Bisoprolol. Any fellow takers/sufferers ?

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Protimenow

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Afib is a rhythm disorder. I don't have it - but I think that it's pretty easy to diagnose. I would imagine that it shows up on an EKG.
 

newarrior

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Okay I just did a bunch of EKGs less than two months ago a chest x-ray a treadmill test and echocardiogram I've had my blood pressure and pulse check numerous times I'm sure if I had it somebody would have said something
 

Enigmalady777

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I started taking both Bisoprolol and Amiodarone about three weeks ago when I was in the hospital for an ICD implant and my heart rate went wonky at over 130. I was also on an Amiodarone IV drip for 24 hours to try to control the heart rate (didn't do much) and then the doctor did a cardioversion. I've not done well on Metropolol or Atenolol in the past, so I was very skeptical that these new beta blockers would do anything but make me extremely tired and extremely dizzy. Yes, the day I got home from the hospital I tried to get out of bed to use the bathroom and was so dizzy that I fell onto my nightstand and then slid down to the floor.

But you know what? I continued to take the Bisprolol and Amiodarone as prescribed and within two weeks the fatigue and dizziness became far less noticeable. I've gone back to working out at the gym 5 days a week and my heart rate has remained in the 60 - 70 range, even when exercising (highest it got was 76 while exercising).

Bisoprolol is supposed to have fewer side effects than some of the other beta blockers. I don't know about amiodarone. In any case, I am doing much better now, I think my body has finally gotten used to these new meds.
 

Protimenow

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Interesting. Bisoprolol can cause dizziness and tiredness. I didn't think much about that.

I'm taking 1/2 the dose that my cardio prescribed.

When I came home from the hospital in November (I had a Popliteal cyst in my left leg, and the doctors were afraid that I had compartment syndrome), I tried to walk to my front door, and fell from the walker when I got near the door. I blamed it mostly on the damned pain meds that I left with.

Thinking about it now, I suspect that the hospital was giving me full doses of Bisoprolol - more than I was used to - for a few days. Maybe THAT had something to do with my dizziness. I was so dizzy after this fall that I couldn't stand up and had to raise my butt to get into the house, and push myself backward to get to the dining room, where I rested until I had the strength to scoot back to the bedroom.

I don't plan to ever double up (prescribed dose) of bisoprolol.

I get SVTs, so I may need a beta blocker, but if I can cut them out altogether, I probably will.

Thanks, Enigmalady for reminding me of that side effect.
 

Eva

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......By the way how does everybody know if they've got afib or not? Is there a definitive way?
When one’s heart rate, while at rest, is continuously above 130 bpm. Personally, I had no idea I was having atrial flutter when I went to the emergency at midnight...it was only because my Fitbit showed my heart rate was 135 bpm all day that day. I had no other symptoms at all...I was alert, fully comprehending the situation, normal blood pressure, no dizziness, but steady high heart rate which scared and confused the doctor. They kept me for four days under strict continuous observation!!
My diagnosis was “unspecified atrial flutter “!

Overview from Mayo Clinic: has ttps://www.mayoclinic.org/diseases-conditions/atrial-flutter/symptoms-causes/syc-20352586
Quote:
In atrial flutter, your heart's upper chambers (atria) beat too quickly. This causes the heart to beat in a fast, regular rhythm.
Atrial flutter is a type of heart rhythm disorder (arrhythmia) caused by problems in your heart's electrical system.

Atrial flutter is similar to atrial fibrillation, a common heart rhythm disorder. However, the rhythm in your atria is more organized and less chaotic in atrial flutter than are the abnormal patterns common with atrial fibrillation. Sometimes you may have periods of both atrial flutter and atrial fibrillation.
Although people with atrial flutter may not experience symptoms, the disorder can cause stroke, heart failure and other complications. There are effective treatments for atrial flutter, including scarring small areas of heart tissue (ablation) or medication.”unquote
 
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Eva

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I started taking both Bisoprolol and Amiodarone about three weeks ago when I was in the hospital for an ICD implant and my heart rate went wonky at over 130. I was also on an Amiodarone IV drip for 24 hours to try to control the heart rate (didn't do much) and then the doctor did a cardioversion. I've not done well on Metropolol or Atenolol in the past, so I was very skeptical that these new beta blockers would do anything but make me extremely tired and extremely dizzy. Yes, the day I got home from the hospital I tried to get out of bed to use the bathroom and was so dizzy that I fell onto my nightstand and then slid down to the floor.

