Bisoprolol withdrawal or not???

Hi all, had stents done 4 years ago. All has been good, however, I now see that bisoprolol is usually withdrawn after a year or so . Is this right? My GP is not very proactive and just says if you feel ok why change? My hr is 50 to 55.

[SpiritoftheFloyd]

Hello and welcome to the forum.Bisoprolol is normally a long term medication, frequently for life. Have a look at the link below - section 9 - How long will I take it for.

nhs.uk/medicines/bisoprolol/

[Hidden in reply to SpiritoftheFloyd]

Thanks for replying so quickly. I have read that info. However, the BHF site suggests it may be stopped if no other problems exist. I am on ramipril also. My HR is 120/65 on average. My worst side effect is very cold feet particularly toes. Oh well, I'll just keep popping them I suppose.

[SpiritoftheFloyd in reply to Hidden]

I was on Bisoprolol and found that I had freezing cold hands and feet and a constantly runny nose, I changed over to Carvedilol and found that the problem was much better, still get a running nose if I'm out walking in a cold wind, but much improved.

[Peony4575 in reply to Hidden]

If you put Bisoprolol withdrawal into the search above lots of information and previous threads will come up which are well worth a read . They are not the harmless smarties some doctors make them out to be

[Peony4575 in reply to Hidden]

Sorry am not very good with links, but if you put Beta Blockers are Busted into google an article from New Scientist comes up which discusses trials that dispute their usefulness for some cohorts of patients in this day and age

[Hidden in reply to Peony4575]

Interesting read, thanks.

[tommywaits in reply to Peony4575]

An interesting read. it suggests that historically beta blockers were beneficial in preventing arrhythmia in patients with heart failure but had no effect when methods to open blocked arteries were put into practise. That article was from 2010 so I searched for something more recent and came up with a meta-analysis from 2020.

bmcmedicine.biomedcentral.c...

A difficult read but the conclusion is straightforward:

"Although beta-blockers are widely used in routine clinical practice, this analysis indicates that their overall clinical effect depends strongly on the clinical situation. In patients with heart failure and reduced ejection fraction who are in sinus rhythm, beta-blockers show clear benefit in terms of mortality reduction and lower rates of hospitalisation. However, beta-blockers show neutral effects for many other clinical situations in the modern era, and in some cases, harm".

[Peony4575 in reply to tommywaits]

Thank you for the update Tommy I couldn’t agree more. Practice is slow to change even though the evidence that they don’t improve outcome in many cases has been around since at least 2012

[Peony4575]

Lots of reasons to stop bisoprolol if you don’t have to be on it. Increases your risk of type two diabetes by 50% to name but one disadvantage . I feel so much better off it. Felt awful on it . Had problems on it. Problems coming off it. Am getting back to normal after 10 weeks off can walk more briskly etc. Some people can just stop it but my advice would be wean off gradually

[Bry14]

Hi pokerman, I suffered/suffer from constant dizziness and reading bisoprolol had a side effect of this I couldn't wait to stop taking them. My HR was constantly in the 40s whilst taking them and being relatively fit I felt they were actually dropping it too low. I managed to reduce my dose after a year of my HA and CA, then stopped all together without any issues. Check with your pharmacist too they can sometimes be very helpful.

[Mart25]

Your question interests me too. I too have read that some patients can reduce/stop beta-blockers after 6 months/1 year post-surgery. I had bypass surgery in October last year and have been on 2.5mg bisoprolol since then. My resting heart rate is around 60bpm......and this has been my resting HR for at least the last 25 years. My resting blood pressure is very similar to yours. Like you, I have cold hands and feet, which is a known side effect of some beta blockers and I also have some postural hypotension (dizziness when I stand up) so I am keen to stop taking bisoprolol but I do not understand fully the downsides of stopping. From my reading, I can see that it's complicated. The decision depends on whether you have a risk of atrial fibrillation or other arrythmias (because this is mainly what the beta blocker controls) and this depends on your heart history, and whether a 24 hour Holter monitor has shown up any issues. So the decision is clearly a very individual matter. For me, I had a review with my cardiologist last week and we agreed to reduce bisoprolol to 1.75mg. He said we might stop it altogether in 6 months, but I want to understand a bit more about the pros and cons before we make that decision. So I'll be interested in the responses to your post. Thanks for raising the question.

