Bisoprolol - How to come off them safely - Help wanted .. TIA

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Some years ago I had what the Hospital said was an AF attack .. I was told I was just anxious & was producing too much adrenaline - which was also increasing my Blood Pressure .. I was given Bisoprolol 2.5mg twice a day, 12hrs apart - & also Losartan for the BP (now stopped & replaced with Doxazosin) ..

I have various side effects but by far the worst is the extreme fatigue .. Lie down on the settee & I'm asleep - Sit in a chair & I'll fall asleep .. Lie in bed & well, sleep does come, but only until I need to spend a penny .. 

Over the past few weeks the fatigue has got worse & worse & now, I have absolutely no energy to do anything, not even watch my favourite TV programmes, without nodding off & missing most them (thank goodness for Sky+ when I can be bothered) ..

After reading several postings on here, I have decided to come off the Biosoprolol .. How's this for a plan ? ? ? . 

Weeks One & Two - Cut one of the 2.5mg pills in half & take one half (1.25mg) every 12 hours - thus taking a total of 2.5mg a day (half what I was taking) .. 

Weeks Three & Four - Miss taking the "Evening" pill, thus reducing the dose in half again - to just 1.25mg a day .. 

Is this about right, or should I stay on each reduction longer ? .. I am scared the AFs will return .. Even though the bisoprolol do give you some horrid side-effects they are good at quelling anxiety .. 

I really would welcome your comments .. I am so sick of feeling as I do it's making me so depressed & unable to enjoy my life .. 

Thanks for listening .,.. 

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16 Replies

  • Posted

    I know what you are saying, I also was diagnosed with AF 4 years ago now, also prescribed Bisoprolol 2.5 and also I'm like you in worrying that the AF may start again, I think we both know that we really should talk with our GP about any reduction but I am very tempted to try it on my own (I'm a bit awkward like that :0)), if I was to reduce it myself then I would cut it down to 1.25 each day as taking 1.25 twice a day somewhat defeats the object of cutting down, so 1.25 each morning (or whenever you take it) and see how I got on and if there were any signs of the AF starting, if not then I would stay like this for at least 3 months before cutting out.

    I am in no way suggesting that anyone should do this on their own, the sensible thing to do is to speak to our GP's, I may speak to mine next week about it even.

    Good luck.

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    • Posted

      I was taking 2.5mg twice a day, making a total of 5mg per day .. 

      From today, I'll be taking 1.25mg twice a day - half of what I was .. 

      I'll continue with this for a while & see how it goes, before deciding what to do next .. 

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    • Posted

      Hi I too am taking 2.5mg bisoprolol and I cannot keep my eyes open. In March of last year, I contracted sepsis after having cellulitis, and I thought the tiredness was coming from that. Maybe it's both the bisoprolol and getting sepsis, that is making me the way I am. I am still recovering 10 months later, but don't think I will make a full recovery. If were you, I would see your GP before cutting them down. I tried cutting them down, but the af returned. I hope you manage to get sorted.

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    • Posted

      Sorry to hear this Lesley .. I hope you do make a full recovery .. 

      I have come to the conclusion that lowering the heart-rate too much (mine went into the 40s) can cause other problems .. 

      Now my pulse is rising slightly, it's getting some getting used to again .. smile .. 

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  • Posted

    I think you should ask to see a cardiologist again if you have not seen one for years.  I did after 23 years of taking Sotalol for SVT (no doctor ever suggested a review) and the cardiologist changed me to 2.5 mg Bisoprolol.  I felt a bit unwell so went to my GP who upped the dose to 5 mg.  I have decided after reading posts on here that 5 mg is too much for my fairly minor SVT and I am reducing it down to 2.5 mg which I might even reduce again to 1.25 mg!  If you are already taking a drug for BP then perhaps you don't need a beta blocker.  I'm very concerned reading these posts at the number of variants in doctors' prescribing habits.  In my  case there has been no follow up - you are just left to get on with it and hope for the best.  Also if you are that sleepy perhaps you should be tested for other things like anaemia, low Vitamin B12 levels etc etc. 

