Bradycardia Continuing After Reducing Bisoprolol?

[Rhodog2612]

Hi everyone,

I have posted on the forum before about me potentially being very sensitive to Bisoprolol, after I had to half my 1.25mg dose on the advice of A&E and my GP to see if this would bring my heart rate up which was previously sitting in the low 40s and 50s the majority of the time. This means I was taking approximately 0.66mg per day.

This dose did help a little, but recently I noticed the drop in heart rate again into the lower 40s at night which was causing me to wake up through the night, and causing me constant tiredness and fatigue the next day.

A recent trip to A&E saw the doctor recommend that I try coming off Bisoprolol entirely due to my low heart rate, and so for the last 3 days I have been taking around a quarter of a 1.25mg tablet, which is around 0.31mg, with a view to continue this for 1 week and then slowly reduce this to a quarter or a tablet every other day, and then to eventually stop. I’m doing this to prevent side effects and withdrawals, since quite clearly I am very sensitive to the medication.

initially, when I started taking a quarter of a pill 3 days ago, I noticed quite a big increase in heart rate which seemed to be more like what I used to get before I started getting ectopic beats (70 - 80 bpm) rather than the mid 50s in the day and lower 40s at night, however I’ve noticed today that the bradycardia is back again despite the lower dose, and my heart rate has been dropping back into the high 40s and 50s - especially when I lay down and when I’m asleep which is when it drops to the mid - low 40s - never below 40.

The A&E doctor told me that coming off the medication and writing a letter to cardiology for another 24 hour ECG to be done is the way forward, and so initially when my heart rate rose back to normal I was quite happy, but now I’m not sure what could be going on.

For reference, I am a 29 year old male, don’t drink alcohol much anymore, don’t smoke, no drugs or other meds, around 5.5ft tall and I’m currently under the overweight category at around 85.5kg. I’ve had an echocardiogram showing no physical abnormalities, and had a 24 hour ECG in the past picking up 1 - 2% ventricular and atrial ectopic beats, with sinus bradycardia at times due to the Bisoprolol.

For measuring my heart rate, I’m using a pulse oximeter and also an Apple Watch which are both showing similar, if not the same results.

Has anyone else had any experiences with bradycardia which continues even after coming off or starting to come off of Bisoprolol, and should my heart rate have improved by now since reducing the meds with a view to stopping them completely?

It seems like a very small dose to me and I’m obviously very sensitive to the medication in general by the looks of it, but naturally I’m worried about the bradycardia - more so than the ectopics which were the original issue, in case this could indicate a more sinister issue rather than just a slow heart rate caused by Bisoprolol alone.

Any advice / experiences would be welcome!

[Suzyh]

Hi my cardiologist took me off bisoprolol straight away no reducing and I had no side effects and felt better straight awaySo pleased I did my heart rate is good and my blood pressure is perfect according to the nurse. But everyone is different hope you get it sorted soon

[Potter5678]

I was on bisoprolol 2.5mg for only 27 days. I had very severe side effects and was told at a&e to stop taking it without reducing the dose. I had severe withdrawal with high adrenalin rushes, anxiety and shaking for over 2 weeks. My heart rate was all over the place. I'm still suffering 2.5 months later with periods of high adrenalin and anxiety but my bp has settled down.

[Adhtz21]

Hi, I have Bradycardia and first degree Heart Block. I was on 2.5 mg Bi SF Bisoprolol but self-reduced down to 1.25mg. This was later ratified by my Cardiologist. I also now take Doxazosin which has increased my heart rate which at resting is now 60 ish on mild activity days and 55bpm on no real activity days. It serves two purposes in reducing my blood pressure as well as raising my pulse rate which previously had a resting rate in the 40’s. Regards, Andy

[Douglas91]

Bisoprolol is heart specific which means it acts directly on the heart to make it more efficient at pumping blood around the body. It can and does have the side effects of slowing heart rate down quite substantially. It does say on the information leaflet inside the medicine box not to use if you ordinarily have a slow heart rate. Doctors will weigh up the pros and cons of using this medicine in cases of a normally low heart rate. I’m told that if you aren’t having any disabling symptoms from the drug like dizziness fainting or fatigue then don’t get too hung up about the heart rate number. Your heart will probably be just as efficient at pumping blood around the body. If you are concerned then it’s a good idea to talk to your doctor about changing to another beta blocker There’s many different ones which work in different ways. Good luck