8 days off Metoprolol

[Gary Miller]

It’s been 8 days off metoprolol and I think it’s getting better! Of course I'm ready to see some more withdrawal effects after reading up on this drug and what happened right after I stopped. I did talk to 3 local pharmacist and they all said I should be done with the side effects in 2 weeks or so. The anxiety and PVC's and skipped beats were real bad for the first 5 days, but have let up a little each day since. I was curious about how long it took me to wean off. 50mg for 15 days, 25mg for 12 days, 12.5 5 days, 12.5 every other day for 5 days. Each time the dose was lowered there were signs of low BP, low HR and then long bouts of arrhythmia (bradycardia) and chest pain/discomfort. I'm no doc but don't the side effects of metoprolol contradict its use in some patients, and the use of amiodarone is also a pretty drastic (most say last resort drugs) approach to control a-fib. My EP has cut the amiodarone to 100mg a day on Friday so I'm bracing for more side effects this week even if they say it’s all right to do so (So was stopping the metoprolol). I read on one blog that I should get my EP to put it in writing that it’s ok to drop the amiodarone to 100mg from 200mg a day (boy he must be some kind of lawyer). My EP has told me that amiodarone is bad stuff but sometimes must be used for a bridge to get past the healing period of OHS so they can address the rhythm issues(pacemaker,ablaton) once I’m healed. He said he will get me off as soon as possible! He has been the only honest doc in this whole process. The surgeon and cardoilogist never mentioned how toxic and dangerous these 2 drugs can be, especially lung issues and amiodarone. Here's hoping for a good week with few side effects! Hey I got the spriometer up to 2800 yesterday (can't believe 65 year olds can do 3100) boy that makes your chest sore for a few seconds. To those of you waiting, hang in there. To everyone in recovery hoping you have a bump free time healing.

 

[Bill B]

Each time the dose was lowered there were signs of low BP, low HR and then long bouts of arrhythmia (bradycardia) and chest pain/discomfort.

Gary:

This description is the opposite of what I would expect from reducing the metoprolol dose. Personally I wouldn't be so sure these are directly related. Your rhythm issues must be more complex than appears on the surface. And, although amiodarone can be nasty stuff, MANY surgeons believe it is essential post-OHS to reduce serious complications from arrhythmias. In europe it is used routinely post-op to prevent arrhythmias. In your case, you have real arrhythmias. All drugs have side effects. I don't consider metoprolol on the bad end of the scale, even though, yes, some people have trouble with withdrawal. Anyway, you need and appear to have a good EP. I hope things settle down soon.

 

[DanielB]

Gary,
I was on 100mg Metoprolol extended release (1x per day) since my surgery last October until last Wednesday. I have had issues with slow and variable heart rates in the last two months and my cardio thought I might need a pacemaker. Long story short, I learned last Wednesday that my cardio was under the impression I had stopped taking the med after a stress test a few weeks ago and told me to stop it cold turkey that day. I do not recommend that for anyone else, but, in my case, they had a ton of data on my heart through tests and felt it was okay, and thought I would feel better being off it the sooner than later.

The last dose I took was last Tuesday night, so tonight will be six full days without taking it. For reference, last week, I was a week into bradycardia, with regular heart rates of about 45. The first few days after stopping Metoprolol my heart rate was 'jumpy' in the mornings, swinging between 45-60, then settling down to a regular 43 BPM in the afternoons. The last few days it has been slow, but more stabile at about 50 BPM all day. Today, it started out slow at about 50 BPM, but in the last few hours it has been jumpy again, but staying mostly in the 80-85 range. So, my adventure continues. My BP has risen from 110/85 to 130/85, which it was pre-surgery, so no big jump there. I should also note I have not felt any of the extra anxiety some have reported in other strings (yah!) and that my cardio and electrphisiologist both told me that I should be over side effects from this in one week -- we'll see. I will say overall, I do feel better.