But you know what? I continued to take the Bisprolol and Amiodarone as prescribed and within two weeks the fatigue and dizziness became far less noticeable. I've gone back to working out at the gym 5 days a week and my heart rate has remained in the 60 - 70 range, even when exercising (highest it got was 76 while exercising).

Bisoprolol is supposed to have fewer side effects than some of the other beta blockers. I don't know about amiodarone. In any case, I am doing much better now, I think my body has finally gotten used to these new meds.
If you’re on warfarin, you need to check you INR more often! My INR was always night until I dropped the Warfarin dose by 20 percent. Good luck.
 

doclewis

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I was on bisoprolol 10mg for several years before surgery for aortic aneurysm and AS. It decreases the rate of rise of blood pressure with each heart beat. Cardiologist picked this beta blocker because "it came in many strengths and was easier to adjust dosage". I never had any side effects. Post op the dosage was reduced to 5mg daily because blood pressure a bit to low. Have been on this dose for 4 years. Still no side effects noted. I do feel fatigued and depressed, but seems to be after a migraine which I have much more often after surgery. Other than this I feel fine. Cardiologist has said that I will stay on beta blocker for ever. He puts everyone on one after surgery. I have no experience with any of the other beta blockers but know that some people can tolerate one and not another. Some are more specific to effect the heart and others better for blood pressure. I was off bisoprolol for several weeks after surgery before it was started back along with other meds I was taking.
 

Protimenow

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Eva: You said that if we're on warfarin, we need to check our INR 'more often.' More often than WHAT?

If we're not on warfarin, why do we need to check our INR at all?

What does this have to do with bisoprolol?

I'm confused.
 

Eva

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Eva: You said that if we're on warfarin, we need to check our INR 'more often.' More often than WHAT?

If we're not on warfarin, why do we need to check our INR at all?

What does this have to do with bisoprolol?

I'm confused.
Thanks for asking so that I can clarify better. My message to Enigmalaady777 because Amiodarone messes up INR, if one is on Warfarin! One should check their INR more often than they normally do...more often than once a week or once a month, depending on Amiodarone dosage!
If one is not on Warfarin, I don’t know! I hope I clarified what I tried to say.
 

Protimenow

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Eva: thanks for your answer.

Lots of things affect INR. I may be taking medications now that have some affect on it - I don't know.

What I do know is that, once you're taking it (and Amiodarone should be no exception), you can adjust your warfarin dosing to accommodate for the affect that the medication causes. As long as you're taking the same medication, at the same dose, you should be able to determine what dose keeps you in range.

Determining the necessary dose may take extra tests, more frequently than usual, but once the correct dose has been determined, you probably won't have to test more often than once a week. I can't imagine that a steady dose of a medication, taken daily, will cause INR to fluctuate from day to day.

Is there something special about Amiodarone that causes fluctuations in INR when you're taking a steady, consistent dose?
 

Eva

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Eva: thanks for your answer.

....

Determining the necessary dose may take extra tests, more frequently than usual, but once the correct dose has been determined, you probably won't have to test more often than once a week. I can't imagine that a steady dose of a medication, taken daily, will cause INR to fluctuate from day to day.

Is there something special about Amiodarone that causes fluctuations in INR when you're taking a steady, consistent dose?
Pro time now: Exactly, that was my point! Once I lowered my dose from 7.50 mg to 6 mg, I stabilized but it was a hell of time until then.
When I had flutter I was given massive dose of Amiodarone at the hospital. I was discharged with pills and I wasn’t warned about it’s effect on INR until I saw an Electrophysiologist. Though he took me off Amiodarone, he wanted me to keep checking my INR often until it’s out of my system completely.
 

Protimenow

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It sounds like your Electrophysiologist may have been a bit of an alarmist. I'm assuming that the Amiodarone raised your INR -- but was it way out of range? The issue was probably balancing your warfarin dose to the changes that declining levels of Amiodarone in your system were causing. Clots take a while to form on mechanical valves - so even if your INR dropped from, say, 6 to 1.5 (assuming, perhaps, that you stopped taking, or severely reduced, your warfarin dose while the elevations caused by Amiodarone finally stopped), it would have taken a while to cause a clotting risk, according to a paper from the Duke University Clinic. Testing your INR with your meter every two or three days (yes - increased frequency) should have shown the Amiodarone related changes - and would probably have given you an idea when to resume your previous Warfarin dose.
You probably could have managed this pretty carefully, avoiding the 'roller coaster' effect that some people have reported.
OTOH - if the Amiodarone decreased your INR, ou probably increased the warfarin dose to compensate. Testing every days until the drug's effect stopped would have helped you to determine when to return to your prior (pre-amiodarone) dose.

