Beta blocker/Bisoprolol withdrawal and breathlessness

This:- "The breathing thing was so weird!  It's like my lungs forgot how to breathe and I had to be super conscious about forcing them to breathe.  I was scared to fall asleep thinking I would forget to breath.  A very strange sensation." is exactly how I feel, and still, after being off them for about seven weeks now. Sometimes I will hyper ventilate, especially when under stress, but other times I will stop breathing and have to force myself with what seems like an effort.

Even my GP refuses to blame it on the BB, even though the syptoms and the cough occurred as soon as I started taking them, he has tried me on ashtma inhalers which are making no difference to me.

Islybot, hi

I will put a link to one other forum, I have been following that topic for years and found 100s of helpful posts from people who have been through the same.

I hope that it is allowed to post a link to some other forum here.

Anyway, my advice: read it from the oldest post, in conversation order:

http://www.medschat.com/Discuss/metoprolol-withdrawal-202479_p1_s1.htm

this was for Bob but I'm new here and not sure how to do it.

I was on metoprolol for over 10 yrs. ended up in er with really low hr and asthma was bad. they told me to stop the BB right then so I did. that was 4 wks ago. still having issues. ballpark figure on how long this will take. I'm glad I accidentally ran into this forum. it has helped me not be so alarmed when my body goes crazy.

If you have been taking it only for 5 weeks, then it is easier.

Even though, your dose was quite large.

Good luck

Please, ask here if you'll need help, and of course, call your doc if you will have problems.

Hi Bob,

I've been reading through all these messages and I feel like I need some re-assurance too.

I was diagnosed with SVT in 2015 and had a successfully ablation. I have been diagnosed with SVT again and currently awaiting a date to have the ablation done.

I asked my cardiologist to prescribe me beta blockers (Atenolol 25mg, once a day) which I took for approximately 2 weeks. I was experiencing awful side effects and decided to stop taking them. So I've suddenly stopped.

I'm currently at day 12 of not taking atenolol. In the past 12 days I've only felt like my normal, well self for 2 days only. From what I've read I think I'm experiencing awful withdrawal effects too but i'd like to hear from you too please.

My sleep is disturbed, I find myself waking up extremely early in the mornings. I feel nauseous with no appetite whatsoever. My resting pulse is higher than it used to be. Later in the day I feel like I feel slightly better besides the migraines and aches and pains that I get in certain parts of my body.

Are these withdrawal symptoms common after a sudden stop to atenolol?

I'm on day 12 of not taking them, how long will I have to wait to feel better again?

Ok, because I'm a coward I decided to do tiny cuts...a week ago I cut from 10mg to 8.75...

Yesterday I started having lots of pvcs and short (10-15 beats) fast runs...

You think that tiny cut could have done this, or just coincidence?

It's plain bisoprolol.. smallest pills they make are tiny 5 mg ones..

I'm supposed to be at 5mg on July 18th so I was planning to cut a quarter of a pill every 10 days and I should be there on time

Yasemin, a good thing is that you were taking drugs only for 2 weeks.

Withdrawal usually comes after 1 Month or more or taking a drug, but everything is possible (each person and each body is unique).

Also, since you were taking drugs for only 2 weeks, a withdrawal will last shorter and it will have milder symptoms than in people who were taking drugs for years.

Classical withdrawal symptoms are: elevated heart rate all day long no matter what you do (sleep, rest, walking, sitting), being breathless, some dizziness, headaches, some nausea, anxiety.

Just drink a lot of water in these early days and say to yourself: I will be fine in 2-3-4 weeks.

On days when you will feel better, try to do some walking (not too much), but you need to have some activity.

About how you are feeling better at evenings: this happens often. Your central nervous system is "broken" currently (due to drugs who are altering processes and mechanisms of action in a central nervous system like pace and strength of heart rate, pace of breathing, blood pressure) and during the day, it is too sensitive. At night, when majority of our systems are shutting down since the day is over (and CNS don't need to work as hard anymore), your central nervous system starts to work less and this is why you feel better, since your broken CNS is doing less damage at evening and night.

Again, you should be fine in 2-3 weeks, in my opinion.

Also, remember from other posts that a withdrawal goes up and down, like: feeling bad for 5 days, then 2 good days. Then 5 bad days again, then 3 good days. Then 3 bad days, then 3 good days. Then 1 bad day, then 5 good days. Then 2 bad days again, then 7 good days etc.

So, you will have good and bad days interchaging for some time, but over time you will have more and more good days and bad days won't be as bad as in the beginning. And eventually you will have again good days all the time.