From what I've read and learned is that everyone can respond to stopping this drug differently as it is a powerful drug. For me, listening to and tracking what my body is doing so I can relate that to my doctors is what I am doing to make sure I move off it as best as I can, while making sure the line of communication is open with my doctors if something out of line comes up.

Best of luck to you and keep listening to those doctors.

 

[SusQ]

Hubby was on what I thought was a huge dose of Metoprolol. They had him taking 75 mg twice daily and it wasn't working nearly as well as it should have. So after he had his second surgery to remove the fluid from around his heart (which I know contributed to the lack of control the Metoprolol had over his HR and BP), we discussed it with the second surgeon and he decided to take him off it and put him back on the same beta blocker he'd been on pre-surgery which he never had any issues with. I did double check this with his original surgeon's office and they said they didn't care which beta blocker he was on, as long as he was on one. So he went back on Atenolol instead. Though he is on double the dose he was prior to surgery (now 25 mg twice daily), it's still way less than the Metoprolol and is working fantastically.

However, hubby never had any arrythmia issues.

I've seen an improvement in his mood (less anxiety) and ability to control his temperature.

I have to say that one of biggest drawbacks of the surgery was all the new medications and the fact that he seemed to suffer from the worst side effects they all had. Poor guy went from 3 prior to surgery to 11 afterwards. We are now back down to four and two of those will be ending within the next month (but then he'll pick back up a third one that he had to stop prior to surgery).

 

[Mom2izzy]

I had mitral valve repair surgery at the end of Feb. Surgeon put me on Metoprolol then. I had never been on a Beta Blocker before. He said I should take it for six months while my heart is remodeling. Then he released me from his care, so follow ups are being done by my cardio.

Cardio said since it's such a small dose, if I'm tolerating it well, he would prefer to keep me on it indefinitely. Is that something you would get a 2nd opinion?

I have to admit, I am a bit of a hypochondriac, so I don't read side effects. If I read them, I WILL get them. I do occasionally get dizzy, but that was happening pre-surgery as well. (seems to run on my monthly cycle...if anyone here happens to have a good explanation for that...I'm all ears! My heart has pretty much been ruled out as the culprit). My BP both pre and post surgery is about 80/60...low...could explain dizziness from any minor dip in BP. I would think any meds that could lower BP would be bad, but I'm not a medical person.

Pre surgery, I would get a racing heart which would occasionally spiral into a full blown panic attack (or I suppose maybe the panic attacks could have been the cause of the racing heart rate). I tried a daily anti anxiety pill, but it made me sick. I haven't had an episode like that since I started rehab. Since metoprolol has an anti-anxiety effect, I wonder of it isn't helping in that regard.

Maybe I should stay on it indefinitely...I just hate being on meds...funny since I work for a pharmaceutical company.

Gary...sorry to hijack your thread...I was just hoping to glean some of the expertise from you and other Metoprolol users that Have been chiming in here.

 

[Gary Miller]

That’s ok Mon2izzy.Every comment on this site is valuable and very much appreciated. While everyone’s experience is unique to the individual, there can be many similar side effects that affect a lot of people that are not reported or in clinical studies. Most of us are searching for reassurance, possible answers to our problems, and encouragement to continue on. There are some great sources of information and clinical studies that help us to be informed and ask intelligent questions about heart disease.

 

[Bill B]

Pre surgery, I would get a racing heart which would occasionally spiral into a full blown panic attack (or I suppose maybe the panic attacks could have been the cause of the racing heart rate). I tried a daily anti anxiety pill, but it made me sick. I haven't had an episode like that since I started rehab. Since metoprolol has an anti-anxiety effect, I wonder of it isn't helping in that regard.

Yes. Beta blockers have long been used to reduce aniexty by blunting the physical manifestations of anxiety.

Maybe I should stay on it indefinitely...I just hate being on meds...funny since I work for a pharmaceutical company.