[Peony4575 in reply to Mart25]

Beta blockers control RATE of your heartbeat not rhythm . To be blunt anyone who walks into a cardiology dept is more likely than not to come out in a beta blocker most commonly bisoprolol as far as I can tell . I shouldn’t have been put on one in the first place and bisoprolol actually caused arrhythmia I didn’t have before which seem to have more or less settled now I have been off 10 weeks

[Mart25 in reply to Peony4575]

I have the same feeling as you that there is a default "recipe" for medication , but this then needs adjustment for individuals as they respond to treatment. I'm sure cardiology departments try their best to do this (I've certainly been impressed with mine) but I think the NHS is just so busy that patients should get themselves informed and request a review if they have concerns. I disagree that betablockers control only rate. They can also control arrythmias. (see bhf.org.uk/informationsuppo... in some people they can cause arrythmia (and you are clearly one of those). This just emphasises my point that the decisions are very individual.

[Hidden]

Hi. I was taken off Bisoprolol three months after my CABG and had no side effects. I take an ace-inhibitor to control my blood pressure so didn't need to stay on it.

[Cruise1]

I was put on Bisoprolol after having 2 stents fitted in January, despite already taking Perindopril for high blood pressure. I suffered a runny nose and white fingers so GP suggested reducing dosage and if that didn’t help, just stop taking it. On checkup with consultant last week he looked surprised that bisoprolol had been prescribed and told me to stop taking it. I told him I already had due to side effects and I produced daily blood pressure readings for the past month since discontinuing it, which he was pleased with. He also said to discontinue isosorbide mononitrate, which I had already done too. He then discharged me.

[Prada47]

Hello People

Just one word of caution I have read how Bisoprolol has side effects most Meds have side effects for someone . The negative press for Bisoprolol is I believe sometimes a little over the top.

The Question No one can Answer is how many Lives has Bisoprolol Saved Now that would be really interesting. I am only on the 7.5 mg dose but I get on with it pretty well. Sometimes I think because I am looking for more Positives than Negatives all I can offer is give it a decent trial.

You never know it may be what Saves Your Life.

Vaccinated Hands Face Space to stay safe

[Peony4575 in reply to Prada47]

Actually you wouldnt think it was over the top if you experienced them, and patting yourself on the back for looking for more positives so presumably those that suffered it was all in the mind, isn’t helpful . I am glad you can tolerate bisoprolol pretty well, others can’t and it isn’t their fault

[Prada47 in reply to Peony4575]

The question is still how many has it saved I wasn't looking for a pat on the back but 100s 0f thousands do take Bisoprolol without any problems Lucky I am one of them. I never mentioned it was possibly in the mind , but I do believe if someone is looking for side effects this is the place to find them.

Vaccinated Hands Face Space to Try to Stay Safe

[Hidden]

Personally I am in the anti-Biso camp. I have kind of got used to the side effects (cold hands / feet etc) but my biggest complaint is that it slows my heart rate down into the 50's at rest. (What is wrong with it being high 60's / low 70's at rest)?

After an acute event over-medication is the policy - to be on the safe side. There are all kinds of promises about medication being reviewed in the future but even pre-Covid these were, in my case, empty promises. In reality the cardiologist loses interest as you become 'history' and the GP won't go against the cardiologist (if they look at it at all).

For the NHS the easiest course of action is to leave you over-medicated. If you suffer another acute event they can say 'well we gave you every pill we could give you'. If they take you off medication and you suffer an acute event then there is the risk that you or your family will sue for negligence. Unfortunately that is the kind of world we now live in now.

I have asked my cardiologist to reduce / eliminate Bisoprolol from my daily meds list. After 5 weeks the silence is deafening.

[dikda]

DikdaA warning from personal experience. Seemingly, we all respond in very different ways to Bisoprlol Fumerate and its withdrawal. Quad heart bypass (restricted arterial blood low) seven years ago and have been taking 2.5mg of Biso and Ramipril ever since as prescribed ex Kings College and have been v very fit ever since with no heart related probs whatsoever and have been able to regard my surgery, truly as a"non-event"!!! Last November my 'new' GP became 'proactive' and began a 'review' of meds and health state - a total novelty to me as I have no need of a GP from one year to the next and at 84 am fortunately both mentally and physically very fit. Now, a precautionary ECG highlighted my low pulse rate which had been 'hard earned' in the course of training to be a 'free diver' 60 years ago(50 feet/up to 3 minutes). GP halved both meds which had little effect in any direction. The decision was then to withdraw Bisol totally to raise my pulse rate despite my weekly monitoring and reporting since my surgery 7 years previously. The result was catastrophic - within 3 days, I had a compacted bowel, cleared both manually and by laxative, followed by acute stomach pains which I could not relieve by any method - followed very suddenly with a crash in body temperature, violent shaking and shivering, mouth locked in a 'gape', teeth chattering uncontrollably and hands shaking violently AND I was totally alone! I suspect that for a time, I was barely conscious. What to do - one dose of 1.25mg of Biso and in 3 hours all symptoms abated. Fortunately, I am mentally very strong but it was VERY, VERY UNPLEASANT. Now, my response may be exceptional but withdrawal of this med is NOT straightforward.