Sedgly, those are not tiny cuts.

2 years ago, I was taking only 1,25 Mg of Bisoprolol for one year and when I have quit, I ended 2 times at ER and I thought that I will die during the 2nd time when it happened.

When I have quit Beta blockers, it seemed that my central nervous system was broken and that it couldn't regulate heart rate properly.

My resting heart rate before drugs was 70-ish.

On beta blockers, my resting heart rate was 58-60.

And when I have quit BBs, my resting heart rate jumped to 90-100 all day long.

Also, another problem was that central nervous system wasn't able to "cool down" heart rate when you are scared or similar.

For example, in a healthy person, if you hear a gun shot, a lightning near you or something like that, your HR will jump from 70 to 150-170.

But after a minute, when you will calm down, it will go down to 100-120 and after 5 minutes, you will be normal with a heart rate 70-80.

So, central nervous system is working properly and it is able to slow down/cool down your heart rate when needed.

When I have quit the drugs, if I would be scared of something or if I would do some physical activity, my HR would jump to 140-150, but it wouldn't go down after that.

Or, it would go down, but you would need like 10-30 minutes to cool down, instead of 1-5 minutes (in a normal person).

So, one day, 40 days after quitting a drug, I was doing some housework and my HR suddenly jumped to 150 and it didn't want to go down.

It stayed at 160+ for half an hour.

When I came to ER, a doc said that a part of my heart muscle could have died or exploded if I didn't come to ER since a heart can't pump so fast for too long periods.

So, the problem was: my central nervous system couldn't cool down heart and heart rate due to a withdrawal.

CNS was broken and way too sensitive.

I had to go back on BBs, but after a few Months, I weaned off again, but this time I was weaning off for 8 Months.

Like: 1,10Mg for one Month. Then 1,00 Mg for one Month. Then 0,90 Mg for one Month etc.

And it was still painfull with months and months of elevated heart rate, axietyand breathing problems.

So, about your case, you surely aren't a coward for taking a slow route.

In fact, that is the best way to do it.

I am personally afraid that lowering by 1,25Mg could be a too large drop, but you will have to test it by yourself.

So, please, do it slowly, and try to lower the dose only for 0,60 or 1,25 Mg per week or each 2 weeks.

A long road is infront of you.

Good luck.

If you will have any questions, please ask here and ask your doc.

A few tips: drink a loooooot of fluids, that will help you slow down your heart a little during a withdrawal.

Magnesium also helps.

Small doses of Valium also help during a Beta blocker's withdrawal in some cases.

Another drug, like Calcium channel blockers can also help.

 

 

How did you make suck small cuts?? These pills are so tiny, a fourth, 1.25mg is so small I can lose it in my mouth.

The only way I can think you did this is did you use a scale?

I know about having a sensitive CNS..I have experienced with it as a side effect of other meds.

In May I spent 10 days in hospital with a heart rate rocking 180s-190s.. Out of no where my thyroid had gone rogue...

Every day was a different drug, and every day my cardiologist told me my heart would not continue to survive..and every day it did

They maxed me on metoprolol and magnesium....no effect..

They maxed me on diltiazem and then added a drip of it (which surprised me but it was ok)..no effect..

They maxed me on bisoprolol...no effect....

Had a variety of blood thinners and shots to the stomach..powdered drugs mixed with water that taste bad etc etc..

Finally they decided to stop and restart my heart.....they shocked me multiple times ....it worked...I came out with a rate of 65...pre all of this my resting rate was 64 and I hadn't taken any type of medication in years....

I came home from hospital on 10 mg eliquis, 240diltiazem, 10 mg bisoprolol and 60mg methimazole.....I couldn't walk 5 feet with out panting..my heart rate stayed between 39-69... even climbing my stairs it couldn't get above 69...

Finally the drugs were cut....currently I'm on 10mg methimazole and 8.75 bisoprolol...I'm hoping to be off by September...my heart rate doesn't feel good in the 40s...I take meds at 7:15 am... by 8:15 it's feeling like my hr and bp are both too low..

Bp ranges from 106/74-- 90/56....but occasionally out of no where will hit 138/87..that also doesn't feel good..

So I guess I am most interested to know how you managed to cut the bisoprolol by only.10....I have checked here and had my pcp check and the smallest mg we can get are these tiny 5mg....

