How long do withdrawal symptoms last after discontinuation of bisoprolol?

[Systemlord]

I was instructed by my doctor to tapper off and then stop my beta-blocker due to experiencing hypotension which occurred at half original dosage. The hypotension is gone, barely elevated blood pressure (140/80), a bit low in energy.

It has been 5 days now without the beta-blocker.

Are there withdrawal symptoms from beta blockers even after it’s technically out of your system?

@madman

 

[BadassBlues]

I was instructed by my doctor to tapper off and then stop my beta-blocker due to experiencing hypotension which occurred at half original dosage. The hypotension is gone, barely elevated blood pressure (140/80), a bit low in energy.

It has been 5 days now without the beta-blocker.

Are there withdrawal symptoms from beta blockers even after it’s technically out of your system?

@madman

Why were you on Bisoprolol? Just curious as it's a selective beta blocker used mainly for heart patients. I did find this from Drugs.com:

Bisoprolol: Package Insert - Drugs.com

Bisoprolol package insert / prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions and pharmacology.

www.drugs.com

Abrupt Cessation of Therapy

Exacerbation of angina pectoris, and, in some instances, myocardial infarction or ventricular arrhythmia, have been observed in patients with coronary artery disease following abrupt cessation of therapy with beta-blockers. Such patients should, therefore, be cautioned against interruption or discontinuation of therapy without the physician‘s advice. Even in patients without overt coronary artery disease, it may be advisable to taper therapy with bisoprolol fumarate over approximately one week with the patient under careful observation. If withdrawal symptoms occur, bisoprolol fumarate therapy should be reinstituted, at least temporarily.

 

[madman]

I was instructed by my doctor to tapper off and then stop my beta-blocker due to experiencing hypotension which occurred at half original dosage. The hypotension is gone, barely elevated blood pressure (140/80), a bit low in energy.

It has been 5 days now without the beta-blocker.

Are there withdrawal symptoms from beta blockers even after it’s technically out of your system?

@madman

When taking the medication peak plasma concentration 2-4 hrs, half-life 9-12 hrs and steady-state is achieved within 5 days.

Yes one could experience withdrawal/rebound especially when stopping abruptly but the chance of that happening should be minimized/avoided when using lower doses and discontinuing the drug properly which would be tapering the dose slowly over a 2 week period before stopping the medication.

Some may need a longer taper period before stopping the medication.


*Beta blockers should be withdrawn slowly to prevent clinical deterioration and withdrawal symptoms, which in some cases can be severe, e.g. ischaemic cardiac symptoms even in those with no history of coronary heart disease.19, 45

Safety and tolerability of β-blockers: importance of cardioselectivity

ABSTRACT Cardioselective b-blockade is generally well tolerated in practice and contraindications to this therapy are uncommon. b-blockers are a diverse therapeutic class, and their individual tolerability profiles are influenced strongly by their pharmacodynamic effects across different...

www.excelmale.com

β-blockers are not all the same

ABSTRACT b-blockers are a heterogeneous class, with individual agents distinguished by selectivity for b1- vs. b2-and a-adrenoceptors, presence or absence of partial agonist activity at one of more b-receptor subtype, presence or absence of additional vasodilatory properties, and lipophilicity...

www.excelmale.com

 

[Systemlord]

Why were you on Bisoprolol?

Yes, 2.5 mg. I tapered down to half and then stopped due the half dose still causing hypotension.

So a two day taper.

I increased my vitamin D to 1800 IU and that has brought down my blood pressure.

 

[Seagal]

Yes, 2.5 mg. I tapered down to half and then stopped due the half dose still causing hypotension.

So a two day taper.

I increased my vitamin D to 1800 IU and that has brought down my blood pressure.

Not directly related to your answer: I noticed that my BP drops if I take taurine. I cannot use it anymore, however, it might be the right supp for you. Looked it up quickly:

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.115.06624

 

[Systemlord]

When taking the medication peak plasma concentration 2-4 hrs, half-life 9-12 hrs and steady-state is achieved within 5 days.

So tomorrow the Bisoprolol

Not directly related to your answer: I noticed that my BP drops if I take taurine. I cannot use it anymore, however, it might be the right supp for you. Looked it up quickly:

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.115.06624

I tried taurine today and it makes me feel weird. Thanks for the suggestion.

 

[Systemlord]

When taking the medication peak plasma concentration 2-4 hrs, half-life 9-12 hrs and steady-state is achieved within 5 days.

