I want to reduce my 1.25 Bisoprolol medication to every other or even every two days. My heart rate is stubbornly in the 50s; a daily dose brings it down to low 50s and alternate days brings it up to higher 50s. I want to prevent my heart rate going too low and want medical approval for this action. I check my heart rate on a fitbit watch so ensure it does not go too low or too high. I wondered if other members of this group have reduced the 1.25 dose..
fyi the reason I take the Bisoprolol was due to a racing heart two years ago. It was brought down and I was put on bisoprolol 5mg twice a day which I gradually reduced to 1.25 daily. I have not had AFib for nearly two years but there was some evidence of flutter.
I would appreciate insight into your experience of reducing low levels of Bisoprolol. I am seeing a pharmacist from the surgery tomorrow to discuss this.
Thank you.
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futureheart
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If you are checking your heart rate daily, would it be an idea to take the Bisoprolol as a PIP (pill in the pocket) just when you have an attack of AF or flutter. Another thing to consider is slicing the 1.25 pill in half with a cutter and taking that reduced rate daily.
Thanks Jeanjeannie. I have thought of halving the pill, but I don't like the idea of rough edges catching in my throat. Bisoprolol is long lasting so I reckon alternate days might be better. I definitely would need advice to use it as a PIP. I appreciate your reply.
Future heartI cut my 1.25 pill in half and have done so for years, I have a naturally low heart rate and low diastolic BP, my heart rate on that is average 55 , it suits me fine,
I am in the same boat, On Flecainide 2x 100mg and 1.25mg bisoprolol, but resting HR low 40’s. EP said in an email to just stop it and take 2.5mg if AFib shows up ( But when in afib before Flec, 10 mg Bisoprolol was not enough). Anyway more cautious than the EP, I cut the 1.25 in half this morning, took the slightly larger half (tiny pill, hard to cut) and still in 40’s, but will try half again tomorrow then if still 40’s after a few days will drop completely.
I had to stop taking 1.25 daily after just three days as it brought my heart rate down to the low 40s! We are all so very different and do hope you find a regime that works for you. Flecainide has put an end to episodes for me, taken daily but may have increased the fatigue I acquired with the paroxysmal AF and messed up my digestion a bit but I’m still alive at 81.
I've been on Bisoprolol for 6 years at various doses to try & eradicate pacs&pvc's to no avail. I have seen my cardio about completely changing to another medication because of horrendous nightmares (a nasty side effect) but he is reluctant because of more side effects! I have Bradycardia & my PM lower rate is set to 60bpm so the Bisoprolol is to bring down a high heart rate because of tachycardia too. We have agreed to ride it out, not the outcome I wanted but the beat goes on! I'm awfully tempted to wean myself off it gently rightly or wrongly. It's my body RIGHT. Best wishes on your own journey.
Yes it is your body. If you want to do it go for it. Weaning down to a lower dose would give you an idea of whether your heart would tolerate that and you can always go back up if it doesn't. Yes I know that we are always told we should not change our dosage without the agreement of our doctors but if we don't get that agreement and really don't want to stay on a particular drug at a particular dosage then in the end it is our decision what to put into our body.
IMO, you should never change dosage without doctor's prior agreement.Remember, you are not an expert and even though it's your body, do you want to risk permanent damage (aka death)?
I know my body better than any doctor . I am very sensitive to drugs in general and I find most doctors that I have encountered to be woefully ignorant when it comes to drug side effects. If not downright gaslighters. I have been floxed 4 times and my health has been severely affected by this over a number of years. So I will make my own decisions thank you as to what I put into my body. I was started on 5mg Bisoprolol and felt like a zombie on this dose. That seems to be the standard starting dose here for afib. One size dosing practices are rife in medicine and take no account of sex or genetic differences in metabolism. So your "experts" neglect to take into account key parameters. The GP said I could reduce it to 2.5 mg. I still felt bad so I reduced it myself to1.25mg. No damage still here 10years later. Doctors are not actually experts on drugs. They are taught what drug to prescribe for a condition but most have very little knowledge as to how drugs work at a molecular level. That is taught in pharmacy and there just isn't time in med school curricula.
my HR was going into the 40's and so with approval i adjusted my Metoprolol down from 2.5mg equivalent Bisoprolol to 1.25mg i then took it down to 0.65mg and HR back around 60... after getting a short AF episode we settled on around 1mg which has me in the mid to high 50's I do also take 25mg Flecanide twice daily.
When i am in AF generally my HR at rest is 75-85 so cardiologist prescribed it not for high heart rate but for tamping down the adrenaline spike that can kick off my AF
1. Low to high 50’s hr is really not an issue. Yes it is called bradycardia but that is only of concern if you suffer symptoms such as fainting, light headed , dizzy etc
2. I’ve always had naturally low hr of mid 50’s but now on dronedarone and bisoprolol 2.5 it’s very low 40’s. But it’s still not an issue because I don’t suffer any symptoms.
