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Overdosing bisoprolol- can anyone offer advice?

Rhiannonimity1 profile image
22 Replies

I don’t know whether it is where I live ( the NW) but I really struggle to get appropriate treatment.

Anyway I picked up my meds on Saturday. Opened them in the car and noticed my bisoprolol was suddenly in 5 mg tablets not 2.5 mg. I went back into the pharmacy to be told that I have been on 5 mg tablets since Aug 1st. I told them this means I have been taking upto 25 mg bisoprolol per day instead of 12.5 . The have also given me 128 tablets 3 times since then without checking why I needed them.

On 21st August I was advised to take 12.5 mg bisop reducing to 10 mg after 2 weeks. Then 10 mg ongoing. I was ofcourse really taking 25 mg then 20 mg. After a week my hr reduce to 90 bpm but then I had a week of not being able to breathe especially at night. My ankles and stomach swelled badly. I had no energy. I went to the dr who did blood tests, bnp tests, chest X-ray and gave me diuretics. Blood tests no issue. Bnp high at 1200 suggesting heart failure, chest X-ray showed fluid on lungs. ECG showed no probs except AF. I have tests often. The dr was confused as to why I would have sudden heart failure.

I spoke to an emergency dr over the weekend who said an nhs incident had to be raised and reduced me down to 15 mg bisop. They have asked for the original dr to ring me tomorrow. I don’t know what to ask or say. Today I have had 4 episodes of the shakes for no reason - except maybe withdrawal? My hr will presumably rocket again but I will hopefully feel better on less bisoprolol. I am quite frightened about reducing. I have more tests booked for next week and an Echo the week after, but should I have these tests if I’m not stable? Can I insist on speaking to a consultant or should I trust this gp? How serious is this?

Psychologically I am screwed. I have been so ill for the last few months. I thought I might be dying.

I can’t believe I didn’t notice the tablets were 5 mg but I don’t usually collect my own meds and I had been on the same meds for 7 years. Should they just change your tablets without telling you?

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Rhiannonimity1
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22 Replies

That all sounds awful, I think most of us on repeat prescriptions could fall into that trap so whilst it a great reminder for us to always check what we are given, that doesn’t help you. I don’t really know what to say but if I were in your shoes I think I would email your EP’s secretary saying what has happened and say that you will ring her later the same day. You must also make sure your GP knows as he/she are responsible for helping you get through this. They will doubtless say that it’s your responsibility to make sure you only take the dose prescribed but the important thing now must be doing the right thing to make sure are and remain OK. I just hope that you get the help you need. It’s a shame you left it a bit late to tell us because most Brits will be in bed so help now is likely to be a bit thin…..if necessary DO NOT hesitate to dial 999 or go to A&E, at least you will be in safe hands, best of luck

Rhiannonimity1 profile image
Rhiannonimity1 in reply to

Thankyou for taking the time to reply at night flapjack - appreciated. I really need to contact my EP

in reply to Rhiannonimity1

Just hope you are feeling OK…..

opal11uk profile image
opal11uk

Only the cardiologist should change your medication if you are a heart patient, he/she in turn then writes to your GP advising accordingly what your medication should be, This really needs to be attended too so, if it was me, I would be asking for an urgent appointment with the Cardiologist or a member of their team. I too am on Bisoporal, originally 2.5mg but went into permanent A/F for some unknown reason which left me breathless, dizzy and with a cough, had chest Xray, echo cardiogram etc., and diagnosed then as heart failure, immediate appointment with the cardio team where I received excellent care and re medication plan, gradually increased Bisoporal up to 10mg plus a water tablet. Regarding your prescriptions you should receive a printed copy each time a prescription is dispensed, I keep all mine so I can look back and see exactly what has been prescribed and when so if you have yours it might be an idea to have a look and see when your script was changed.

Rhiannonimity1 profile image
Rhiannonimity1 in reply to opal11uk

Hi Opal. This is really interesting. I have all sorts of people change my meds. The bariatric surgery team. An arrhythmia nurse attached to my local hospital. My cardiologist is in a different hospital. Various gps have changed my meds. Thankyou for your reply. It is really helpful.

opal11uk profile image
opal11uk in reply to Rhiannonimity1

Each specialist team you mention will have the knowledge and expertise to know which drugs will be best suited and to monitor progress whilst administering, so quite in order for the Arrhythmia Nurse to administer as she reports back directly to the Cardiology Team. I have found the GP's, once you are under specialist care, will not want to change drugs as quite simply they do not have the expertise. My grandson is a scientist, makes drugs and knows content, he I would trust, a GP has very limited knowledge and often refer to a 'drugs' book so thats why they defer to the Specialist who prescribed in the first place. I hate being chemically controlled and always hesitant at starting a new or mixing drugs so I try to make sure I know exactly what is going into my body and why lol

