Meds and Fatigue - is it Bisoprolol?

[Massa]

Just over 3 years ago I had an AF which we think was triggered by Chemo. Prior to that I was relatively fit and active and on no meds. I spent 48 hours in Hospital where the doctors managed to sort HR out with drugs. I then left with meds / prescription for Amlodopine 10 mg and Bisoprolol 5mg x 2 per day. More recently I have had issues with ectopics and low heart rate but as soon as Losartan dosage was dropped back from 100mg to 50mg they stopped. Fast forward and I am continuing with my push on a very healthy diet but have absolutely zero energy, poor fatigue, unable to (stay) asleep at nights. Started to push back on Cardiologist re meds whom I haven't seen for 3 years and after both the holter monitor and echocardiogram coming back fine, heart in sinus rhythm he agreed to drop Bisoprolol to 3.75mg x 2 / day and Amlodipine to 5mg.

He said that I need to take both as the work together but I don't feel like the Amlodipine is doing anything especially for the BP. I do feel however that the Bisoprolol is the main culprit for basically feeling tired and lousy most of the time. GP said he needs to be guided by Cardiologist, and Cardiologist has said see you in 12 months. In the meantime I am wasting another year. To confirm I have only had the one episode of AF which was when I was on Chemo. Seen lots on hear about the good and bad of Bisoprolol but would welcome peoples thoughts on both experiencing similar side effects, how best to manage, and of course how do I get off this stuff

[Jalia]

My sympathies with the Bisoprolol. All but the lowest dose .....1.25mg...makes me feel the same. Zero energy and feel like I'm wading through syrup. I only take it when I flip into AF , not that it does much good.

If your GP isn't able to help I would suggest you leave a message with your cardiologists secretary requesting authority for lower dose as its affecting your QOL

[Massa in reply to Jalia]

Thanks Jalia, Cardiologist had reduced it from 5mg to 3.75mg but can help feel in the grand scheme of things the benefits re QOL are all but negligible.

[Ewloe]

I think as jalia said contacting the cardiologist secretary is a good idea. I’ve done that before and it’s worked. Compose a short letter ( keep it short and relevant making it easy for them to deal with), explaining things. I was on the same dose as you but struggled with it so contacted the EP via his secretary and he replied lowering my dose to 2.5mg x2 daily. I know I definitely need bisoprolol but the lower dose works for me. Good luck

[Massa in reply to Ewloe]

Thank you Ewloe, good advice. I have been awake since 4:30 am and after giving up any notion of nodding back off I took Jalia's (and now your) comments onboard and have started to draft a letter which hopefully will have the desired effect

[Drawforaliving]

I agree with Bisoprolol being the culprit. I take 6.125 dose daily and it certainly does cause those problems. I once went up to 7.5 and I honestly could barely function. The difference for me is I get dangerous arrhythmia's. I have had full cardiac arrests and Bisoprolol does stop the dangerous beats that can lead to cardiac arrests for me. So I need to tolerate it to the degree I can manage. I do think the low heart rate it causes is the root of your problem. I have an ICD that keeps my heart rate at a min of 60 bpm, which I felt really helped with the drug induced fatigue I had previously. It is important they help you find a dosage you can live at, not just exist. Good luck.

[Massa in reply to Drawforaliving]

Thank you, and we are all very different and in the grand scheme of things I am not to bad I suppose but the side effects are impacting on the QOL. I think I just need to preserve and get the right dose / mix and trade those off with the side effects but at the moment the side effects have to much bearing on my daily life

[Roughandtumble]

Hi Massa, I have been taking Bisoprolol 2.5mg once a day since a sudden out of hospital cardiac arrest in July 2023. Also had ICD implant. Also taking atorvastatin for cholesterol. Am 67 years old. I do feel tired a lot of the time and sleep badly, but I find best antidote is exercise and sensible diet. I expect to be on Bisoprolol for rest of my life but am still able to do everything I want to, which includes long distance walking and cycling. Try to find the right mix for your own body as everyone is different. Hope that helps.

[Massa in reply to Roughandtumble]

Hey rough and tumble, I know exactly what you are saying but I don't seem to be able to break through the fatigue / insomnia. I have been a sporting Billy all my life up until 3 years ago and would cycle 100 to 150 miles per, play squash, and just love the outdoors. But I honestly don't have an ounce of energy to do any of that plus have always had a sporting life the impact mentally of doing nothing is mentally challenging

[fishonabike]

it's a nuisance when medications cause side effects which affect your quality of life - some people find that taking beta-blockers like bisoprolol in the evening eases the fatigue, but they can affect your sleep more then - maybe worth a try?