Yes one could experience withdrawal/rebound especially when stopping abruptly but the chance of that happening should be minimized/avoided when using lower doses and discontinuing the drug properly which would be tapering the dose slowly over a 2 week period before stopping the medication.

Some may need a longer taper period before stopping the medication.


*Beta blockers should be withdrawn slowly to prevent clinical deterioration and withdrawal symptoms, which in some cases can be severe, e.g. ischaemic cardiac symptoms even in those with no history of coronary heart disease.19, 45

Safety and tolerability of β-blockers: importance of cardioselectivity

ABSTRACT Cardioselective b-blockade is generally well tolerated in practice and contraindications to this therapy are uncommon. b-blockers are a diverse therapeutic class, and their individual tolerability profiles are influenced strongly by their pharmacodynamic effects across different...

www.excelmale.com

β-blockers are not all the same

ABSTRACT b-blockers are a heterogeneous class, with individual agents distinguished by selectivity for b1- vs. b2-and a-adrenoceptors, presence or absence of partial agonist activity at one of more b-receptor subtype, presence or absence of additional vasodilatory properties, and lipophilicity...

www.excelmale.com

So let's say the Bisoprolol is out of my system, does that mean symptoms of stopping it can continue for a few weeks until my body resets?

I don't have the energy back yet.

 

[madman]

So let's say the Bisoprolol is out of my system, does that mean symptoms of stopping it can continue for a few weeks until my body resets?

I don't have the energy back yet.

Yes, 2.5 mg. I tapered down to half and then stopped due the half dose still causing hypotension.

So a two day taper.


Tapering off of the medication should be over a 2 week period.

Chances are if you were to stop abruptly or not taper off the medication slowly you will feel off for awhile before your body bounces back.

 

[Systemlord]

I wonder what the mechanism is that causes the beta blocker to allow me to tolerate higher doses of vitamin D. I can’t hardly handle any vitamin D supplementation at all now that the beta blocker is out of my system.

The bottoms of my feet turn bright red and burn when I take more than 600 units of vitamin D. This usually happens when I become dehydrated. Magnesium and vitamin K don’t change this outcome.

I noticed all of this on the sixth day after stopping the beta blocker, which gives with what @madman is saying with regards to the beta blocker being out of my system after 5 days.

 

[Seagal]

You are a case for Dr. House

How about ditching all meds pills supps (except T) for a few weeks and rely on your food. Afterwards a blood test including vitamins minerals etc to see where you are deficient.

 

[Systemlord]

You are a case for Dr. House

How about ditching all meds pills supps (except T) for a few weeks and rely on your food. Afterwards a blood test including vitamins minerals etc to see where you are deficient.

I have tried to go without vitamin D a few days ago, within 2 hours I start feeling unwell. I still take 500 mg potassium and levels are 3.9. Other than that it's just the Jatenzo.

The vitamin D @ 1800 IU causes my leg muscles to lock up, today @ 1200 IU leg muscles are not locking up but are twitching like crazy. I'm also crazy dehydrated (urine very dark) with no known cause.

Fasting glucose this morning was 115. My glucose become lower the furether away I get from taking my supplements.

Tomorrow back to 600 IU.

 

[Systemlord]

You are a case for Dr. House

Maybe my body is recycling the vitamin C. I felt nauseated after taking 45 mg vitamin C this morning, this nausea was more intense at 90 mg which causes brain fog and even the bottoms of my feet to turn bright red and burn.

Maybe I only need 30 mg vitamin C as I've seen recommendations from 30-180 mg.

 

[Seagal]

I have tried to go without vitamin D a few days ago, within 2 hours I start feeling unwell. I still take 500 mg potassium and levels are 3.9. Other than that it's just the Jatenzo.

The vitamin D @ 1800 IU causes my leg muscles to lock up, today @ 1200 IU leg muscles are not locking up but are twitching like crazy. I'm also crazy dehydrated (urine very dark) with no known cause.

Fasting glucose this morning was 115. My glucose become lower the furether away I get from taking my supplements.

Tomorrow back to 600 IU.

Maybe it is an electrolyte imbalance. On keto I'm always thirsty.

https://uniontestprep.com/nclex-rn-exam/resources/electrolyte-relationships-calcium-phosphorus-and-vitamin-d

 

[FunkOdyssey]

You are a case for Dr. House

How about ditching all meds pills supps (except T) for a few weeks and rely on your food. Afterwards a blood test including vitamins minerals etc to see where you are deficient.

This is basically the same advice I gave in his other thread:
90 mg of Vitamin C causing erectile dysfunction, low libido, 24/7 painfull penis sensitivity, burning skin, joint inflammation and stomach cramping?

