Coming off ticagrelor

[Heartmum56]

Sorry another post from me about medication. Am a year post HA and getting it all reviewed ATM. Have just come off the ticagrelor and feeling worse than before. Very cold hands and feet, numb toes sometimes and tingly fingers, and also lots of funny heart beats more than before. I'm thinking that must be the bisoprolol which after a year and much exercise and losing weight has brought my rhr below 50. My theory is that without the ticagrelor my blood is thicker and with the slow heart rate it is making circulation more difficult than when I was on it. No idea if that makes sense physiologically! Whenever I mention low heart rate to gp she says don't worry it's just the bisoprolol. I haven't pressed her yet but she would probably let me drop it if I did. On discharge Harefield said they wanted rhr under 65 and I am way under that now. Does any of this make sense to anyone? Just worried about making these decisions with gp rather than a cardiologist but now discharged from Harefield and feeling the lack of gp expertise. Sorry for long post.

[HenryTudor]

I had a telephone review with my cardiologist about 15 months after my HA in February 2020. I’d been off the ticagrelor for a few months and mentioned that when waking in the morning I felt as though my heart was struggling to pump my blood around my body. He put me back on a reduced dose (60mg) for a further two years. I think this quite common. All is well now.

[Lowerfield_no_more]

You have been discharged back to your GP who is now your point of reference. So in the first instance you should go back to him/her for guidance on your situation. But if in the end you feel you are not getting the support you want from your GP you can always ask to see someone else aka get a second opinion. Your other alternatives are to talk to a pharmacist or the BHF heart helpline nurse.

[davebal67]

I didn't have a heart attack but had a bypass. During my 6 month check in, my Surgeon agreed to take me off my bisoporal because of the cold hands and feet and that it was making me miserable. Within two months my bp and heart rate came back to exact same levels as when I was taking the meds. In Feb I came off the BP meds, so Amlodopine, in discussions with my cardiologist, and he still didn't give me the all clear because the amlodopine was prescribed by the GP. I showed the GP my BP results for a month and he finally updated my notes to say that the amlodopine could be stopped on Thursday.My BP this morning was 109/74 with a heart rate of 51.

Doctors are loathed to take you off meds due to the duty of care but good luck to you.

I would definitely engage with the GP first.

[Qualipop]

COming off ticagrelor had no effect on me at all but that rhr is low. That's what bisopralol did to me so my G P changed it to a calcium channel blocker but he did contact the cardiologist first. I had had no follow up by cardiology after my heart attack and didn't even know who the consultant was. Except for a very technical discharge letter I hadn't a clue who to contact or exactly what had happened. I had to ask my GP to "translate" the letter. SInce then, whenever I've had a problem or needed meds changing, my GP has always contacted cardio if he felt it was outside his expertise. That's what your g |P shoudl be doing. You shoudl insist that this low rhr is really concerning you and if she doesn't know what to do ask that she contacts cardio right away.

[Clarijohn]

Bisoprolol does slow down the heart rate and this will make you feel cold. I have been on it for 19 years in varying doses, currently 2,5mg It doesn’t work by thickening the blood but by controlling certain nerve impulses. I hope this helps.