Medixation

[Juliet46]

Hello, Is anyone on rivaroxaban and bisoprolol and hydroxycarbamide and have any side effects.?

I feel tired and breathless all the time with back pain and I’m not sure if it’s a reaction to the medication.

Any comments would be appreciated , Thankyou.

[Rem31]

This is my experience: I’ve been on hydroxycarbamide and aspirin since 2013. I first noticed breathlessness on exertion (eg fast walking) a few months later. In 2018/9 lung and heart tests narrowed it to a heart problem and I was given a low dose of bisoprolol, along with other heart meds, as a safety measure pending an angiogram.

I already experience MPN related fatigue (it’s what led to my ET diagnosis) but the bisoprolol floored me. It lowered my already ok blood pressure and heart rate. It was all I could do to function physically and stay awake so, with cardiology clinician agreement, I stopped taking it.

My angiogram was fine with no firm diagnosis for the breathlessness (now recognised as angina). It’s managed with heart meds and by me recognising how far I can push myself. I’m now under the care of another, more specialist cardiology team, and testing is ongoing (not helped by covid disruption) to find its cause.

From my experience I can say it’s important to raise your symptoms with your care teams and don’t give up if you feel you are being fobbed off. I stayed quiet about my symptoms way longer than I should have done.

[Juliet46 in reply to Rem31]

Thankyou, I really need to discuss bisoprolol with my doctor. It’s just hard getting an appointment

[PhilReade in reply to Juliet46]

I was on Bisoprolol and hydroxycarbamide recently the stroke specialist took me off Bisoprolol and put me on propranolol I kept getting blurred vision

[hunter5582]

Hydroxycarbamide and bisoprolol can each cause fatigue and breathlessness. Taken together it is reasonable to suppose that the effects may be more pronounced. I took a low dose of atenolol (another beta blocker) and it left me very fatigued and breathless. I could not even make it around the block without getting very winded.

Rivaroxaban does have back pain listed as a common adverse reaction.

online.epocrates.com/drugs/...

The combination of hydroxycarbamide, bisoprolol, and rivaroxaban show this interaction.

Avoid/Use Alternative

bisoprolol + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (P-gp-mediated transport inhibited)

online.epocrates.com/intera...

The adverse effects you are experiencing need to be reviewed with your care team. Suggest you contact them at your earliest opportunity.

All the best.

[Jelbea]

Hello Juliet - I have ET/PV and take hydroxycarbamide 500 mg. daily since May 2021. Because I did have blood clots - one in a leg and three small in lungs - I have to take Rivaroxaban 20 mg. daily for life. I suffer, like you, with extreme tiredness but not really breathlessness. You are also on Bisopropol, I assume for hypertension, and I cannot comment on this other than to say that it is a beta blocker which can slow your heart rate too much and could make you tired and breathless. I cannot take betablockers because it slows my heart rate too much and caused me hair loss. The only other time I was breathless was when I had a small blood clot in each lung. I almost did not bother seeing about this as I was not very breathless. I am not sure of your age but I am aged 80. I have never been aware of side effects from rivaroxaban and I am lucky with the hydroxy which is keeping my blood levels great. It certainly does seem to make me very tired but it is working well.

You might need to check on your heart rate and it is unlikely you have a clot when you are taking rivaroxaban. Hope this helps.

[Juliet46 in reply to Jelbea]

Thankyou for replying

[Wesleygrange2a]

Hi

[Wesleygrange2a]

Hi I have had PV for 15 years and have taken Hydroxycarbamide for all that time with very few problems. However last year I developed Atrial Fibrillation and was started on Bisoprolol. I immediately felt extremely breathless , even going up the stairs floored me. The cardiologist tried me on another drug Verapamil which was just as bad. I now just take a blood thinner twice a day and although I do get a bit puffed out it’s not nearly as bad.

Hope you get sorted. Best wishes

[Juliet46 in reply to Wesleygrange2a]

Thankyou for your comments I’m going to ring my gp on Monday

[Andrew8]

I was on hydroxy in 2016, but after about 8 months experienced extreme fatigue, but my Haemo said it was not connected to hydroxy, however my doctor realised I had irregular heart rhythm, and I was diagnosed with AF .Heart problems are a known side effect of hydroxy .

After lots of tests and medication changes I was put on Jakavi and aspirin, for the MF ( was ET) and Sotalol and Warfarin for AF . After several cardio versions my rhytm is stable, and platelet level about 500. I do take magnesium oral supplements, which seems to help with fatigue, with the full knowledge of my Haemo and Cardio. Rivaroxaban caused me to have severe bruising on arms and legs.

[Juliet46 in reply to Andrew8]

Thankyou for replying!

[Scotishtaffy]

When I started taking hydroxycarbamide I would have the most horrific nightmares and would only vaguely remember (real or dreaming), and still 20 years later not as bad but I will hear noises or voices or think my wife has left the house, except she's still sleeping beside me.