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    • Posted

      Thanks Linda .. 

      As my Grandpa died from Pernicious Anaemia, I already take Vit B12 & Vit D - plus a Magnesium / Potassium supplement, along with Taurene & Cod Liver Oil .. I refused to take Statins & take Plant Sterols instead .. And instead of the recommended half-aspirin (which upset my tummy) I take Turmeric which does a good job of thinning my blood .. 

      As I only have one kidney, I regularly have blood tests, although I haven't had any for a few months .. After the flu season has finished, I'll make an appointment to have my bloods taken .. 

      Back in 2013 I lost my footing going downstairs & ended up with a broken leg (mis-diagnosed for a week) & then, back in 2016, I fell in the middle of the night & broke my back (T12 wedge fracture) .. Until now, I really hadn't a reason for these falls, but I'm now wondering if the fatigue caused them .. One minute I'm getting out of bed to go to the loo, the next minute I'm falling backwards into a sitting position (just like a toddler does) - all in a zombie like fog - boy did it hurt .. !!

      This morning I took 1.25mg & tonight I took another 1.25mg - half of what I usually take .. I'll do this regime for at least 2-3 weeks & see how I go ..

      I shall take my BP from time to time to keep an eye on that, but, as you say, I already take a water-pill & the Doxazosin for that .. But, I expect it'll go up slightly, as will my pulse - but again, I'll keep an eye on things ... If I need, I can always up the dose again .. 

      Wish me luck .. 

       

       

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    • Posted

      Dear Sue, I do certainly wish you luck - you have a lot to contend with.  I started reducing my 5 mg a day which I took as 2.5 twice a day, by cutting one in half and just taking one 2.5 mg plus a half (1.25 mg) once a day in the morning - I did this for a couple of weeks.  I am now cutting the 2.5 mg into quarters (difficult) so I am taking one 2.5 mg and a quarter of a 2.5 mg once a day in the morning.  In a few days I shall go down to 2.5 mg once a day.  However my SVT was not severe and I was still getting odd very short episodes even on 5 mg a day.  My main concern with taking the 5 mg was that I felt short of breath, although I know I am overweight which does not help of course, and depression.  Also as soon as I get any indigestion, i.e. burping, not pain, I can feel my heart thumping so I am not convinced that when I feel unwell it is a heart problem, more excess wind in my chest.  Difficult to explain.  I do take an anti acid (omeprozole) every other day which was prescribed as I was taking Ibuprofen for arthritis but I don't bother with that now.  I don't take the omeprozole every day as there are scare stories about that.  You just can't win can you?   I do take fish oil, calcium with Vit D, turmeric and magnesium most days.  Funnily enough I am sleeping and feeling more tired now I've reduced the Bisoprolol dose but I suppose that could be coincidence.  It's not because I'm more active - apart from walking my dogs (not very energetically) I am embarrassingly lazy.   Or perhaps my heart is reacting to the lower dose.  Anyway I'll press on as I am for now.  I'm glad you get your bloods tested regularly - perhaps you should not wait too long to get them done again in case anything else shows up to account for the tiredness.  Good luck   Linda

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    • Posted

      Thanks Linda .. 

      I toyed with the idea of taking one 2.5mg in the morning & one 1.25mg at night - but decided, in the end, to take one 1.25mg morning & night .. Cutting a 2.5mg in half isn't too hard, but I think to cut it in quarters would be neigh-on difficult .. Sooo, when I've been on 1.25mg twice a day for a couple of weeks, I'll just ask my GP for the lower strength pills .. 

      I also decided that if I'm okay just taking the 1.25mg twice a day, I might stay on that dose for a while, see how I go, test my bloods, have an ECG, etc, before trying to cut it down again .. 

      After just 3 days on the half dose, I'm feeling more strength in my arms - strange to explain really, but my muscles seem stronger .. 