Qualipop profile image
Qualipop in reply to opal11uk

After 4 days in hospital 2 months ago, I got my next repeat prescription and without looking, took one of my tablets. I thought as I swallowed it that it felt bigger than usual; checked the box and saw that it was double strength. Thankfully it wasn't one that had any adverse effect but I hadn't been told at all that it had been changed by the cardiologist. I rang my GP who told me the cardiologist had since changed his mind and I should be back on the usual dose. It just goes to show you need to check each and every box and query any changes. Don't just assume that if it's what they gave you it must be right. My surgery also recently gave me double the amount of oxycodone than I should have had (not double dose ; just twice as much) which got them into big trouble since it's a controlled drug. Mistakes do happen.

opal11uk profile image
opal11uk in reply to Qualipop

Yes, quite agree, always check because it can mean serious side effects for the patient. My trouble is I am always asking questions, I have even phoned manufacturers up when there has been any query, I have always been like this, hate taking any drugs and have always been drug averse, I hate the fact that now I am dependant!!!

Qualipop profile image
Qualipop in reply to opal11uk

I react really badly to many drugs so I always question too

Jalia profile image
Jalia

This is truly terrible. I can't add anything to what has been said already. This is a timely reminder to all to check their meds before taking . I also check new meds prescribed by GP. Maybe I take it a bit far but I never take anything in A&E unless I know exactly what it is and what it is intended to do.

I hope this is sorted for you soon.

opal11uk profile image
opal11uk in reply to Jalia

Me too and this saved me from a serious overdose when two different nurses wanted to give me the same meds, one ten minutes after the other!

Rhiannonimity1 profile image
Rhiannonimity1

hello Jalia. This has been a huge shock to me. The fact that I haven’t checked my tablets and just took the same quantities. I do question the pharmacy and surgery though. They gave me 384 x 5mg tablets in 70 days. 1/8, 1/9 and just this Saturday. Thank you for your reply- as you say it is a reminder to us all - our heart tablets aren’t to be messed with.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Just a suggestion but I had rapid H/R for too long - 187 Day on Metoprolol, changed to Bisoprolol - 156 still uncontrolled. Pauses at night with Metoprolol.

My Locum sent me to her recommended private Heart Specialist.

He went over my history Rapid H/R Persistent with AF and a stroke. Thyroid cancer Papillary type found shadow on my thyroid during a Carotid arteries scan on Day 4.

He prescribed a CCB Diltiazem 180mg.

It was Friday and I decided to introduce it on Saturday.

I took my BP and H/R by my cuff monitor.

The Diltiazem 180mg had taken myH/R down by 105bpm. I was lightheaded.

I rung Healthline and a doctor rung me back. I reduced Bisoprolol again to 5mg.

On Wednesday I rung the NZ Heart Foundation. The nurse knew my H/Specialist.

She rung him and my dr reduced my Diltiazem to 120mg AM. Also reduce Bisoprolol to 2.5mg at PM.

Great. The operation required a.s.a.p could go ahead. My H/R Day was now 88-96.

A year later and I had lost 3kg my H/R reduced to 60s Day at rest.

My Bisoprolol reduces my BP.

My Diltiazem reduces my H/R Day.

At night 24hr Heart Monitor x 3 all show my night rate @ 47 average.

Now 110-130 /69 BP and 60s H/R.

Seems like your H/Specialist could reduce your H/R by introducing perhaps a CCB.

Also doing that should lower your Bisoprolol. I understand maximum is 10mg.

All the best, look to the future to sort out your meds.

Cheri JOY. 74. (NZ)

WardijaWardija profile image
WardijaWardija

Hi. I'm sorry as to what your going through. I do get it, as I too are under many different consultants due to multiple illnesses - it's frustrating to say the least as you end up falling through the gaps, unless you keep on top of them.Something it can be hard to do, especially if you're feeling particularly unwell and just getting through the day is an effort.

I am also on Bisoporil 7.5mgs a day for me.

Started on the 2.5, no effect till it went up to 7.5.

I agree with all the other posters, sound suggestions/information.

I would definitely take up any of the tests you are being offered, even if you feel you are not stable, as it will build up a clearer picture of what's going on, at any particular time, reflecting the effects your medication is having at a set points.

What I would say, is that with the best will in the world, Pharmacist's do make mistakes, even though prescriptions are supposed to be double checked. I've had it happen to me a few times over the years.

As a former health care professional, I religiously check my medication when it's dispensed - it's a pain in the arse, I know, especially when you have a full bag of meds. to check through . . 😫 but it needs to be done, as indeed your situation shows.

I really wish you well and hope your issue gets sorted out. Take care. 🙏

dedeottie profile image
dedeottie

I always check my medication these days since the pharmacy gave me someone else’s chemotherapy tablets instead of my warfarin . Presumably they got my medication so I hope the pharmacy notified them . I didn’t look at my tablets for 2 days so potentially the person they were intended for had 2 days with my warfarin 😬

Leggylady profile image
Leggylady

Really sorry to hear what you are going through. I can’t add to the comments and advice already given, except to say I feel many of us could have failed to notice the change immediately so don’t beat yourself up. Don’t let anyone suggest it is your fault for not noticing - that is not the case. It is the responsibility of the professional who did it - whether it be purposeful or accidental.

