Bisoprolol and hills: Hiya, does anyone... - British Heart Fou...

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Bisoprolol and hills

Hiya, does anyone know if it matters if you take Bisoprolol at night instead of first thing in the morning? I find I can’t exercise and become breathless on hills. Only taking min dose.

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Hiya! When I first started bisoprolol I took it at night because of side effects and I’ve just carried on that way and it’s been fine for myself I’ve never taken it in the morning! I very briefly mentioned it to my cardiologist and he didn’t say anything! If your unsure double check with your GP or a pharmacist x

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That’s great to hear Surf15x. Have just walked the Cleveland Way and it took ages to get up hills. Will take at night I think. Thanks

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no worries! But if you are unsure double check with a pharmacist as I’m uncertain if it’s the correct way to take it!

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Hi, my husband takes his half and half, morning and evening. He was a bit fed up with feeling awful in the mornings and tried it as an experiment. Neither his GP Mr his Cardiologist were concerned when he confessed and so he’s continued to do so.

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I have the same problem with hills and sometimes at cardiac rehab classes and take my 5mg Bisoprolol in the mornings as I was told that's when I had to take it. I also get very drained as the afternoon progresses. Having read these messages I will now be speaking with pharmacist! Let us know how you get on with changing over and good luck.

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Will let you know thanks benjijen

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I take mine morning because my cardiologist told me .

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Yes Sally that’s why I have been taking it in the morning. It must have been the cardiologist. It’s not written anywhere. I’ll ask the pharmacist. Thanks for your reply.

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I started off with 2.5 mgs in the morning & couldn't cope with the dreadful fatigue. After many arguments with my GP she compromised & prescribed 1.25mgs morning & night. I am a new woman!

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Very interesting. Thank you!

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I can't reply. Just says issues and to fix them. If I don't know what the issue is how can I fix it?

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Not sure unless my mobile went out of range

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Hi Helen I’m also on 1.25mg which I believe is minimum dose. After heart surgery last Dec I found my heart rate was faster and banging away in the evening and asked my gp if I could take bisoprolol in the evening. She said it was a good idea & it was much better for me. I think it’s probably better with food but it sounds like you should go for it!

I’m interested to hear yours & others stories because I also struggle with exerting myself in the morning even taking it in the evening. It’s 7 months now and I’m going to ask my gp if I can phase it out. Particularly because I understand it’s given to protect the heart after surgery, but mine was never damaged by heart attack anyway I only had Angina.

Good luck with it anyway.

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I will let you know how it goes! Good luck

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I think Ladycroft raises a very important point here - which is, why are we prescribed these drugs as part of a "blanket" prescription, with no subjective diagnosis? I understand that a lot of people benefit from, for example in this case, Beta Blockers, but for those of us who don't actually need them they are horrible drugs. I was prescribed them, after having stents fitted but no HA, and my Echo was totally normal - they made me feel awful and totally inhibited my exercise regime. My GP agreed that for someone like me they were totally inappropriate - so why was I put on them in the first place? The answer is obvious, the NHS does not have the resource to prescribe on a per-case basis. I even brought it up with the Rehab nurses, who down to a man/woman insisted I keep my HR down to silly levels during exercise, and that "most people benefit from being on BB's" - Really? I was also put on Ramipril which further inhibited my ability to exercise, when I had never had high blood pressure in my life, probably due to having always exercised regularly. Why do they tell you to exercise as much as possible and then fill you full of drugs that stop you doing it??

My advice would be to question everything and don't just accept what you are prescribed!

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Thanks for your thoughts. As well as the fact that they are not good for exercise they cost you lots of money on travel insurance. It is always asked as part of the medical questions.

I have never had high blood pressure but I take beta blockers!

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I’m on 7.5mg of Bisoprolol and have great trouble on hills. Must ask doc if I can take it at night.

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I’m on 7.5mg and have trouble on hills. I’m doing a Nordic walking course to try and build up my strength but am far behind other people and can’t walk far on the flat without resting.

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My husband was told by the heart failure nurse to swap to taking it in the evening because it would reduce the dizziness during the daytime.

