Optimising medications

[Prettypaw]

My husband is living with heart failure EF 35% and is currently getting his medications optimised . His bisoprolol has been increased to 7.5 mgs in last week (5 mgs am 2,5 mgs pm)and is now on 2 nd day of increased ramipril to 10 mgs . His BP has been systolic 100-116 but this am his BP is 89-95 systolic . No symptoms of dizziness pulse 71, but resting heart rate can go down to 52 but not symptomatic. He has reduced the am bisoprolol dose today to 2.5 mgs as BP low this am and will take the remainder 2.5 mgs along with normal 2.5 mgs the pm. He takes ramipril at night 10 mgs

Any advice ?

[SpiritoftheFloyd]

Welcome to the forum.

We are a peer to peer support group for people with cardiovascular conditions. None of us are medically trained so are unable to offer advise on medication.

If the GP is trying to optimise the dosage you need to have an ongoing dialogue as regards the side effects of the medication and follow their advice

[Sunnie2day]

I agree with SpiritoftheFloyd - best to report the BP and heart rate drop to the prescribing medic for advice regarding changing dosages and times.

[Prada47]

Hello

As spirit said we are a peer to peer group so can't give advice on Medication but we all have experience of Heart Medication.

Currently one of the meds prescribed for low E F is Entresto a combination of Sacubitril and Valsartan . I believe I am correct in saying most other medication has to have been exhausted before you are put on Entresto. ( Entresto can only be prescribed by a Heart Nurse Practitioner or Cardiology ) after that your GP can prescribe it.

It takes a while to exhaust the options in particular with regards to the dose, I have been on 10mg Bisoprolol then reduced to 7.5mg put back up to 10mg and currently because my Entresto has been titrated upwards I am now back down to 7.5mg Bisoprolol. This was all monitored by the Heart Failure Nurse/Clinic It takes a while to get it right but worth persevering with honest !!! I am 95% sure that is correct but sure someone will correct me if it's wrong.

Face Space to Stay Safe

[Ianc2]

Has he changed his lifestyle - more exercise? changed his eating to lose some weight? Stopped smoking? Eased back on the alcohol?