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For those of you that use Nebivolol/Bystolic

nothuman

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Anyone get really dizzy from it? I've been having bouts of this for months and can't figure out any other reason. Nothing on my bloodwork would indicate that this should be happening. I've been using anywhere from 5mg to 10mg. It's at its worst right after my first meal if I took it before bed.
 

ThinkTank

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Been taking 5mg for a couple of years. The first 6 months was a little rough due to the lethargy, however I have adjusted.

FWIW, I take it first thing in the AM upon waking.

Never had dizziness. Are you sure your BP is not dropping too low?
 

maldorf

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Did you just increase the dose? Doing that take a long time for your body to get accustomed to the new dose. I increased mine about 2 months ago and I am still adjusting to it.

If you did increase dose you want to do it slowly. At first you might take your regular dose on day one and day two. On day three take the higher dose. Then repeat that cycle. Old dose 2 days and then the higher dose for just 1 day. Repeat.

Later on you can move to EOD dosing of regular dose and then higher dose. Then you might go to two days of higher dose and one regular. Eventually you will become accustomed to the higher dose and be just fine. Have to be patient. I'm about 2 months in on my higher dose and just about done.

Check your BP when you start getting dizzy at night. If its low I found that by doing the above protocol I was able to do away with most of it. If I tried to just jump right in on the higher dose it would mess me up bad. Lots of breaking tabs in half etc to make it gradual.
 

nothuman

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Did you just increase the dose? Doing that take a long time for your body to get accustomed to the new dose. I increased mine about 2 months ago and I am still adjusting to it.

If you did increase dose you want to do it slowly. At first you might take your regular dose on day one and day two. On day three take the higher dose. Then repeat that cycle. Old dose 2 days and then the higher dose for just 1 day. Repeat.

Later on you can move to EOD dosing of regular dose and then higher dose. Then you might go to two days of higher dose and one regular. Eventually you will become accustomed to the higher dose and be just fine. Have to be patient. I'm about 2 months in on my higher dose and just about done.

Check your BP when you start getting dizzy at night. If its low I found that by doing the above protocol I was able to do away with most of it. If I tried to just jump right in on the higher dose it would mess me up bad. Lots of breaking tabs in half etc to make it gradual.

I had raised it to 10mg and then about 1-2 weeks later, the dizziness became an all day thing so I had to go back down to 5-7mg and that seemed to help but I still get it sometimes and it lasts a few hours. Going to just stay at 5mg and see if it persists.

I haven't been home in two months and didn't bring my BP monitor with me so I haven't been able to check my BP. I went to a doctor's office a month ago and they used a really big cuff and got a 120/72 reading (strange because my diastolic is never more than 60 but I can't complain). I'll be home in a week and will be able to measure my BP again to see what is going on. My initial thought was my BP was too low but then that reading at the doc office while dizzy as hell suggested that to not be the case.
 

maldorf

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My initial thought was my BP was too low but then that reading at the doc office while dizzy as hell suggested that to not be the case.

Ive had that before too. Cant remember if I ever figured out what was wrong. If BP is 120/80 or so that is great and means that your heart is pumping well.

Recently after my surgery when my heart got stuck going 135 bpm it wasn't doing so well. When your heart beats too fast and out of rhythm like that there isn't as much filling time so ejection fraction becomes even lower. Less blood pumped from the heart is going to lower BP too. My bp at the hospital was about 80/50 or so if I remember correctly. I didn't feel very well but I am surprised that I didn't feel any worse.

I don't think you have any rhythm issues do you? Could be a case where you feel bad when the rhythm is messed up and then when it gets back to normal sinus rhythm you feel ok. You said though that you had the doctor measure your BP while you felt crappy.
 

nothuman

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Ive had that before too. Cant remember if I ever figured out what was wrong. If BP is 120/80 or so that is great and means that your heart is pumping well.

Recently after my surgery when my heart got stuck going 135 bpm it wasn't doing so well. When your heart beats too fast and out of rhythm like that there isn't as much filling time so ejection fraction becomes even lower. Less blood pumped from the heart is going to lower BP too. My bp at the hospital was about 80/50 or so if I remember correctly. I didn't feel very well but I am surprised that I didn't feel any worse.

I don't think you have any rhythm issues do you? Could be a case where you feel bad when the rhythm is messed up and then when it gets back to normal sinus rhythm you feel ok. You said though that you had the doctor measure your BP while you felt crappy.

