Bisoprolol versus pill in pocket!!!

[DizzyD]

Hi all, hope everyone is well.

Has anyone here reverted from dosing daily with bisoprolol to a "pill in the pocket" which was successful? This is what I aim to achieve based on my own personal experience with bisoprolol. Of course, I am fully aware that it would be a work in progress because I would need to taper off the bisoprolol over time. It could be rough going, it may not be, who knows?

At this point, considering my heart conditions, namely, Stenosis, Left Atrial Dilation (LAD) and AFib which, according to research caused the LAD this could be a pipe dream. But eventually, with more research, some where along the line, I maybe able to have "pill in the pocket" instead of bisoprolol.

One may ask: who in there right mind would want to have "pill in pocket" instead of bisoprolol after recently being diagnosed with three heart conditions as mentioned, termed as heart failure!!!

Let me explain. Initially from June 2019 (and even before this date) I would be abruptly aroused in the middle of the night, from a deep sleep. It was my heart that woke me, going extremely fast, boom, boom, boom, boom, continually, non stop, at the same intensity and speed which lasted for over two hours. I never knew the heart could go this fast...never. My mind told me stay put...don't move, don't panic, breath, just wait it out. What a wait. I prayed like crazy. At some point I slowly placed my hand on my heart, chest, neck, throat and stomach, in turn, expecting to feel a reverberation of the boom, boom, but I felt nothing generating to the surface. There was no echo of the boom, boom in my ears either which was strange. Nothing at all. Eventually the boom, boom stopped, no slow down of intensity or speed just an abrupt stop. What a relief I was still alibe. In all my ignorance, thought it was a silent heart attack. Went to a+e by taxi. Would not drive. They found nothing. I consulted with my GP no referral to cardiologist. In total had three more of these heart experiences in the middle of the night. Same finding at a+e, same response from GP. Told my endocrinologist Oct 2019 who said she would refer me to a cardiologist " if the palpitations continued". (As far I as was concerned my boom, booms were not palpitations). In the meantime I had a whole year to wait and see if I had anymore, questionable, palpitations. Great!

Eventually got a consult with a private cardiologist and told him about heart symptoms and much more bc he was prepared to listen to what I had to say. He wrote a long letter to my GP suggesting he prescribe me bisoprolol, aspirin and to refer me to NHS cardiologist for tests to determine a diagnosis.

From day one of taking bisoprolol I was totally out of it (life that is) could not walk, or function at all. Chest pain, breathlessness, so weak, low mood, couch potato. To my mind it was as if the bisoprolol actually created heart symptoms by slowing the heart rate down so much. My dose is only 2.5 but I had an idea dosage would go up in time.

Me being who I am I worked out that somewhere along the line, as my heart adapted to this drug so lowering my heart rate it would only be a matter of time before my normal heart rate (before bisoprolol) would assert itself and kick in bc it had become accustomed to said dose and so needed a higher dose to lower heart rate again to the bisoprolol level. When it did assert itself, it would be stronger in comparison to lower heart rate induced with bisoprolol and could trigger AFib symptoms bc the heart can't cope with the increased heart rate. This actually happened to me today.

Got slight increased but regular heart rate which was not a problem and took my heart meds as prescribed at usual time. Heart symptoms got progressively worse and i ended up with AFib despite having taken my meds. Waited for it to subside, relaxed, breathing, meditation, lots of water which is the norm for me, but nothing helped. Finally at about 3 o clock I took another bisoprolol and within half hour the AFib symptoms started to go away.

I just got to get off the bisoprolol. So far after being put on bisoprolol I have had three AFib attacks in a matter of six months. Prior to this, apart from the boom, booms mentioned above, I have never had a AFib episode.

Has any one here changed from bisoprolol to "pill in the pocket"? Really would appreciate some feedback. Sorry for this long post.

Have a great evening

[LBCdance]

Found that all very interesting, but sorry to be stupid: what is a "pill in pocket"? Also interested in recent posts on bisoprolol. My prescription doesn't seem to be time limited and medications never reviewed so just go along with them. Nothing to do with covid either but I feel completely on my own vis-a-vis GP, nice enough when you get to speak to any of them but nobody seems remotely interested so although of course I realise we are all different I do find this site very helpful. I did work, not for but in the NHS for 27 years so I do have an understanding of their pressures, and I still have friends in that area.

