Bisoprolol. Any fellow takers/sufferers ?

[libra rising]

I returned home from hospital 6 days ago. I have felt far tireder than I did on the ward. My first thoughts were that it's one of the two anti-biotic tablets I'm on. That course finished on Friday, and my tiredness persists.
Ony on Saturday morning did I think let's see what the internet has to say on bisoprolol and tiredness. The answer is loads !
it's also possibly known as Cardicor, Congescor, or Ziac.

Some people found that taking their tablet in the evening, rather than the morning, helped with the symptoms. I did this yesterday evening, and the following two things happened both of which were suggested by patients taking this drug : I slept better and longer. Usually I might wake at, say, 5.30am and decide to get up as I wouldn't sleep any more. This morning I was able to doze till after 7 (this really is most unusual for me). Secondly, I did more dreaming.
I wait to see what today brings regarding tiredness. This tiredness doesn't stop me doing anything. It's just always there like an invisible barrier.

Does anyone have experience of this drug ?
Geoff

p.s. I have 'form' with other drugs. My GP once put me on Ramipril, which turned me into a zombie, and after falling down my stairs at home, I discontinued.

 

[LondonAndy]

Yep! I was started on Bisoprolol after my heart surgery too, and beta blockers definitely leave you feeling tired all the time. I generally respond well to medication, but really struggled with Bisoprolol which seems to be the default beta-blocker here in the UK. I had some pain in my legs after a while, and although this is mostly though to be because of diabetic complications, I had not had pain before, and after switching to another beta-blocker I ended up on Nebivolol, which has a reduced impact but still causes tiredness. I also switched to taking mine at night for reduced impact during the day.

Like you I had pacing problems with my AVR surgery, and I am one of the 6% ish that has ended up on a permanent pacemaker and am 100% paced. I have asked my Cardiologist if I can come off the beta-blocker but they always say no, and don't stop taking it as it can then cause problems.

 

[epstns]

Sorry for the late response, but life gets in the way sometimes.

I do not take Bisoprolol, but I do take Metoprolol - a similar beta blocker. Just after valve surgery, I was prescribed metoprolol at 100 mg/day. I still remember the vivid dreams. I used to think to myself, "It is almost bedtime. I wonder what's showing tonight." Just like going to the movies, but with no choice of what to watch.

I also remember feeling like I was dragging a sled full of rocks behind me all day. I put up with this for a few months, but when I was due to start cardio rehab, I couldn't do the class activities. I stopped in to see my cardio and negotiated a reduction in my metoprolol dosage from the initial 100mg/day to 50 mg/day. This made a major difference, and I was able to easily keep up with the rehab class. When I completed rehab, about 6 months out from surgery, I negotiated a second reduction of metoprolol dose from 50 mg/day to my present 25 mg/day. Another major improvement in my exercise tolerance, and the dreams went away.

I do NOT recommend that you decide all by yourself to reduce your beta blocker dosage. I DO recommend that you discuss it with your cardiologist. At some point, the doc may agree that it may be safe to try a lower dosage. If the reduced dosage still has the right effects on your blood pressure and heart rate, you may be OK there.

In my case, even at 25 mg/day, my maximum heart rate is in the range of 145-150 BPM. This sounds right for a guy of my age (now 70), but I am a long-time gym rat, and I'm sure that if I did not take the beta blocker my max heart rate would be back up in the 160's, where it was before surgery.

 

[honeybunny]

Like epstns, I was prescribed Metroprolol 50 mg/day. I didn't like how I felt...just sort of out of it. So I called my cardio after a week or so and he said I could reduce it to one 25 mg tablet a day. I felt much better afterward.

 

[Paleowoman]

I was prescribed Atenolol and didn't feel too great on it and had vivid dreams. After three weeks or so my cardiologist halved the dose and then after seven or eight weeks he stopped it altogether.

 

[libra rising]

I was prescribed metoprolol at 100 mg/day. ... I stopped in to see my cardio and negotiated a reduction in my metoprolol dosage from the initial 100mg/day to 50 mg/day. ... I negotiated a second reduction of metoprolol dose from 50 mg/day to my present 25 mg/day.