Do hope it is resolved to your satisfaction very soon. Please do update us when you can. Take care. X

Very sorry to hear of your recent woes… and the understandable concerns you may have…

Before anything .. you must follow the doctor/hospital advice…here are some points that may give you peace of mind…

Bisoprolol works in similar ways to Propranolol by reducing the effect of Adrenalin on the hearts adrenal receptors… thereby lowering the heart rate…

I was on propranolol 40 years ago.. started on 10 mg twice a day .. and within a month forced up to 160mg a day… my breathing became laboured my fingers went blue…I felt like I was dying… three months before I decided to cut my losses.. only I too had to taper off.. slowly .. because in lowering the blocking effect .. your heart responds to the extra Adrenalin hence a faster rebound HR.

I too went through the jitters and shaky spells.. there are Adrenalin receptors all over the body which will not know why you are producing the anxiety juice in such quantities.

Over time your body adapts to these changes so when you reduce.. the heart rate tends to go back up… in someone with any level of heart failure it is going to make the heart work harder than it needs to at a time when it needs to reduce excessive loads.

Taking diuretics helps to reduce the work of a tired heart by getting sodium out of the tissues……when really you need to restore the exchange between sodium ions and potassium ions.. this is normal cellular practice.. but people in heart failure have sluggish metabolisms.. and sodium gets locked into cells..and tissue… hence swollen legs.

There are things you can do alongside your medication that actually speeds up recovery…

Using magnesium helps because it is the ATP switch that helps sodium ions leave a cell to let potassium ions in.. this creates energy .. Krebs cycle..you can improve things by taking magnesium taurate.. found mainly in heart cells..and CoQ10 .. d-ribose… astaxanthin.. all these improve the energy capacity of the mitochondria within the heart(each heart cell has 5,000/10,000 mitochondria) whilst helping the body get the excess fluid out .

If you retained fluid with high blood pressure your heart will have been working a lot harder than normal… it is able to recover once you reduce its load please remember that.

My mother had heart failure for 20 years and she found her swollen legs reduced much quicker when using magnesium even though she was on potassium and diuretics…

I really do hope you find some comfort in my message… reduce your meds slowly… try adding magnesium taurate.. see if your legs lose that excess fluid… then rebuild your mitochondria.. because you cannot exercise right now.. it makes sense to use certain supplements that increase mitochondrial health.. you should notice a difference with two weeks using Astaxanthin.. lots of papers show this to be correct.

Best Wishes from North Wales

Desanthony profile image
Desanthony

Wow. A similar thing has happened to me once. I had tried lots of beta blockers calcium channel blockers and the Cardio - just before my first successful cardioversion put me on digoxin - because I had had problems before thought I would be started off on a low dose. took them for about 6/7 weeks and had the same old problems as I had had on other medication. As it happened we were about to go and visit a friend (who just happened to be a pharmacist) and hadn't been able to pick up a repeat prescription. She said her Dad was on low dose digoxin and they had plenty there, she told us the size 62.5 and we realised I was on 125. So called GP and asked to be put on lower dose. I was much better for the month I was on the lower dose and put in a repeat prescription about 3 weeks before my cardioversion. About a week before my cardioversion I felt awful again. Don't know what made look at the box but did and realised the repeat had put me back to the original 125 dose! Luckily, after my cardioversion it was decided not to put me onto rate control as I was far better without it. We just don't think to check the tablets on our repeat prescriptions unless we have been told by the GP or consultant that they are being changed. Usually the pharmacist tells me when I collect my repeat prescription if anything has changed but not always especially when locum pharmacists are on duty.

BeeBee79 profile image
BeeBee79

This has happened to me although not to that extreme. I was on 2.5 and mistakenly taking 5mg but it turned out my body needed it. Eventually I was on 10mg per day and had to change brands as Bisoprolol was making me too weak to climb the stairs.

Teresa156 profile image
Teresa156

I’m really sorry to read your post and I hope you are feeling a bit better.

Do you have an on line app connected to your Drs Surgery? I know a lot do now and I have - it’s where I order my repeat prescriptions etc. you can also view your health record? I just wondered if you checked there as it would tell you ( or should do) exactly what’s going on with your meds and when it was changed ( and possibly why and by who).

baba profile image
baba

Did a Doctor change your prescription or did the pharmacy issue the wrong dose?

Rhiannonimity1 profile image
Rhiannonimity1 in reply to baba

Hi baba. Unfortunately I don’t know. On Saturday the emergency dr said an incident form should be raised and it should be 8nvestigated. The surgery yesterday said they don’t do that and that it is myresp9nsibility.

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