I understand. When I first started reading package inserts when I entered pharmacy school, I was surprised anyone would take any of the meds after reading the laundry list of side effects. But that's just what it is a "laundry list" of mostly uncommon things reported by people on the meds and not necessarily related. No doubt that metoprolol has withdrawal issues, and Gary MAY be experiencing them (although his symptoms don't fit the usual description). And there are a number of direct side effects of beta blockers (bradycardia, poor exercise tolerance and fatigue among them) that may make them intolerable to some people, but for many people they are extremely helpful and and well-tolerated. I've been on metoprolol SR 100mg daily for 3 years as one of my meds for high blood pressure. It also helped to get my racing heart rate under control post-OHS. I can't identify any adverse effects in my case. I intend to stay on it until perhaps my blood pressure drops from further weight loss and exercise (those have helped already but I have a way to go).

 

[Gary Miller]

8 weeks today! Still off metoprolol and my HR hasn't been below 50bpm since. I'm going to ask my EP to get me completely off amriodorine (100mg a day) and try dronedarone if he still thinks I need to control a high heart rate a-fib. I haven't had any more a-fib runs (thank God, knock on wood) and now have a little trouble getting my HR over 90-95 on my morning fast walks short runs. Sometimes a little dizzy out of balance, blurry vision while walking, I think it must be the amiodorine. Out of the last 18 days I’ve had 3 blah days and 1 bad 4 hrs dizzy PVC's and some short chest discomfort. 14 days were just great! If I had to I could do this, as long as I didn't overdo it I felt close to normal and that is very encouraging at this point in my recovery. I have been wearing an event monitor, I have it for a 30 day period, only recorded 1 event so far. The EP will decide on treatment after the results. My PCV's are getting fewer and fewer every day since I really started watching everything (reading all the ingredients, msg, sodium, spices, and caffeine.) I eat. They are probably not all related to food, but I'll bet some are. My surgeon released me yesterday as the only complaint I had was sometimes I had sternum pain/pressure when taking deep breaths. He didn't seem concerned so I didn't pursue it I've got enough with my rhythm issues. Any way things are getting better and I'm getting my energy back a little bit more each day. We even bought a Travel Trailor to do some traveling and enjoying the time we have been given.

 

[TheGymGuy]

Gary,
They can also cut your amiodarone in half, and then in half again To see how you do and if you even need it.

 

[Bill B]

Gary:

I'm glad you're better. Rather than asking your EP about cutting this and doing that, ask him directly about your dizzy spells and inability to get your heart rate up during your morning walks. Those things need to be resolved, whether it involves cutting amiodarone, using dronedarone or something totally different. I may be misinterpreting your posts, but you seem to be playing doctor more than patient. I'm often guilty of that too. People who have SOME medical background (I was a pharmacist) often approach their doctors with their own diagnoses and treatment plans, and this shortcuts the necessary medical process and may impair the chance to get the right answer. Doctors have a natural human tendency to do what their patients want to keep them happy, so you have to be careful to not lead them down that way too much.

 

[sarahsunshine]

Gary - glad you are feeling so much better, and wish lots of happy holiday trailering!

 

[Eva]

Gary:

.........often approach their doctors with their own diagnoses and treatment plans, and this shortcuts the necessary medical process and may impair the chance to get the right answer. Doctors have a natural human tendency to do what their patients want to keep them happy, so you have to be careful to not lead them down that way too much.

A great advice, Bill. This is sooooooo true. I noticed this on my GP and it worried me and decided not to be *a smart patient*!

 

[Gary Miller]

Thanks Bill your absolutely right! I've been reading so many blogs and going to so many websites I'm forgetting who is the doctor, and who is the patient. It was those darn statistics on amiodorine and lung problems. A person can forget that 70 % of people on it only suffer minor effects. My cardiologist's PA said that she would take it without hesitation if it controlled her a-fib and PCV's. It must be helping me a lot as I don't feel the PCV's much anymore or any a-fib. Just hope I can resolve the rhythm issues without using it long term.