I guess your beta blocker is at a totally different strength per mg. Bisoprolol comes in 2.5, 5, 7.5, and 10 mg. I'm merely on 2.5 at the moment. I will be seeing my GP tomorrow, although nominally for a diabetic check-up. I'm sure he'll be aware of my concerns before I leave ; )
Geoff

 

[libra rising]

Like epstns, I was prescribed Metroprolol 50 mg/day. I didn't like how I felt...just sort of out of it. So I called my cardio after a week or so and he said I could reduce it to one 25 mg tablet a day. I felt much better afterward.

That's good to hear but I don't feel good on the lowest dose : ((
Geoff

 

[libra rising]

I was prescribed Atenolol and didn't feel too great on it and had vivid dreams. After three weeks or so my cardiologist halved the dose and then after seven or eight weeks he stopped it altogether.

That's good to hear. I simply don't know whether my Bisoprolol was meant to be temporary or not. Perhaps my GP visit tomorrow will help.
Geoff

 

[Paleowoman]

I simply don't know whether my Bisoprolol was meant to be temporary or not. Perhaps my GP visit tomorrow will help.Geoff

Hi Geoff - I didn't know how long people were meant to stay on these meds post AVR and there seemed no one to ask, so I emailed Mr Simon Kendall, cardiac surgeon and honorary secretary of the Society for Cardiothoracic surgery at the time whose videos are still on that website. He told me that normally people stay on beta blockers for six to eight weeks post AVR. Obviously that is depedent on your cardiologist too. Just let your GP and cardiologist know that the bisoprolol is causing you problems.

 

[LondonAndy]

He told me that normally people stay on beta blockers for six to eight weeks post AVR. Obviously that is depedent on your cardiologist too. Just let your GP and cardiologist know that the bisoprolol is causing you problems.

Interesting, thanks Anne. I am under the impression that my beta-blockers are for life, along with Warfarin, Insulin and a bunch of other stuff given that I am also diabetic and have a pacemaker. As I am 100% paced with, as I understand it, no underlying rate following surgical complication when they did the valve, it has always surprised me that I should also need a beta blocker, and I will definitely gently probe this again at this year's annual checkup. Of all the drugs I take this seems the one that impacts on my life the most.

 

[epstns]

Andy - Your pacing situation may be like mine. Remember that there are two sets of heart chambers that are paced either naturally or electronically. The atria pulse first, followed by the ventricles. In my case, my atrial pacing is 95% natural, but my ventricular (lower chambers of the heart) pacing is 90% artificial. I still take the beta blocker to keep my atrial pacing from going too fast, which they fear could trigger afib. My ventricular pacing just follows the atrial pacing, with an appropriately-set time delay between upper chamber pulse and lower. The nerve channels between the atria and ventricles were damaged in valve surgery, hence the pacemaker (at least in my case).

So, I have the pacemaker to ensure that my heart rate doesn't drop too far, and the beta blocker to ensure that it does not go too high. It was kind of a balancing act to get all the meds and settings right, but once we got it, I've been stable and able to conduct my life just fine.

 

[LondonAndy]

Ah yes, of course Steve. Thank you - I get confused about the pacing between chambers, but Anne's comments are interesting and I will see if i can get the dose reduced, though I am only on 5mg Nabivolol so maybe there is not much scope for reduction.

 

[newarrior]

I have mild AS, way pre surgery--started bisoprolol May 14--1.5 mg---biggest side fx are sexual, depression, fatigue, brain fog, bad dreams, loss of interest in ***/women, constipation...Some fx are getting better---

 

[Protimenow]

This is all interesting stuff. My cardiologist has, as long as I've been seeing him, prescribed twice the dosing that is needed for the desired effect. He once prescribed metoprolol - someone in his office said I should take twice what he ordered, so I was actually taking FOUR TIMES the effective dose.

The side effects were terrible. He switched me to bisoprolol - supposedly with fewer side effects. I'm taking 1/2 of the prescribed dose (without the bottle at hand, I think that I take 1/2 of a 5 mg pill).

I'm not entirely sure that I need the cardiac meds that he's prescribed -- but -- he's the doctor.