If you were still in range, even with Amiodarone, this may not have been a major issue.

Still - thanks for pointing out the need for more testing, perhaps even every few days, when you start, stop, or change dosing of Amiodarone.

I usually keep a close eye on my INR for changes when I start a new medication. HOWEVER, my pharmacy usually catches possible interactions with any new prescriptions, so my risk of taking something new, and having an unexpected change in INR is reduced - or, if there are effects, I keep an eye on it - testing every few days, and adjusting if necessary, until the effects are known - and adjusted for.
 
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Eva

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....
I'm assuming that the Amiodarone raised your INR -- but was it way out of range? The issue was probably balancing your warfarin dose to the changes.
My INR WENT UP TO 10. Hospital skipped my dose twice. At home (since I wasn’t warned) it kept fluctuating between 5 and 8. Now it’s stable!
 

Protimenow

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With an INR of 10, all they did was skip your dose? I'm surprised they didn't at least give you some Vitamin K, if not packed platelets. Even with an INR of 5, there's reason to be concerned - if not pretty careful not to bang into things or cut yourself. An INR of 8 or 10 should be of considerable concern.

How were you testing your INR? If it was a CoaguChek XS, it's possible that your reported INR was actually somewhat higher than your actual INR.

At the very least, the test should have been confirmed with a blood draw (or a Coag-sense meter).

I'm glad you got your INR under control.
 

Cosyloft

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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.
Hi
Do you think bisoprolol which carm and slows heart and a pace maker brings your heart beat up to 60 or 80 seem to conflict with each other check it out thanks
 

Protimenow

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Cosyloft -- your cardiologist would be better equipped to answer this question, but I don't think there's a conflict. You already gave the reason why -- Bisoprolol calms (this is what you meant, isn't it?) the heart. In your case, it may slow your heart down TOO MUCH. You may have a rhythm issue - the pacemaker assures you that the heart is beating at an appropriate rate. So -- in your case, you're probably not using Bisoprolol to change the heart rate -- it's being used for other effect on your heart. But, again, if you have questions, you should ask your doctor.
 

Enigmalady777

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If you’re on warfarin, you need to check you INR more often! My INR was always night until I dropped the Warfarin dose by 20 percent. Good luck.
Yes, I'm on warfarin too. After my ICD implant this past June, the doctors changed my INR target range to 2.5 - 3.0. They had me taking blood draws weekly, but now I'm down to every 2-3 weeks. I notice they have me take the blood draws more often when it goes out of range. If the latest blood draw reflects a "good" INR, they let me go longer. I have a meter and strips so I've started to take it myself weekly. So far, so good. Anything crazy I will call my doctor or the anti coagulation clinic for help.
 

Protimenow

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I'm taking a dose of bisoprolol 1/2 of what my cardio prescribed. My BP unexpectedly went up (too many hot dogs?) and my primary said to go back to the prescribed dose. I felt awful. BP didn't change. I dropped back to my .25 mg dose. All seems to be well.

Enigmalady777 - yes, test weekly. In range or not. The doctors and anticoagulation clinics often don't know much about anticoagulation. If they're comfortable with testing every three weeks, this confirms that they aren't up with recent recommendations.

I test weekly, many of us on this site test weekly. It's been shown that people who self test weekly have INRs that are in range more than patients who go to clinics, labs, or doctor offices for testing less frequently (duh).

If you're not comfortable with dosing advice that you get from clinics (and, of course, weekly testing will show if they're right), there are numerous resources to accurately self-manage.

But, most importantly, DO test weekly.
 

Eva

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Yes, I'm on warfarin too. After my ICD implant this past June, the doctors changed my INR target range to 2.5 - 3.0. They had me taking blood draws weekly, but now I'm down to every 2-3 weeks. I notice they have me take the blood draws more often when it goes out of range. If the latest blood draw reflects a "good" INR, they let me go longer. I have a meter and strips so I've started to take it myself weekly. So far, so good. Anything crazy I will call my doctor or the anti coagulation clinic for help.
Glad you’re doing better now.
I, too, am getting over the fatigue caused by Metoprolol, and the nightmares are getting less and less.
Keep taking good care of yourself.
 
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