[DizzyD in reply to LBCdance]

Hi LDC pill in the pocket is a one off AFib med that you carry with you and take it if AFib symptoms start to occur. Totally agree with you feeling totally on your own. When it comes to post code lottery some of us are not very lucky. Yes this site is very helpful. I have found that lots of people advise me to talk to my GP about health concerns which I have done for years but got no where which is why my heart problem has deteriorated so much. We can talk, but when GP does not listen or take action when a patient presents with symptoms what's the point in trying to communicate with them. I had an ECG done by GP and she said to me quite casually, "Oh you have had a silent heart attack". I was in shock, unable to ask any questions but expected her to suggest what would happen next. NOTHING. I walked out of the surgery, still in shock, like an idiot.Not being pessimistic just realistic....time to get pro-active

[Warm-heart in reply to LBCdance]

'Pill in the pocket' means to take it as and when you feel you need it, putting you in control of its use. This is different therefore from taking it, for example, regularly twice a day. Bisoprolol apparently can be used in the former manner.

[Grayjay]

Please explain what pill in the pocket means.

[DizzyD in reply to Grayjay]

See post above

[gilreid1]

Sorry but have not got a clue what your post means ? Has your GP advised you to stop Bisoprolol and you don’t agree?

[Petercat1]

I used to have palpitation attacks from when I was young, these got progressively worse as I got older. I used to be able to control them by deep breathing etc, but as I grew older that didn't work. I had an aortic dissection emergency op and whilst in hospital recovering, I had a palpitation attack. The Cardiologist prescribed bisoprolol and was shocked my doctor had never given me any medication to stop these attacks.I was on 10mg a day, but have recently reduced it to 7.5 with my drs approval. I have not had any attacks since then (2017).

Have you asked your dr if you can try a different beta blocker? Bisoprolol doesn't agree with a lot of people?

I'm the same as others on here, what is a 'pill in the pocket'.

Could you be getting these attacks due to anxiety about getting an attack? A bit like asthmatics if they forget their inhalers, get an attack because they are worrying they may get an attack?

Best wishes

Denise

[DizzyD in reply to Petercat1]

Hi Petercat see my above reply to other members comments above re: pill in pocket.As my initial post indicates, my anxiety is caused by having to take take bisoprolol on a daily basis, supposedly to ward off any AFib attacks. I would sooner have pill in pocket to take if an AFib attack showed up. Similar to taking a paracetamol if you had a headache. So no I Not worried about having a AFib attack but am worried about the medication (bisoprolol) that is being used to treat it.

Thank you for your comment. Have a wonderful day

[Thecyclist]

Pill in Pocket is essentially what it says on the tin, you carry a pill (on you at all times) for use at times when your symptoms become worse or unmanageable, it can either be as an addition to current medication levels or as a one off. I carry 2.5mg of Bisporolol on top of my 7.5mg to take if I get an episode of tachy or bad PVC's. I find it works well. PiP can only be prescribed by your doctor, you shouldn't do it of your own accord.

[Jibbyjabby]

Hi Dizzy D I had a bad experience with Bisoprolol also, waking up in the middle of the night, sweating,my heart racing, I too thought I was having another HA. this happened at least once a week always at night in bed, to say i was anxious, frightened, panicking, would be an understatement, but like you, my breathing exercises and calmness was a long but slow way out of it. I appreciate that Bisoprolol may be a great drug for some people but not for all, what brought things to a head was in January 2021 I had a cough that was going on for 5 weeks and no sign of going, then I read on HERE that a contributor also had a long-standing cough and when they stopped the Bisiprolol the cough disappeared. So i thought to myself i will try that, and do you know what? my cough disappeared in 2 days !!! .i phoned the cardiac nurse and she prescribed me Nebvilol which is excellent for me and have had NO problems at all. It would appear that Bisoprolol is the cheapest of beta-blockers and it is standard practice for when we are discharged from the hospital , i sincerely hope you get through this and my thoughts are with you , best wishes Chris

[DizzyD in reply to Jibbyjabby]

Thank you Chris for the informative reply to my post. I have noted the medication you mentioned....Nebvilol. Thing is I am not keen on taking medication long term especially if it is making heart symptoms worse. I have never had a heart attack. Todate, I have never been given an explanation as to what the strange, scary boom, boom, episodes mentioned in my initial post were. Mentioned these bc they were first indication that there was something wrong with my heart which was never investigated by my GP or my endocrinologist. It was a private cardiologist who sort of pushed my GP into sending me to a cardiologist.