      Fingers crossed, eh ..  

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  • Posted

    Sue, I also came off from Beta blockers, but in my 2nd attempt.

    I ended at ER during my first attempt because I was weaning off too fast (even though, way slower than you).

    I would suggest you to lower it way slower.

    Try to cut pills in quarters.

    But also, ask your doc if you are allowed to lower a dose.

    Also, often a withdrawal doesn't kick you right away.

    When I stopped Bisoprolol for the first time, more or less nothing happened in the first 20 days after stopping.

    I felt the same as on drugs. Without elevated Heart rate or anything. Completely normal.

    And then, after 20 days, my resting HR jumped to 100 one morning and stayed high for the next 30 days.

    So, if you lower your dose, and you are feeling fine, don't lower it further.

    Wait for some time to see whether you are really feeling good or a drug just needed some time to get out of your system.

    Also, in older people, drug stays longer in your system.

    So, you may lower your dose, but you will have old doses staying in your blood and cells for weeks after lowering a dose.

    So, again, you won't know whether you are feeling good due to a lower dose or because your body is still filled with old doses (you may think that you have lowered your dose, but your body will be still exposed to almost the same level of a drug due to tons of old doses floating in your blood).

    This is why a withdrawal can kick off later (2-3 weeks after lowering a dose), because your body needed some time to get rid of older doses stored in your body.

    Also, drink a lot of water, it will lower your HR during a withdrawal.

    And after a few weeks into a withdrawal, you will start to experience strong anxiety.

    Anxiety usually doesn't start right away when you lower a dose.

    It kicks in later and stays for months, sadly.

    Good luck

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  • Posted

    Thanks Bob .. 

    So far, 1.25mg twice a day 'seems' okay .. The tiredness isn't anywhere near as bad as it was & my muscles seem stronger - I can actually climb up the stairs 'normally'  which I've not done for a good long time .. 

    Thanks for the 'water' tip, will certainly try and do that, as I know how helpful it can be - but, I do have to be careful as I tend to leach sodium when I take more water - I'll keep my eye on things .. 

    I shall also take on board what you say about staying on each dose for longer .. So far, I "seem" okay on 2.5mg per day - but I do keep an eye on my pulse rate .. So far, when sitting around, it's around 63-65 .. When I was taking 5mg per day, it very often went down to 48 - & at that rate I had absolutely no energy at all .. 

    As part of my physio for my broken back I was advised to get a static bike & even after half-an-hour on that, my pulse was still only up to 68-70 - which was hubby's starting rate smile .. 

    A friend has suggested I look out for some 'relaxation' regimes to try and ward off any anxiety .. 

    BTW - how did you do it the 2nd time ? .. Did you have any problems that time ? .. 

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    • Posted

      About my 2nd time, from my experience, let's say it this way:

      Whatever you do, you will feel an enormous pain and lots of horrible symptoms.

      The question is: whether you want to experience it in a short period of time and in full strength, or would you like to have milder symptoms which will last longer?

      So, you can feel the pain, on a scale from 1-10, which is 10/10 strong and it will last for 2 Months, and you will be fine after that (but you will experience a hell during those 2 Months and you can end at ER).

      Or, you can do it slower, feel the pain, let's say of 6/10 or 7/10 strength, and it will last for 6 Months.

      About your pulse, this is my story:

      My resting heart rate before BBs was around 70-72.

      Then, when taking 1,25 or 1,80Mg of Bisoprolol, my resting HR was 60, sometimes 50-ish (at night).

      When I tried to do some exercise or drive a static bike, I had the same problems as you.

      No matter what I did, I couldn't get my HR to higher than 85-90.

      So, I was out of breath, but my HR was still very low.

      And then, when I have quit BBs for the 1st time, after 20 days my resting HR jumped to 100-105 (from 50-60 to 100-105. Imagine a shock for your body and for your heart). If I had to go to a toilet or something, it would jump to 130-140, after only a few steps.