Thanks so much for your help

Sedge

This makes me mad!, this is exactly what I am suffering and its been a couple of months since I finished beta-blockers and I am getting worst, my at rest heartbeat is no longer around 60, it is now beween 100-110, the slightest effort like croucjing down takes it to 160, I am now on ashtma inhaler because my breathing doesnt work, and my T waves are often higher than my R waves, but cardiologists and GP, they all claim it cannot be a result of beta-blockers as it has a half life of 12 hours or something, yet this all started when I went on them and I still feel as if I am on them syptom wise. I suggested to my GP that my receptors were turned off by the beta-blockers and have not turned themselves back on, he smiled and shook his head at my niaevity. Dont know what to do? I am so ill all the time now.

Peter, how long were you taking Beta blockers?

Which dose?

How long are you "clean" now?

I think that you will get better over time.

Sometimes it goes really slowly, but it gets better and better each new week.

I know that it is hard, but a lot of patients who experienced a withdrawal said that they started to feel better when they started walking and doing light excercise.

I know that it is hard to walk if your HR goes up all the time, but if you are off drugs for more than 60 days, my opinion is that you should try to walk slowly each day.

It will strengthen your heart slowly and over time your heart will beat slower while resting since it will be in a better shape.

Sedgly, yes, 1,25-5,00 are tiny pills.

What I did was: I would take 10 doses of 1,25Mg and I would cut a tiny part off of them (let's say 1/10th of a dose) and throw it away.

Then, from those 10 newly made pills, I would take the biggest ones first and each new day I would take smaller and smaller (if you get me?).

So, those doses were roughly 1,20Mg + 1,19 +1,18 + 1,18 + 1,17 +1,17 etc.

So, I would just "go" from the biggest to the smallest.

After 10 days, next time I would cut even bigger part off from 1,25Mg dose and throw it away.

These new pills were around 1,00 Mg.

Then again, I would take them from the biggest one to the smallest (one per day).

After 10 days, I would cut even bigger part etc until I was taking only 1/8 or 1/10 of a dose in the end.

About your case, you had really a lot of problems.

Since you already had CNS problems and they had to restart your heart, please be careful.

If you'll experience a strong withdrawal, your heart probably isn't too strong anymore...

So, please, listen to your body and your heart, and decide on your own how fast you want to wean off.

If you'll have any questions, please call your doc.

And of yourse, you can ask for help here, among people who have been through a withdrawal.

Good luck

Ah thank you for the re-assurance Bob!

GP's and cardiologists haven't given me answers like yours. They seem so unsure and say "oh you should feel better within a week or so".

Today's been an okay'ish day.

Experienced on and off sharp pain in my chest and my body just feels so weak.

Without a doubt, taking and stopping these beta blockers has probably been the hardest thing I've ever had to go through.

I wake up every morning and hope that today will be a better day and that I will return to my old self.

It's been 13 days ever since I've stopped and I feel exhausted of feeling so unwell. I really don't know what to do anymore.

Really hope this horrible episode in my life just passes as soon as possible.

I was put on Bisoprolol 2.5 end of last December, almost right away I cut them in half as they were making me feel like a drunk zombie and I could no longer feel my lungs, In March they put me on Solotolol, but I only took this for a few weeks as it gave me a terrible cough that I still slightly suffer from. I am somewhat worried about doing much in the way of exercise, just washing the dishes the other day took my heart beat to 188 and had an ectopic run that I nearly fainted from, and this is post ablation. Looking up what a broad and elevated T wave indicates is also a cause of concern to me. I am being investigated for Arrhythmogenic right ventricular cardiomyopathy due to a finding on my MRI scan last December, but appointments come only every six months! 

Thank you so much for all the information. I know exactly what you are talking about with cutting the pills and always picking the largest so a small taper is naturally formed there also..always decreasing...

I'm going to continue with the quarter of a pill (1.25)cut each 10 days and hope for the best...while my cardiologist assures me I will have no problem cutting 5mg..then 2.5, then stopping when I pushed him about what if I had problems he told me he really didn't think I would and if I did to just go back on it....

He also told me if my thyroid settled before the 6 week runs to get off them immediately...

Not what I wanted to hear...

I was hoping there was a source for pills smaller than 5mg but I guess that is not to be.

I do have a strong heart going for me...and my age, not being elderly has to be a bonus...and I have a healthy CNS...And am or was a month ago in relatively good physical condition..