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I have been taking 1.25mg of Bisoprolol for a month. Cardiologist won't up my dosage, because I am unable to walk for more than 20 minutes before I am collapsing or fainting. Having MRI and stress test to work out why this happens?! Nobody ever said to change timings of meds, the literature in packets says morning. What a weird situation that nobody seems to be aware of in the medical profession.

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I used to take it in the evening as per my HF nurse as it can make you tired. Eventually they switched me to nebivolol and it’s suits me so much better

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I take 2.5mg Bisoprolol last thing at night along with low dose statin as per cardiologist advice.

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I take Bisoprolol in the morning but was having a few side effects until my pharmacist suggested taking it with food .He thought it was hitting my system too quickly. This seems to be working fine now

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Beta blockers are supposed to reduce the load on the heart by slowing it down. This load is highest during the day when you are moving around or exercising so taking it at night is possibly the wrong time.

Maybe you just need to adjust the dosage?

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Am on the lowest dose possible. Thanks for the info tho. Guess I just have to live with being slow on hills.

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Hi, I take mine at night time now, when i took them in the morning I felt awful all day and so tired, take them at night now and don't get me wrong still tired but not as bad, only thing i notice is that i wake up with a "hangover headache" but that wears off eventually. I just don't like taking them and if i could stop I would to be honest. Good luck x

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Hi Helen, like others I felt exhausted and literally craved a rest after any activity. This was when I was taking 5mg mornings only. A nursing friend suggested splitting it and taking 2.5 mg morning and night. This is better but I literally struggle to stay awake after 2pm and again about 7pm. Evenings are a write off ! None of this is the best so I am going to go back to my GP after reading these comments, so thanks everyone. I originally started taking Bisoprolol for menopausal anxiety not heart problems but after taking a 24 hour bp test, it was prescribed. I also had terrible palpitations at night and a racing heart.

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Good luck Lillytrish. I had a mechanical heart valve fitted 7 years ago and took bisoprolol after that although my blood pressure was always low. GP won’t take me off and says they are good for the heart.

I too tire in afternoons I thought it was my age!

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Hi Helen, it's not age definitely bisoprolol. I've started daily yoga to try to get some umph! Great for joints and aches and pains but no effect at all on tiredness. Please until I get a GP appointment, I'm trying taking 2.5 mg after breakfast only. I take flouroxitine (prozac) 20 mg at night so maybe that makes the Bisoprolol effect intensify as far as tiredness and lack of interest goes ?

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Cross out ,please,

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Hi Lilytrish, can i ask you a question, did you heart problem start then along with menopause? Reason i'm asking is i've been menopausal for over 4 years now however palpitations started last year and GP said was due to menopause, all came to a head couple of weeks ago when they were so bad i thought i was having a stroke and ended up in ambulance and kept in. Now saying i have irregular heartbeat and i'm awaiting more tests, said what GP said is rubbish it's nothing to do with the menopause it's electrical wiring in my heart....

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I have multiple heart conditions (starting with rheumatic heart syndrome since childhood bout with rheumatic fever) - it never slowed me down until 'the change'. I never thought I'd ask for HRT (hormone replacement therapy) until the doctor said the increasing difficulty was probably related to menopause - but when I did ask thinking HRT would help with the heart problems, she said 'No way, the HRT would make things worse including possibly cause a clot'. So I soldier on best I can.

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Hi Jakesterblack, I'm told by my GP it's all linked with menopause which has been about a year (I'm 58). The racing heart and palpitations started a little before then but I too was told my heart was missing a best and it felt like it would stop and start again. This was whenever I was falling asleep. I was also given Fluoxitine for life related depression. I now find i have stopped seeing friends because I have no energy at all or even interest. I am definitely going back to the GP to try to find out of its the menopause or heart at the root of the problem, especially since your reply so thank you.

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Sorry should say; missing a beat

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I just wonder if GP's automatically say it's due to menopause because they know we are going through it so easy to blame it on the lot. I just have no idea why all of a sudden this is happening to me either. I'm hoping when i go back in September they get to the bottom of it... hope you get sorted too x

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I take mine 1.25mg in the morning before I get up to reduce a high heart rate which spikes with very little activity. Heart rates at night drop naturally mine can sometimes drop as low as 32bpm and rarely goes above 50 bpm other than when it spikes during the day,so might be unwise for me too try taking it at night,despite those tiresome side effects. Check with your GP is best. After an svt ablation 12 weeks ago there is now talk of a pace maker!