[Massa in reply to fishonabike]

Hey fishonabike, I have tried taking the other meds in the evening but the Bisoprolol are 2 per day 3.75 so invariably I am stuck with one in the morning and one in the evening.

[Survivor1952]

What you describe will be the impact of most beta blockers of which Bisoprolol is one. They are designed to slow the heart to give it an easier time. The severity of the side effect will differ from person to person and drug to drug. If I were you I’d pester my cardiologist.

[Massa in reply to Survivor1952]

Thank you survivor, based on yours an others feedback that's exactly what I am going to do

[BeeBee79]

I was on Bisporolol and it made me so fatigued - I had gone from being fit and used to run 5 times a week to needing to sit down at the top of the stairs after climbing. Not breathless - my whole body felt like lead. I told my cardiologist this and asked for an alternative so he put me on Nebivilol. It still gives me fatigue and I have to be clever about which time of the day I take it if I want to do a spin class but it’s nowhere near the fatigue levels of Bisoprolol.

[Massa in reply to BeeBee79]

Hi BeeBee79 that is exactly how I feel, did it have any effect on your sleep at all?

[BeeBee79 in reply to Massa]

I didn’t notice much of an effect as I am annoyingly, one of those people who doesn’t suffer with sleep issues. I did find it better to take these beta blockers in the evening though. If I know I’m going to exercise in the morning, I will skip it and take after exercising as I can’t get my heart rate up and fatigue means it pointless even trying 😳

[Crumbling]

hi there, it sounds quite a high dose, I was put on 2.50 once a day but I felt as if I was walking through treacle, I asked my cardiologist about lowering and now I take 1.25 and I feel so much better.

[Grannypat65]

Hi I'm on Bisoprolol twice a day 5mg. All it seems to do is make me very tired and breath less when going upstairs or slight hills. I am wandering what it does for me I have arterial Fibrillation and having a ablation next month. I thought is meant to keep my heartbeat under 100 beats. But it still goes over 100 even if I'm sat down. So i guess similar to your experiences.

[Massa in reply to Grannypat65]

Hi, my HR is about 70 ish and creeps up a bit when waking etc . I am very much like BeeBee79, go up a flight of stairs and it's like I have lead legs, never out of breath just tired. I get up in the morning and shower and get ready for work but when I get downstairs I need a good 15 mins to recover before making my breakfast. Again not breathless at all and HR in low 70s, it's just really bad fatigue

[Goldfish7]

sounds like the Bisoprolol even at low doses it badly affects my sleep, weight, fatigue, breathlessness, and makes me feel cold.

[Massa in reply to Goldfish7]

I never thought about it having any impact on my weight I thought it was me being so fatigued but i have put some pounds on since taking Bisoprolol and can't shift it despite a very healthy diet since Jan

[Goldfish7 in reply to Massa]

I know, I went down to one meal per day for a few weeks when on 10mg of Bisoprolol and only lost 2lbs which didn't stay off' I've been allowed to cut down on my Bisoprolol if I can keep my heart rate down to below 150bpm so have reduced meds to 2.5mg per day (only because I'm still in NSR) and have managed to lose one and a half stone in weight - again on eating one meal per day. I'm desperate to lose more weight but know this is reliant on my rapid AF not kicking in again.

[sam-sam32]

I am on 2.50 mg Bisoprolol which I take once daily at night so the worst effects are not with me all day. I had a terrible time with it initially, but after 2 years I have started adding a few chi gong exercises (raising the chi) recently and they have made a big difference. I am an older person so it is a bit difficult to sort the ageing effects (less energy) from the Bisoprolol. However, I do recommend trying raising the chi (there is information online if you google it). I do yoga and meditation too but tho' they are highly valuable and important to me, they didn't alter my energy levels. It often feels like I have a set amount of energy and when I use it up I am exhausted. Re: getting off it, I suppose you have to be guided by your medics. However, I have been told by my GP that it must be reduced slowly. Best wishes. sam-sam32

[888srt8]

Hi, I take bisoprolol, 2.5, and i'm constantly exhausted and fall asleep as soon as i sit down. Also have other major health issues that prob affects too. I'm 63, type 1 diabetic for 50yrs, pacemaker and waiting for two valve replacements also pernicious anaemia.

[Massa]

Hello everyone, many thanks for all your comments which reconfirm my suspicion regarding the side effects I am experiencing because of the Bisoprolol. The advise regarding engaging with Cardiologist and GP has also proved very useful and his Secretary is now trying to get things reviewed. My GP has also showed a more than sympathetic ear and has agreed to work with me and the Cardiologist to get a long term fix whether it's a slow withdrawal or change of meds to something better for me. So all in all its a good start and thank you all once again. I will post and update on a new thread as and when things progress