Like others, I'm still feeling a great deal of fatigue, drowsiness, depression -- and maybe, with your anecdotal descriptions of YOUR side effects, might have put a finger on what might be causing it (aside from depressing issues already clouding my life). My heart rate is fine. Benazepril keeps my BP in a healthy range.

So -- in answer to the question that started this string - I take Bisoprolol. I take a low (baby?) dose - but still get symptoms that might - just might - be side effects, even to the low dose. In my case, I think Metoprolol was even worse on me.

 

[carolinemc]

This is all interesting stuff. My cardiologist has, as long as I've been seeing him, prescribed twice the dosing that is needed for the desired effect. He once prescribed metoprolol - someone in his office said I should take twice what he ordered, so I was actually taking FOUR TIMES the effective dose.

The side effects were terrible. He switched me to bisoprolol - supposedly with fewer side effects. I'm taking 1/2 of the prescribed dose (without the bottle at hand, I think that I take 1/2 of a 5 mg pill).

I'm not entirely sure that I need the cardiac meds that he's prescribed -- but -- he's the doctor.

Like others, I'm still feeling a great deal of fatigue, drowsiness, depression -- and maybe, with your anecdotal descriptions of YOUR side effects, might have put a finger on what might be causing it (aside from depressing issues already clouding my life). My heart rate is fine. Benazepril keeps my BP in a healthy range.

So -- in answer to the question that started this string - I take Bisoprolol. I take a low (baby?) dose - but still get symptoms that might - just might - be side effects, even to the low dose. In my case, I think Metoprolol was even worse on me.

Is there anyway for you to explore other cardiologists? Can you do it within your health care plan? Sounds like you need to find another Cardio that will listen to your concerns on the meds. If you feel that the meds are making you feel worse, they might be. You can change doctors. be proactive and never accept 2nd rate care from a 2nd rate doctor. For you do deserve the best.

 

[Thomas]

I'm on 2.5mg bisoprolol once a day. I'm taking it at night to try to minimize the effect of feeling fatigued through the day.
I've been experiencing bad dreams like newarrior mentions. I didn't realize that could be a side effect; I thought it was just spicy food at dinner time or something like that.
My cardio says he's got me on it to try and reduce the extra beat that my heart is throwing in now and again. I've been taking it for nearly a year now. I know he wants me to continue with it until my next follow up in about 6 months. Other than warfarin and 81mg aspirin that's all I'm taking.

 

[Paul1972]

I’ve been on 5mg of bisoprolol since my second surgery two years ago. Surgeon and cardiologist want me to stay on it indefinitely as they say it has proven benefits in the long term .

 

[Agian]

New warrior, why don't you try another beta blocker? I tried Metoprolol for a while and thought it was crap. Now I'm on atenolol. I love the stuff. Keeps my heart rate nice and mellow. Ask if you can switch over. It might be a better fit for YOU. Everyone responds differently to a particular medication.

 

[Protimenow]

Agian - I took Atenolol years ago, and don't recall trouble with it. Perhaps if my cardio will waive my deductible (which I can't afford) and see me again, I'll ask him about making the switch.

Carolinemc - thanks for your urging to switch cardiologists. I've already mentioned my history with him, and perhaps I SHOULD switch. He does a good job with the angiography - but I had it twice, and didn't really need it either time.

My current situation doesn't allow me to see any cardio. I'm on Medicare, my medicaid SUCKS ($1600 a month deductible), and I don't think I can afford supplemental, and my wife doesn't want an advantage plan. So - basically, we're both screwed.

I'm hoping that my PCP will waive deductibles so at least my wife and I can see him.

Maybe I'll ask my primary doc about switching to atenolol (but I'm not entirely sure why I switched off of that).

 

[newarrior]

I thought about seeing other drugs and in two weeks I'm heading back to America for a visiy Of time I'm not in a position to be switching drugs at this point
. Trying to answer a bunch of people's questions. I am going to look at getting on to other drugs when I come back from America. I also want to start maybe taking the drug at night myself as well. By the way how does everybody know if they've got afib or not? Is there a definitive way to test for it? Yes vivid dreams and nightmares are part of the side effect profile. Scary to hear about Medicare Medicaid I was going to rely on that myself if I ever move back to America. Maybe I'm better off staying in Asia where I can get things done cheaply we are Thailand or I could even go to India for the surgery.