Ivabradine vs bisoprolol for POTS and palpitations

[chestnutty]

Has anyone any experience of Ivabradine? I have worsening (or a bad patch?) of palpitaions with underlying mild POTS. The bisoprolol doesn't seem to be helping with the palpitations which seem to have worsened recently and changed from ventricular focussed to atrial. It seems an odd choice to me (and my GP) since I have naturally low blood pressure and pulse which appears to be a contraindication on the BNF. The GP is awaiting a reply to her request for further advice and guidance. TIA all

[VelvetSky]

Hi, I had to stop Ivabradine, I was having hallucinations at night, black bars on the wall and the hallway full of black snakes. Interestingly even though this was several years ago I still put my slippers on at night to walk across the hallway, just in case of snakes. Totally illogical but it must imprint on your subconscious. I’m not really frightened of snakes and what protection would fluffy slippers be against them anyway. Send for the men in white coats!

[chestnutty in reply to VelvetSky]

That sounds very unpleasant - and scary!

[VelvetSky in reply to chestnutty]

Hi, not as scary as the Stevens-Johnson syndrome I had last year but that’s another story. I have guilt over the Avabradine, my very elderly Aunt was put on it and she had exactly the same side effects but as she was so elderly we just thought she was getting senile. It wasn’t until I had the same problem we realised it had been the medication but by then it was too late.

[Cherrelleford]

Hi.

I have recently stopped ivabradine after a hospital admission. My pulse rate dropped to 34 and my heart was doing extra beats. I was extremely weak and dizzy. So the tablet was stopped. I'm still on my bisoprolol though and I don't have any issues with it.

[MelB51]

Hi. I take ivabradine twice a day and have done for maybe 6 years. In my case it is to stabilise and lower my heart rate to a normal level. I have had no side effects at all.

[FeetheBookworm in reply to MelB51]

I’ve been taking Ivabradine twice dailyfor 6 yrs too. I’ve had no side effects either. The Bisoprol prescription was upped to 2.5 last yr and initially it gave me terrible upset stomachs but that has now stopped. Took about 10 months.

[Maythyme]

I can’t take Bisoprolol because it worsens my normally stable asthma so I’ve been placed on Ivabradine twice a day. I don’t have any problems with the morning dose. However, I was taking the evening dose at 6 pm and found that by about 10 pm I started to experience visual disturbances. If I moved my arms it was like there was a motion-blur and also it was like there were insects whizzing around!

Following a suggestion from my practice nurse I delayed taking the dose until just before bed. This largely seems to have sorted the problem. I don’t seem to have had any other side effects apart from this. So I think timing of dose is important.

Hope that helps!