3. You may find that cutting out the bb will result in the racing hr or ectopics returning. Bb offer valuable long term benefits but as others have said, exploring use as a pip is a good idea with your GP.
4. My GP cut my bb from 2.5 to 1.5 because she said hr was too low and the ectopics returned. My cardiologist went mental with my gp and I’m now happily back on 2.5 and only very occasional ectopic.
My GP dropped mine to 2.5 and my cardiologist was upset and put me back on 5. HR is in 80s, regardless amount.When it comes to heart, cardiologist has priority.
I wasn't prescribed a beta blocker as I'm asthmatic. I took daily Flecainide. After my heart rate shot up during an operation to remove my appendix, I was put on 2.5 Bisoprolol. After 7 weeks I started with painful urticaria. I was weaned off Bisoprolol, during which time I had a very sudden exacerbation of asthma and chest pains. I was in a pharmacy at the time. I was taken to hospital in an ambulance. I spent 3 days there. My medics have taken me off all beta blocker. For the last 7-8 years I've had permanent, though asymptomatic AF.. The only medication I take because of the AF is my daily anticoagulant, Warfarin.
I am sure the members of the Forum will offer and share advice based upon their own experiences of taking Bisoprolol. We advise that changes in medication dosage must be agreed in advance by your doctor to avoid any major side effects.
You may find some helpful information in our patient resource: Atrial Fibrillation (AF) Drug Information booklet: api.heartrhythmalliance.org...
Alternatively, if you prefer, please contact our Patient Services Team via our dedicated Patient Helpline; +44(0)1789 867502 or via email: heartrhythmalliance.org/afa...
hi. I am a pharmacist with permanent a fib , and also take Bisoprolol. It would be inappropriate to take alternate days as the drug level would drop too low and would be better to reduce to 0.625mg daily, but the issue is with the tablet being too small to split in half. I think the half life of Bisoprolol is about 13 hr. They do not make a liquid formulation that is licienced, making it easier to reduce dose.
The only easy way would be to dissolve a 1.25 mg tablet in exactly 10ml of water ensuring well ground down and take a 5ml dose.
This is something you should check with your GP before doing as this dose reduction could theoretically initiate your A fib again
I used to cut 1.25mg in half with a pill cutter, it’s fiddly by if you weigh each half your doing the best you can to get an even dose as long as the active ingredient is evenly distributed. I found this to be effective.
Hi there I have a intolerance of most of the heart meds and bisoprolol is the only choice for me but it gives me lots of side effects but after speaking to my cardio I now split a 2.5 mg tablet and in half which gives me a slightly smaller dose than 1.25 which with there approval I take once a day as I drop to about 55 bpm at rest and 50 ish when asleep due for ablation in the next few weeks I also take a extra 1/4 of a 2.5 mg if I start to get a bit of afib starting up all tablets taken under a cardiologist knowledge
I take the same but have lower rates. The part played by bisoprolol in this, I don’t know. Looking online, that dosage seems unlikely to have much of an effect but your figures are interesting. I asked about stopping it but I get regular AF with a manageable rate of 130bpm and my GP suggested the bisoprolol might be important in this, so I Ieft matters as they were.
I have read (although individual medical approval is absolutely required) that such a low dose can be stopped quite speedily without risk of withdrawal effects.
One thought. There is good evidence, so far as I know, that a beta-blocker offers useful long-term cardio-protection, as do drugs like statins and some anti-hypertensives. Before stopping, it might be worth asking about this. Given our Western lifestyles, they might be a Rather Good Thing!
I have halved my dose of several medications, including metoprolol, without asking my doctor, though I did tell him the next time an appointment came up. I wonder if you have physical symptoms from the bisoprolol, something you feel in your body rather than something you know in your mind. 50s does not sound that low to me.
I do not trust my Fitbit watch. For example, it will sometimes report a pulse in the 50s when in actuality, I'm in afib with a pulse of 115.
Oddly, the Fitbit will then report afib if I press the buttons to get the test.
At other times, the Fitbit will report a pulse of 120 when in fact it's 60, as reported by my Kardia monitor and my own hand counting.
Plus, the Fitbit miscounts my steps rather comically in the early morning, although it's probably useful enough when the counts is in the thousands.
Finally, I'm often in menu hell on the Fitbit, stuck with YouTube Music or Google Wallet sometimes for more than a minute. Taking the watch off often helps.
I do regard it as reliable as to afib occurring in the moment, primarily because my own physical sensations support that impression.
But getting tests often takes several minutes of pressing the sides many times, trying different combinations of finger on left, thumb on right, thumb on left, finger on right, non-watch hand raised, non-watch hand flat.
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