      It stayed that way (it was almost impossible to get out of bed and make something to eat) for 2-3 weeks.

      Then slowly my resting HR dropped to 90. It was still too high, but better than 100-105.

      You see, you can really damage your heart or suffer a deadly complications when you heart beats 100+ for several weeks in a row (especially when it was beating at heart rate 50 for 1, 2, 5 or 10 years. That is a huge stress for your heart in those weeks. Your heart is just not used to beat that fast and to work that hard anymore).

      Then after a few weeks, anxiety kicked in. Like a lot of people here, I have never had any anxiety issues in my life. I was reading about it, but I never knew what it is.

      And then, after 3-4 weeks into a withdrawal, I just started to feel enormous fear from everything.

      And I was nervous all day long. Strange feeling in my stomach, tight neck, you are feeling hot all the time.

      For no reason.

      You'll see it, it is not psychological.

      You can't stop it on your own. It is a sort of a chemical imbalance in your body.

      The thing is, when we take Beta blockers, they work like an anesthesia towards our adrenaline receptors.

      Normally, when we don't take Beta blockers, adrenaline receptors in our body react to adrenaline.

      When you are happy, your body pumps more adrenaline. When you are scared, your body pumps more adrenaline. When you are nervous, your body pumps more adrenaline.

      And then, when more adrenaline is pumped due to being happy, scared or nervous, your adrenaline receptors send a message to your brain: we have a lot of adrenaline in our bodies, something is happening, you need to raise a heart rate and raise a breathing rate (or a fight or flight response).

      You know, when you are scared, how your heart rate jumps up?

      Well, it is because of adrenaline, adrenaline receptors and our brain. This mechanism controls our heart rate 24 hours per day.

      And now, when you take Beta blockers, these drugs work like an anesthesia towards these receptors.

      Why?

      Well, if someone already has a too high heart rate, too high blood pressure, or some arrhythmias, then it is safer to avoid being nervous, scared and similar, because your Heart rate will jump too high and you can suffer a heart attack or something.

      So, basically, these drugs are preventing our bodies to be too scared, too happy and similar, and they are preventing our hearts to beat too fast (in order to protect our hearts) and they are preventing deadly events.

      But, the problem is: if you want to quit the drugs, you will experience problems then.

      Since your adrenaline receptors were "sleeping" while you were taking drugs, they "forgot" how to work properly and how to deal with the adrenaline.

      And now, when you quit the drugs, your body and these receptors are too sensitive to adrenaline, and to every emotion.

      In numbers, imagine that you were feeling 100% of emotions before you were taking Beta blockers.

      Then, while you were taking Beta blockers, you were able to feel only 50% of emotions (or only 50% of their total strength).

      And now, when you will quit BBs, you will feel 200% of emotions.

      So, when you quit BBs, in the first few weeks (or Months), whatever you will feel, you will feel it stronger than ever.

      If you will be happy, you will feel strange, "stronger" happiness than before.

      But, if you will feel sad, scared, nervous or something, it will also feel 2-3 times stronger than ever in your life.

      And this is when anxiety kicks in.

      You will just feel strange all the time.

      And your brain won't know how to deal with anxiety and fears in the first few weeks, until it will re-adjust.

      I have wrote before, for some reason I had problems with loud noises, with strong light, with sunlight in the first few weeks.

      If there was a normal light in a room, I would say: oh, please, turn off that light, it is killing me (I can't explain why). The same was with music, movies, news on a tv or any type of noises.

      But you see, my brain forgot how to deal with everyday life, because Beta Blockers have put my adrenaline receptors to sleep.

      About water, drinking fluids raises our blood volume.

      And in every person, whenever you don't have enough fluids, your blood volume goes down, and then a heart beats faster to compensate it.

      When you have enough of fluids, your blood volume is higher and a heart beats slower.

      This is important for all people, but especially during a withdrawal, when your HR will stay at 90-100-110 while resting for a few weeks.

      You can lower it down with fluids.

