Ivabradine, adjusting

PrairieLights

PrairieLights

Senior Member (Voting Rights)
I have tachycardia from dysautonomia (not POTS). I had been on bisoprolol for several months.

Today is my first day on ivabradine. Nothing alarming happening or anything but I can feel differences and my heart rate is following a different pattern of ups and down than I am used to seeing.

I can't find anywhere online what to expect and how long until it establishes a pattern. Does anyone have any experiences they can share about adjusting to ivabradine?

I asked my cardiologist if I could be flexible with my dose as I don't always feel the same and sometimes I felt like half a dose of bisoprolol would have been better than a full tablet.

He said yes I could take less as needed just not to go above a certain amount. I won't ever be going above the prescribed dose so that isn't an issue.

Just so it's clear, bisoprolol stopped yesterday, ivabradine started today.

I'm just generally nervous about medication changes and it would be nice to hear how it adjusted for others.
 
I had some issues adjusting and had to tweak things until it felt right, I’m wary of giving advice for obvious reasons. There is a longish half life for ivabradine and any medication changes can take some time. But am glad to hear you have a cardiologist giving advice.
 
hotblack said:
I had some issues adjusting and had to tweak things until it felt right, I’m wary of giving advice for obvious reasons. There is a longish half life for ivabradine and any medication changes can take some time. But am glad to hear you have a cardiologist giving advice.
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Oh yes. I don't need advice but hearing others experiences gives me a sort of way to adjust my expectations.
 
PrairieLights said:
I can't find anywhere online what to expect and how long until it establishes a pattern. Does anyone have any experiences they can share about adjusting to ivabradine?
Click to expand...
I'm on a low dose and did not really see much of an adjustment, very mild and easy on the uptake. I take (edit: 2.5mg) in the morning, as I was already much more stable in the evening and night, with mornings being the worst time. My morning rest pulse was, and still is, generally in the low 50s.

It's been two months. I don't remember much beyond a slow stabilization of excessive heart rate, slight but enough to be noticeable, and especially palpitations (skipped and 'hard' beats) pretty much stopped entirely.

I described it to the cardiologist as mainly difficulty with exercising, emphasizing just how low my capacity was, but with zero mention of anything related to ME/CFS. I haven't been able to really up my effort level, but I have been able to do things I haven't been able to do in many years, most importantly: on a regular basis. Some of it is likely due to an overall slow but upward trend over the last few years, and also getting acid reflux under control, with Dexilant/dexlansoprazole, so it's hard to say how much of an impact each had.

One of the most notable changes I have seen, small but noticeable, has been that my respiration increases along with effort and heart rate, whereas I used to only get a heart rate increase. I've been constantly slightly out of breath for years, but never seemed to breathe faster when exerting. I would sometimes breathe deeper (if that makes sense), but that was always when PEM was higher. Of course I still very rarely get to aerobic state, but my capacity to do so has noticeably improved. My guess is that this is in part due to higher respiration, whereas before my muscles would quickly run out of energy.

From what I read drugs like bisoprolol are much more impactful than Ivabradine. It doesn't affect blood pressure and, especially at low doses, is very mild as far as medication goes.
 
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rvallee said:
I'm on a low dose and did not really see much of an adjustment, very mild and easy on the uptake. I take 5mg in the morning, as I was already much more stable in the evening and night, with mornings being the worst time. My morning rest pulse was, and still is, generally in the low 50s.

It's been two months. I don't remember much beyond a slow stabilization of excessive heart rate, slight but enough to be noticeable, and especially palpitations (skipped and 'hard' beats) pretty much stopped entirely.

I described it to the cardiologist as mainly difficulty with exercising, emphasizing just how low my capacity was, but with zero mention of anything related to ME/CFS. I haven't been able to really up my effort level, but I have been able to do things I haven't been able to do in many years, most importantly: on a regular basis. Some of it is likely due to an overall slow but upward trend over the last few years, and also getting acid reflux under control, with Dexilant/dexlansoprazole, so it's hard to say how much of an impact each had.

One of the most notable changes I have seen, small but noticeable, has been that my respiration increases along with effort and heart rate, whereas I used to only get a heart rate increase. I've been constantly slightly out of breath for years, but never seemed to breathe faster when exerting. I would sometimes breathe deeper (if that makes sense), but that was always when PEM was higher. Of course I still very rarely get to aerobic state, but my capacity to do so has noticeably improved. My guess is that this is in part due to higher respiration, whereas before my muscles would quickly run out of energy.

From what I read drugs like bisoprolol are much more impactful than Ivabradine. It doesn't affect blood pressure and, especially at low doses, is very mild as far as medication goes.
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Thank you for your experience.

I was precribed ivabradine twice a day at 5mg which is supposed to be the equivalent to the bisoprolol I was on. I am leaning towards cutting the pill this evening and taking half as the evening/night is my better time of day. Will see tomorrow if the same makes sense or if half a tablet in the evening suits me.
 
So today is day 3, only had my first dose today about half an hour ago.

I know there are adjustment periods for medication, but I am already wondering if ivabradine is working less well than bisoprolol had been. I am not going back to bisoprolol due to it being the suspected cause of my constant tinnitus.

My heart rate seem to be generally higher at rest and moving around the house, but with less of a range from lowest to highest. That doesn't seem to feel better so far. I'm hoping that will settle. I do have other things bothering me too (starting before ivabradine) like increased PEM and fatigue.
 
PrairieLights said:
So today is day 3, only had my first dose today about half an hour ago.

I know there are adjustment periods for medication, but I am already wondering if ivabradine is working less well than bisoprolol had been. I am not going back to bisoprolol due to it being the suspected cause of my constant tinnitus.

My heart rate seem to be generally higher at rest and moving around the house, but with less of a range from lowest to highest. That doesn't seem to feel better so far. I'm hoping that will settle. I do have other things bothering me too (starting before ivabradine) like increased PEM and fatigue.
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Is there a known adjustment period?
 
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