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I take 2.5mg in the morning with breakfast and I’ve had no issues.

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I take mine at night because of extreme tiredness during the day. Feel a lot better, not perfect , but can live with it.

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I'm female, 62 (63 the end of the month), and take 1.2mg+300mg aspirin every morning. I must be the poster girl for Bisoprolol - no side effects at all and it has reduced angina to maybe once a week or so (down from three or four times a day). I take the meds and an hour later I'm usually out the door for the morning mile returning home ready to get cracking on the day. The first few weeks I did seem to flag by nine in the evening but now I'm back to hitting the pillow around 2330 and sleeping straight through to 0630.

As for hills, well, the truth is I've never been able to do hills. I have Rheumatic Heart Syndrome (since early 1960s) and until menopause that's the one way the RHS has always made its presence known - stairs and hills were to be avoided if at all possible, and if unavoidable I knew I was going to have to take it slowly and stop frequently for a rest. In all honesty, now I'm on the Bisoprolol I actually find inclines and hills a bit easier.

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Like Ria31 I was also advised to take it at night to avoid dizziness, etc, in the day. Just had the dosage increased from 5mg to 7.5mg so I’m adjusting at the moment, but sticking to taking at night.

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I appreciate that we are all different in our reactions to bisoprolol. However, please be careful about changing the dose, and changing the time you take the medicine.

According to drugs.com drugs.com/ppa/bisoprolol.html the onset of action is 1-2 hours with a peak at 2-4 hours. Since one of the major effects of bisoprolol is to reduce the heart rate, and the heart rate naturally decreases at night, if taken at night there is a risk of bradycardia, ie a real risk that the rate will be too low.

The risk of bradycardia is lower in the morning because you are active and conscious.

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Thank you for the info. Good to know the timings. I will just have to get a bit fitter I think and slowly build up.

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Hi Helen. I take mine twice a day, but if you only take it once a day I don't think it matters whether it's morning or night.

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Hi I started taking it nearly four years ago and I was having bad side effects so my doctors , including my cardiologist , told me to take half in the morning and half at night . I have been doing so ever since

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Hi Always took mine in a.m tbh.xxx

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It one of those tablets that if you can tolerate it, great life is good. But if it does affect you then it can seriously curtail your exercise ambitions. It really does feel strange that they want you to exercise to be healthy but then the drugs can make you feel that you are dragging a tyre around behind you. I like my mountain walking and biking and eventually after talking to cardiologist I was let off them. I am a lucky one, NSTEMI, 1 stent,no damage and my blood pressure is good. It took me 12 months to escape them and I can

understand why you need them after a heart event. Everyone is different as to their condition talk to your doc / cardiologist

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Thank you

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I am on 2.5 mg/day. GP said I could take it morning or evening. Started off taking it p.m. so its slowing effect was whilst I slept, hoping that my activity during the day would be unaffected. But I think it is/was affecting my sleep - a known beta blocker side effect. So I moved it to lunchtime - seemed to help with the sleep, but then not, so am currently taking it a.m. Still sleep problems; it's a slow release version. No obvious change in my physical abilities at any time, but it is definitely hugely better than Metoprolol. Was changed onto it by the GP due to supply probs with Metoprolol. However, though better, it's still not good, and my abilities (regardless of time of day taking it) are limited. Have an annual review (post aortic dissection) in a month and will be seeing what the alternatives are.

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Hi Helen, this has been a great read about all the different side effects and symptoms of taking Bisoprolol, I am on 10mg which is the max dose i think, i take mine first thing in the morning when i get up and before food as was told told that the benefits are far greater while we are awake during daytime than asleep at night time 'ticking over' . Have been on these many many years and yes along with my many other medications they contribute to major tiredness and muscle fatigue to name a few. So mornings for me. Dave

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Thank you Dave for your response. Still taking in the morning until I get an answer from a medic.

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