but not the Flecainide. I am better now since ablation although I still get occasional episodes. I have never experienced any side effect with Diltiazem so it obviously suits me but it's worth giving it a try.
Good morning, I have been taking 180mg Dilatzium prolonged release capsules for four years without any side effects.
I had awful problems with bisopralol although not with sleeping. I started waking up at night having hallucinations. My GP changed it to a calcium channel blocker. I think it was Candesartan but as I had so many tablets changed I'm not certain. I also had to have that stopped but it certainly didn't affect sleeping.
Diliazem made me dizzy!
Diltiazem dropped my heart rate and blood pressure too low, left me feeling faint and dizzy.
I can remember what doses I was but they kept lowering it without effect,.
I have taken a beta blocker like Bisoprolol and found that it didn't suit me as it stopped my heart working as soon as I was walking uphills or upstairs. I had no problems sleeping while taking it but I only took it for a period of months. I have been taking 60mg of diltiazem twice daily for many years and have had no difficulty sleeping associated with it.
I’ve been taking 180 mg of Diltiazem once a day for years. My doctor just increased my Diltiazem to 180 mg twice a day due to my Afib and worsening arrhythmias. My arrhythmias are now half of what they were before and I have no side effects at all. I would give it a try. Everyone is different. I only wish I would have started the double dose on Diltiazem sooner as my arrhythmias were terrible and starting to get the best of me.
I take Diltiazem in preference to Bisoprolol because my heart rate is naturally very slow, usually in the 40s at rest. I take 60mg morning and evening. No swollen feet, no real problems. I do get brief runs of tachycardia, but generally only 10-20 seconds at 130, and I’ve no idea if that is linked to the Diltiazem.
Hi
Diltiazem SAVED MY LIFE.
Beta Blockers did not control mt H/R rapid with AF Day. 186 Metoprolol, 165 Bisoprolol.
My H/R is below 100.
I take Diltiazem 120 CD mg early morning 8am. No swelling. Sleep well.
That's low and safe. But 180 was dramatic. In 2 hours when first introduced the 156 as above went down to 51 in 2 hours! So be careful. 360 is the most mgs in 24 hours.
It also lowers BP a little. Acts like an anti-arrhythmic med too. Safe.
Go for it.
I eat fibre to keep me regular.
cheri JOY. 76 now. (NZ)
Diltiazem