Well I haven't seen a diastolic reading above 60 on my home monitor for a few years, which is a result of aortic regurgitation in my valve. That is why I was surprised by the office readings last month. I'm guessing that once I can use my own monitor again next week, I'll see the low diastolic numbers again unfortunately. I do not have any hearth rhythm issues or anything else like that. Just the valve problem that I am hoping doesn't get worse. I'm getting another echo cardiogram in under two weeks so we will see if the added nebivolol, probenecid, and higher telmisartan dose helped at all. My main focus is preventing any worsening diastolic function. My systolic is about as good as it gets for now.
 
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gotgame

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Well I haven't seen a diastolic reading above 60 on my home monitor for a few years, which is a result of aortic regurgitation in my valve. That is why I was surprised by the office readings last month. I'm guessing that once I can use my own monitor again next week, I'll see the low diastolic numbers again unfortunately. I do not have any hearth rhythm issues or anything else like that. Just the valve problem that I am hoping doesn't get worse. I'm getting another echo cardiogram in under two weeks so we will see if the added nebivolol, probenecid, and higher telmisartan dose helped at all. My main focus is preventing any worsening diastolic function. My systolic is about as good as it gets for now.

No issues for me on bystolic. I do however like the rate control better on atenolol though.
 

nothuman

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I also wonder if it's from L-theanine
 

A50#

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I just posted in another thread but 10mg + did make me dizzy.
With 3-5mg I have no problems at all.
 

MyNameIsJeff

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Some speculation: One can get dizzy if blood pressure is too low. But that does not seem the cause for you. So maybe it's related to your heart rate being too low and/or not adapting sufficiently to increased oxygen needs when physically active? In other words, the dizziness could be a symptom of (mild) beta blocker induced bradycardia.


Bradycardia is a condition wherein an individual has a slow heart rate, typically defined as a resting heart rate of under 60 beats per minute (BPM) in adults.[1] Bradycardia typically does not cause symptoms until the rate drops below 50 BPM. When symptomatic, it may cause fatigue, weakness, dizziness, sweating, and at very low rates, fainting.
https://en.wikipedia.org/wiki/Bradycardia

Maybe your heart rate doesn't even need to go that low to produce symptoms, especially if someone is borderline hypotensive and/or has a low ejection fraction.

Beta‐blocker medication should be started at a very low dose and should be titrated up to the high maintenance dosages shown to be effective in large outcome trials. However, from clinical experience and data of intervention trials, it is evident that some patients cannot be up‐titrated due to the induction of bradycardia. Indeed, in the US Carvedilol program, the CIBIS study and the MERIT‐HF trial, bradycardia was one of the most common reasons, why patients could not be up‐titrated to the target dose (Table 1). In mildly and moderately symptomatic patients in the US Carvedilol trail, bradycardia was documented as an adverse event during the double blind up‐titration and maintenance phase in 12.9% and 9% of the carvedilol group compared to 0.7% and 1% in the placebo group, respectively 1,2. In the MERIT HF trail metoprolol CR/XL could not be fully titrated due to bradycardia in 9.1% of patients in NYHA class II, while bradycardia was observed in 2.4% receiving placebo. In more symptomatic patients (NYHA III/IV) bradycardia was even more frequent (11.3% in the metoprolol CR/XL group vs. 3.3% in the placebo group) 3. Discontinuation of the beta‐blocker due to low heart rate, however, was rather rare in the large outcome trials (0.3–0.9%) (Table 2).
https://onlinelibrary.wiley.com/doi/full/10.1016/j.ejheart.2004.01.015
 

nothuman

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Some speculation: One can get dizzy if blood pressure is too low. But that does not seem the cause for you. So maybe it's related to your heart rate being too low and/or not adapting sufficiently to increased oxygen needs when physically active? In other words, the dizziness could be a symptom of (mild) beta blocker induced bradycardia.



https://en.wikipedia.org/wiki/Bradycardia

Maybe your heart rate doesn't even need to go that low to produce symptoms, especially if someone is borderline hypotensive and/or has a low ejection fraction.


https://onlinelibrary.wiley.com/doi/full/10.1016/j.ejheart.2004.01.015

This is a good thought but I don't believe to be the case. My RHR is 60 on Nebivolol and can get as high as 168 during HIIT using the hand sensors on the cardio machines. I think the Nebivolol causes dizziness directly and not always as a mechanism of low BP or HR. Just from searching around the net, seeing people reporting dizziness on it. Even 6-7mg was bad. I'm dropping to 5mg to see if that resolves the issue.
 

Thebigone

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2.5-5mg no sides. 10mg and I notice I’m very out of breath during normal non vigorous tasks like walking,etc..
 

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