Basically my post was aimed to point out that I have had two serious episodes of AFib since dosing with bisoprolol. (Admitted to a+e via ambulance on both occasions). Both times I had taken daily bisoprolol prior to AFib attack. My third AFib attack was yesterday which occurred despite taking the AFib meds so had to take a second bisoprolol to stabilise AFib. Question is: why didn't the my usual dose of bisoprolol stabilise the AFib? Why did I have to take a second dose? The end paragraph in my initial post explains what I believe is happening. In a nutshell, I believe bisoprolol is actually making AFib worse. Never had AFib attacks until I started taking bisoprolol. Docs will deny this and say it's my heart condition that is getting worse. Whatever, just want to stop bisoprolol and get pill in pocket for ward off any future AFib attacks when I actually Have sign that one is about to occur.

Have a prosperous day Chris...once again, sincere thanks

[gilreid1]

Dizzy. My understanding of pill in the pocket is a smaller dose of medication on top of what you already take. This has to be prescribed by your GP. So again not sure how this will help you with Bisoprolol.

Good luck

Gil

[OAPjust in reply to gilreid1]

I only have Pill-in-the-pocket and do not take anything daily on top of.

[gilreid1 in reply to OAPjust]

Is that bisoprolol ? As this medication takes 2-6 days taken daily to have any affect. As far as I am aware taking one occasionally would not do much. But I am not a doctor so if this has been prescribed then keep with it.

Stay safe

Gil

[OAPjust in reply to gilreid1]

Hi Gil - yes, it is bisoprolol. I've had the same packet in my handbag since October,(box is getting quite tatty now!) so as you can tell, luckily, havn't needed to use it. Interesting what you mention (2-6 days to have any affect) as when I was admitted to A&E with racing heart, they gave me 2 Bisoprolol immediately also given a cup of Potassium to drink. Since then, no Bisoprolol daily, only pill-in-the-pocket. So, even though I hope to never need it, I'm hoping it WILL help me if I should.Elly

[DizzyD in reply to OAPjust]

Hi OAP regarding the point, bisoprolol takes 2-6 days, taken daily, to have any affect!!!! Like yourself, I was also admitted to a+e with. erratic racing heart and I was treated with bisoprolol which stabilised it in a matter of a few hours. What concerns me is that I had never had a AFib attack or racing heart issue prior to being prescribed bisoprolol. It was prescribed to me while I wait ( still waiting) to see a NHS cardiologist. In all honesty, I suspect that bisoprolol I dosed with, never having had a AFib attack or diagnosis, actually caused my A Fib. In other words: Pharmaceutical induced AFib, which can and does happen. This is why I want to get off bisoprolol. As a precautionary measure i would need a pill in pocket to play it safe.

Hey lovely, one day I could end up like you, with a tatty box in my pocket.

Thank you most sincerely

[gilreid1]

If they give you a high dose then I understand. This from NHS web site

It slows down your heart rate and makes it easier for your heart to pump blood around your body. How long does bisoprolol take to work? Bisoprolol starts to work after about 2 hours to reduce high blood pressure, but it can take 2 to 6 weeks to fully take effect.

[SamuelJB]

Hi I was like what you describe on bisoprolol then pill in pocket which had same effect on me sorted rapid bpm but sent me very unstable then that led into AF came off pill in pocket onto Sotalol anti arrithymia drug ....all good immediately and has been sstable. My problems got worse fast when I was on the pill in pocket. Feeling much better on Sotalol. Hope this helps.

[DizzyD]

Thanks you Samuel good to hear you feeling much better now with Sotalol. I have took note of this drug for future reference.Have a rewarding day

[Swalecliffe88]

Hi new on site but joined since having CRTD device implanted last week. Have been on Bisophrol since by pass op 7 years ago ( only 1.25 mg) once a day. But now has been increased to 2.25 mg twice a day felt so bad I accently may on purpose stopped taking AM dose when got home from hospital. Feeling more like myself. Thinking of requesting private consult with allocated consultant to discuss meds as not been reviewed adequately for 5 or more years. I’m interested in this ‘Pill in the Pocket’ you mentioned can you tell me where I could get more info ?