      If you won't drink them, then your withdrawal's HR will jump even higher.

      So, you will have: 1. a withdrawal plus 2. a lack of fluids

      About my 2nd time, when I started to take BBs again, I was taking 1,25Mg of Biso, but after 2-3 weeks I dropped to 0,90Mg and 0,62Mg (half a dose) and after that point, I started to lower 0,10Mg per Month.

      Like: 0,60Mg, then 0,50Mg, 0,40Mg etc.

      It was a hell even that way. I needed 8-9 Months to go down to 0 and even then I had 8-9 months of weaning off plus 2 months of a mild withdrawal.

      During these 8-9 months of weaning off and lowering a dose, I had minor withdrawals all the time.

      But, as explained, in my 1st attempt, when I weaned off fast (in 6 weeks), my resting HR jumped to 100-105 and stayed that way for 3 weeks.

      While when I weaned off slower, it looked like this:

      I lowered my dose to 0,50Mg: I would feel bad for 7 days, then it would be ok-ish.

      I would stay on that dose for 2-3 more weeks and I tried to walk slowly and do some normal everyday activities.

      Then, when I would feel better, I would lower a dose to 0,40Mg.

      Then the same would happen: a few days of a HR 90-ish, breathing problems, nausea.

      After 7 days it would get better.

      And I would stay on that dose again until I would feel better.

      And then repeat the same for 5-6-7 times.

      So, I still had dizziness, nausea, breathing problems, elevated resting HR, it was hard to walk etc.

      But everything was milder, like at 50%, of what I have experience in my 1st attempt.

      Plus, I didn't have to go to ER, and currently I am 1 years off drugs.

      But, my original arrhythmia was milder and my doc told me that I am allowed to quit the drugs, if that is my choice.

      So, not everyone can stop taking drugs.

      Each of us is different, of a different age, with different heart/blood pressure problems.

      What worked for me, may not work for you.

      So, please, ask your doc whether you can lower drugs, because during a withdrawal, we usually get lots of different tachycardias, arrhythmias and similar.

      And they can be deadly in some cases.

      Good luck

       

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    • Posted

      Thanks Bob for your extensive reply .. 

      You are right, we are all different - we took Beta Blockers for a variety of reasons & we'll all have different symptoms when coming off the pills .. 

      I find it helpful to hear other peoples' experiences as they give me an idea of what "Might" happen to me .. I do have a listening GP, but, at the moment I'd rather stay away from his surgery, as the numbers of Flu patients rise .. 

      For now, I've dropped down from 5mg per day to 2.5mg per day & will stay like this for a while .. Like I said before, I am more alert & my muscles seem stronger - perhaps due to me getting more oxygen .. 

      I take my PR throughout the day & if I do anything & will keep an eye on it & won't do anything drastic ... 

      As for the anxiety - well, it was one of the reasons I was given the Beta Blockers in the first place - the consultant thought my AFs were possibly not helped by my anxiety ... A Circle - I felt the AFs & got anxious .. As you say, adrenaline does weird things to a bod ..

      After being on the Beta Blockers for a couple of years, I had a Chemical Stress Test & had to have the maximum of the drugs to make my heart beat at the 'required' number - & even then, it didn't stay at that high number for longer than a few seconds .. I was given the all-clear .. 

      That was the last time I saw the consultant - a good number of years ago now .. 

      I don't think my AFs were very severe - not at the beginning anyway - but they were scary - hence the anxiety ... I'm sure I'm not on my own here ..

      All these years later I have learnt many things, such as when my Tummy or Bowels are upset, they can trigger an AF episode - & learning how to deal with this hasn't been easy, but I'm about there .. smile .. I've cut out all the offending foods & no longer eat large meals .. Instead of 3 meals per day, I have 4-5 meals, but they are much smaller .. 

      I'm also several years older & more secure in my life - this makes a difference too, especially on the anxiety side .. Learning how to relax has been so beneficial .. 

      Thanks again .. 

        

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