Thanks again for the information, it's rather sad that one cannot depend on medical personnel for help getting through things like this

Sedge

Bob, maybe you could help me with my symptoms. I've been on nebivolol (bystolic) for a month and a half. 5 mg - the first month and then 2.5 for another half. Then I started feeling tighness in my chest and short of breath, sometimes nausea. So I just quit it and went back to Lisinopril. Nebivolov was suppossed to be the bridge getting off from Lisinopril that I've been for about a year. It's never been succussful in keeping my bp stable though. It would go up and down. Now it's been 2 weeks since I've been off nebivolov and I do get short breath here and there. Today I went out and it was very very humid, started sweating and my bp went up to 145/100 from 130/90. A year ago I was diagnosed with hyperthyroidism. And my bp was all over the place, panic attacks etc. But my thyroid hormones were normal for the past month. I also have bicuspid aortic valve that never bothered me before. So I wonder now whatever I have is it withdrawal from beta blocker, bicuspid valve, or lisinopril? Thank you for your answer.

 

Hi, Denys

Lisinopril is Ace inhibitor, a drug for treating high blood pressure and some other heart conditions.

While Beta blockers (Nebivolol is the newest one) are used for high blood pressure, arrhytmias and other heart conditions.

Beta blockers are slowing the heart down more than Lisinopril.

Also, a lot of people say that Nebivolol is weaker than Bisoprolol and older Beta blockers. So, it can help in milder cases of high blood pressure and in milder arrhytmias.

I have also heard from some docs that Nebivolol isn't as powerful as some other drugs.

As you see, it is not strong enoughnin some cases and often it needs to be combined with other drugs to get the desired effect. 

Further, Nebivolol is a Beta blocker and it messes up your central nervous system and adrenaline.

That means that when you will wean off, you may experience a withdrawal, anxiety, tachycardias, nausea, dizziness, breathing problems etc.

But again, since majority of docs don't think that Beta blockers are causing a withdrawal, they will prescribe Beta blockers for everything (in your case, it was prescribed as a drug which will help you to get off from Ace Inhibitor).

All drugs for heart and lowering blood pressure can have a dangerous effects if you stop them abruptly.

But I have personally read on internet that people have way more problems with quitting Beta blockers.

Anyway, I think that your problem is=a Nebivolol withdrawal.

You see, you were taking 2,50Mg and now you dropped to 1,25Mg. Your body got used to 2,50Mg dose and now when you lowered a dose to 1,25, you are experiencing problems.

Others had similar problems in this topic when they were lowering their doses of Beta blockers.

A good news is that you haven't been taking Nebivolol for too long.

The bad news is that when you will quit from 1,25Mg to 0,00Mg, you will feel way worse than now, for a few weeks, and expect some anxiety and tachycardias.

Just thought I'd update.. I am at 5mg... feeling pretty good... just a little nervous.. think it's probably from the thyroid...

Since being off the methimazole the pvcs have pretty much left me alone... only one or two soft ones each day...

I took the 8.75 for 8 days.. then the 7.5 for 6 days.. then 6.25 for 3 days....

Trying to settle now with 4-7 days between each cut...I thought I would do 10 days but that seems too long.. so hopefully in 3 weeks I will be free of this.

I've already experienced most of those withdrawal symps: chestpain, dizzyness, bouts of fatigues, anxiety,occationally ( maybe once a day) pusle increase from regular 60 to 75 out of nowhere. What about bp fluctuations? Is that typical too? How long will that last? I'm off of Nebivilov for 3 weeks now....

 

BP fluctuations are common, of course.

Some people don't have any withdrawal.

Some people have problems for 2 weeks.

Some people have problems for 2-12 Months.

Some people end at ER and have to go back on drugs.

Each person is different.

How long have you been on methimazole and what dose, if you don't mind me asking? Has it stabilize you T3, T4, TSH? Have you wean off from it or just quit?

Hi denys; I don't mind you asking 😊 I've been on methimazole since certain May 3rd, when I walked into hospital with my heart "chugging"

In afib with rvr...caused by thyroid going rogue....

I was on 80 mg in hospital... spent 10days on cardiac ward...sent home on 60mg...

Stopped it for 6 days for radioactive uptake scan...went back on 40..week later Stopped it for 5 days for radioactive iodine ablation of thyroid...went back on 20 for a week then 10 mg for a week then stopped it...

At 20mg my t3 and t4 were in range but the tsh was still lagging..

I have blood draws on Friday and suspect they will show I'm hypo...

I never weaned when stopping the methimazole..but I do think stopping it the same day as cutting the beta blocker caused some of the palpitations..

80 mg is quite a bit! How far out of norm was your T3 and T4? I bet TSH must have been quite low as well.