 

[Belekas]

You are a case for Dr. House

How about ditching all meds pills supps (except T) for a few weeks and rely on your food. Afterwards a blood test including vitamins minerals etc to see where you are deficient.

Exactly that. Plus genetics to open another can of worms. For many years I tried a lot of combinations under the sun but with marginal success. Done genetics this year and now I have a better understanding why.

 

[Systemlord]

My energy levels returned yesterday out of the blue as well as my erections and libido is only briefly here and there. I think another factor for the hit and miss erections and libido is related to me supplementing iron for three weeks last month unknowingly treating hypotension.

Yesterday after eating my breakfast, tri-tip steak, I got a lot of heart palpitations and hot flashes. Today those symptoms seem much more diminished after eating steak.

 

[Systemlord]

Maybe it is an electrolyte imbalance. On keto I'm always thirsty.

https://uniontestprep.com/nclex-rn-exam/resources/electrolyte-relationships-calcium-phosphorus-and-vitamin-d

I get the same symptoms at 600 IU that I got at 1200. I seem to be reaching intolerance to vitamin D as time goes on. 600 IU causes slight dehydration and 1200 IU (Vit-D @ 32) hyper absorption of nutrients and even more dehydration.

The hyper absorption of nutrients is what’s causing my ED, because my kidneys are trying to regulate everything and flush out the excess, and this ends up, making me dehydrated.

I noticed I can only handle 20 g of whey protein per day when I had more than one protein shake I felt punch drunk all day.

Actually found a study when people take high doses of vitamin D, it can cause urinary calcium to increase. In my case, it’s to the extreme. This loss of calcium can cause or aggravate vitamin D deficiency.

A low calcium intake causes a high turnover of vitamin D metabolites, due to higher production of 1,25(OH, and higher breakdown of vitamin D metabolites. A low calcium intake causes or aggravates vitamin D deficiency while a high calcium intake is vitamin D sparing.

In other words, I need calcium supplement together with my vitamin D supplement, however, I don’t need the calcium supplement when not supplementing vitamin D.

When I eat a ribeye steak, I feel symptoms similar to taking iron supplements. I performed a little experiment and took a little pile of salt in my palm and consumed it.

Hours later, I became severely dehydrated and I was out of it mentally, almost like a hangover.

My urine was very very dark. every muscle in my body was twitching like crazy.

Maybe a coincidence maybe not, but my blood pressure is continuing to drop since stopping the beta blocker indicating my body is still trying to find homeostasis.

I’m on zero prescription medication, only Jatenzo.

These blood pressure numbers are with hemoglobin at 19.4, and hematocrit at 55%.

 

[Systemlord]

Chances are if you were to stop abruptly or not taper off the medication slowly you will feel off for awhile before your body bounces back.

This is spot on, I was still experiencing withdrawal a week after Bisoprolol had washed out of my system. I was extremely lightheaded, in an altered state mentally, like a hangover or getting high.

I read that the beta receptors are blocked by beta blockers become more sensitive once you withdraw the medicine.

Then adrenaline interacts with these overly sensitized receptors, due to being blocked, causing heart rates to exaggerated responses to simply getting up or even exercising, taking some time to come to a resting heart rate.

I had abdominal bloating, cramping along with the inconsistent blood pressure as if blood pressure was jumping all over the place.

Now things are mostly under control, but I doubt my body is fully adapted to being without the beta blocker.

 

[Seagal]

.

These blood pressure numbers are with hemoglobin at 19.4, and hematocrit at 55%.View attachment 46716

Good progress.
Your chillaxed position might bias the BP measurement. The reference is an upright sitting position .

 

[FunkOdyssey]

The hyper absorption of nutrients is what’s causing my ED, because my kidneys are trying to regulate everything and flush out the excess, and this ends up, making me dehydrated.

This is what I was warning you about previously. You are jumping to conclusions about cause and effect that you have no evidence for.

If you feel bad after you take vitamin D, just report that you feel bad. That's all you can safely conclude. The rest, where you attribute symptoms to specific mechanisms and interactions with other nutrients, is speculation, and when you start taking action based on that speculation, you get yourself into trouble.

It is not that uncommon for people to feel bad taking vitamin D (or any other supplement for that matter). Oral ingestion is not that way we are meant to absorb vitamin D, and the process and transport of the vitamin is totally different compared to receiving it from sunlight.

How did you receive our advice to cease all supplementation beyond your testosterone? Was that not feasible?