T3 was 6.04 (2-3.50) t4 was2.25 (.60-1.20) and tsh was low enough it didn't measure..

They were drugging me with all they could... the afib with rvr was with a heart rate 180-190 and apparently I was med resistant...

Since I've never had any type of cardiac problems, not even afib prior to this, they deduced the heart stuff was all caused by the thyroid...

I have since had radioactive iodine ablation 5 weeks ago...I see endocrinologist in 9 days...

That's how I came to be on 10 mg of bisoprolol...now down to 5....started having a few pvcs today.....hoping to be off the bb before starting on thyroid replacement and not knowing what symptoms are from starting or stopping

Why do you need thyroid replacement? Are you sure you are hypo now?

 

No, I am not sure I am hypo. Not till blood work... I guess I just assume I will be.

They gave me 17.5 millicuries of radioactive iodine almost 6 weeks ago...

3 weeks ago my t4 was in range.. they told me I would likely be hypo in 4 weeks when I had the RAI...

I have some symptoms of being hypo and wonder if that and not the bb withdrawal is causing some of the pvcs and other problems...

They also tell me once my thyroid is dead I will need replacement for ever.....oddly up until roughly two months ago I didn't even know where the thyroid was located......

Yes, if they kill your thyroid then nothing will be producing your T3, T4 and that's what regulates your bp, heart rate etc.....very essential... so you will be dependant on hormonal therapy for life. Unless, you have cancer or really serious complications with thyroid I would think twice before removing it or killing it. But again check into it. Maybe you can still save it. Get a second opition if possible. 

Thanks for your concern..I think with the 17.5 millicuries that boat already sailed..

I'm good with my choice,

Did you  ever experience sudden bp spike in the sun? Today the UV index was 11 plus ( extremly high). In the morning I didn't take any meds ( usually 5 mg liz and 10 methimazole). My bp was almost good  125/95 and then after being in direct sun for 10 minutes I started feeling heat, sweating,mild aching in the heart area. Checked bp. It went to 155 over 105.

I am in mid 30s and up to a few years ago, I used to play sports under very hot temperatures and didn't have any problems.

In 2015 I started to take Beta blockers and in that summer for the first time ever, I started to have problems during summer and with a hot weather.

During hot days, I would be sweating like never in my life, I was nervous without apparent reason. And if I wanted to walk or do anything outside, I felt as if I will die or something. After a few minutes outside, I would felt very strange and as if I am overheating (it is hard to explain).

In the next summer, 2016, I was still on Beta blockers, this year it was Nebivolol (it was Bisoprolol in 2015), and I still felt very bad during summer Months, but slightly better than on Bisoprolol.

I have quit Beta blockers around a New year, 6-7 Months ago, and this year I am feeling better during hot Months, but still not as normal as before Beta blockers.

I hope it will get better in upcoming years.

I didn't have BP problems (but I never had BP problems), but I did have an elevated HR during summer months, more anxiety, feeling nervous, sweating all the time, more breathing problems, feeling more tired, difficulty with walking and breathing (compared to winter months).

Beta blockers are probably influencing our mechanisms which regulate body temperature, BP, heart rate and then we have more problems in summer days.

In short, Beta blockers did cause me a lot of side effects, but side effects were the strongest during hot summer days.

Thank you for your input. BBs do influence the hormones in the body ( through adrenaline suppression), which in turn affects the whole endocrine system, which in turn IS actually responsible for body temperature and  its reaction to the outside changes. Besides bbs steroids do the same 'job", because they influence adrenals also. And thats when my problem started. I never had bp increases in hot days. I could easily run for a mile or two with 30-35 C tempearture, I would do construction, work on the roof without any problem and actually would feel better in the sun. But once your hormonal mix is messed up ( or altered by meds, changed from homeostasis) then you are pretty much on  your own. Your body doesnt know how to property react to changes and has to work against meds on its way to normalcy. So this clash between what your body wants and what the meds do, creates all these symptoms including hot flashes.

I just had a thought. Have you checked your thyroid, cause a lot of your symps might indicate that you are hyper

Update 2

. I am at 2.5 mg. Heart rate still slow. I am forcing myself to hold 5 days or so between cuts

Thinking I will be at a quarter of a pill, 1.25mg on Monday...

What does it mean when it says.. this reply is waiting to be moderated?

It means that the mods, the people who police this forum, need to check the content of your post before it appears, so probably will be Monday now befor eit does. Its to protect this useful forum from spam whcih I have seen destroy less effeciently moderated forums. Maybe you posted with a link or something that they want to check out first?