Dizziness

[PJmomrunner]

I'm hoping you folks might help me figure out what's going on.... I've been experiencing a very little bit of dizziness, mostly when getting into bed at night or for a rest, but also once when getting out of bed. It's as if my head moves and my brain takes a second to catch up and I get a fleeting sensation of mild nausea along with it. I have taken my BP on several occasions and it is not low at the time. This started about a week ago, which happens to coincide with when I switched to split 100mg Toprol XL pills from two 25mg pills twice a day (same dose for 3+ months). Any ideas?

 

[BIGHEARTED]

Hi P.J. - I also take Toprol XL - went from 25 mg twice a day to 50 mg twice a day (cut the 100 in half and was told later not to do that) and now I am on 100 mg. twice a day. I had the dizziness sensations each time my dose was increased, but it went away withing a couple weeks. Sometimes I still feel a little "spacey" but that's just me! Have a great day. Leny

 

[OldManEmu]

P.J. it?s strange that half a Toprol XL 100mg pill would have a different effect to 2*25mg. Were the 2*25mg regular metoprolol or Toprol XL. I was on a 47.5 mg Toprol XL for 6 months and was increased to 95mg Toprol XL both of these once a day. I found 95mg of Toprol too much. I took it for 8 weeks before I reverted to the old dose. I found I was extremely fatigued, had a permanent headache and no concentration. Previously before the Toprol XL the cardio had tried me on Carvedilol and this had severe side effects on me. Beta-Blockers can have these types of side effects.
I know if I took the 200Mg a day that BigHearted does I would be comatose and unable to even get out of bed.

 

[LLJ]

Yup, it's the Toprol. Iwas told by one of my running buddies, who also is a cardiac rehab nurse, that one of the common effects of this increase dose is lightheadedness. When I decreased my dose from 2 25mg 2x a day of regular toprol to once a day 25mg Toprol XL the lightheadedness also went away.
Laura

 

[parker04]

The toprol

The toprol

Yes, The toprol can do it.. After my last surgery I had the same symptoms of dizziness. My doctor said the toprol can do it he then decresed my dose. I was only on it for 3 months post op. So talk to your doctor about it..
Lynette

 

[geebee]

Maybe I am misunderstanding but isn't a split 100mg the same as 2-25mg pills? OR are you taking the split pills more than twice a day?
Also, does the XL stand for time released or something else? If it stands for time released, were the pills really meant to be split? I am wondering if you are actually getting a dose different from the 50mg you are expecting from the split pill. I am one of those skeptical people who think active ingredients are not consistent throughout a pill.

 

[PJmomrunner]

Maybe I am misunderstanding but isn't a split 100mg the same as 2-25mg pills? OR are you taking the split pills more than twice a day?
Also, does the XL stand for time released or something else? If it stands for time released, were the pills really meant to be split? I am wondering if you are actually getting a dose different from the 50mg you are expecting from the split pill. I am one of those skeptical people who think active ingredients are not consistent throughout a pill.

You are understanding--actually that's kinda what I was getting at. Both are the same dose and XL does stand for extended release. When I sent in my newest prescription to be filled it was for 50mg 2x per day and Caremark (prescription service linked to my insurance) filled the scrip for 100mg and told me to split them. They included a form letter saying they had checked this out with my doctor. I'm wondering if splitting them obliterates some enteric coatings that accomplish the time-release or something. I'm also wondering if it has nothing to do with the medicine and my valve is more leaky and that's causing the dizziness?

 

[geebee]

I could be wrong but I always thought time-released pills could not be split because it affects the time release. Maybe you are getting way too much medicine. I am not sure how you would check it out except to contact the manufacturer and ask them outright.
The dizziness could be caused by something else but, since it started around the time you changed you meds, I would eliminate that first.

 

[Mary]

You are understanding--actually that's kinda what I was getting at. Both are the same dose and XL does stand for extended release. When I sent in my newest prescription to be filled it was for 50mg 2x per day and Caremark (prescription service linked to my insurance) filled the scrip for 100mg and told me to split them. They included a form letter saying they had checked this out with my doctor. I'm wondering if splitting them obliterates some enteric coatings that accomplish the time-release or something. I'm also wondering if it has nothing to do with the medicine and my valve is more leaky and that's causing the dizziness?

I agree that you should check out your med situation first. Your dizzy spells don't sound the way mine did presurgery. Mine were more apt to happen during a period of exertion or stress, whereas you seem to experience them with getting in or out of bed.

 

[PJmomrunner]

Thanks guys. I've been talking to my nurse friend and she says the rule of thumb on pill-splitting is if it's scored it's generally okay to split. This one is scored and drugs.com says it's okay to split too. That said, she had me check for postural hypotension by taking my BP while lying down and then when sitting up. It happened that I checked this about 2 hours after taking my morning dose, so when the level of the drug is highest in my blood, and my supine BP is 93/65. Pretty low. My seated BP is not a lot higher at 106/78. (This is also right where it should be--aneurysm) She suggests maybe taking the whole 100mg two hours before bed. We were interupted in our conversation, but when we figure out what we think I should do, I'll call the doctor.

 

[Cris N]

If it stands for time released, were the pills really meant to be split? I am wondering if you are actually getting a dose different from the 50mg you are expecting from the split pill. I am one of those skeptical people who think active ingredients are not consistent throughout a pill.

from Drugs.com:
How should I take Toprol?
? Take Toprol exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.
? Take each dose with a full glass of water.
? Take Toprol with food or immediately following a meal.
? Do not crush or chew the extended-release tablets and capsules (e.g., Toprol XL). The tablets can be divided in half if prescribed by your doctor and the half tablet should be swallowed whole, without crushing or chewing. These tablets are specially formulated to release the medication slowly in the body.

 

[dmoses1]

I could be wrong but I always thought time-released pills could not be split because it affects the time release. Maybe you are getting way too much medicine. I am not sure how you would check it out except to contact the manufacturer and ask them outright.
The dizziness could be caused by something else but, since it started around the time you changed you meds, I would eliminate that first.

It's true!!! YOU CANNOT TAMPER WITH TIME-RELEASED MEDICATIONS AT ALL. The coating acts as some kind of barrier (preventing an untimely release of the medication).

 

[BIGHEARTED]

Just yesterday I saw my cardio. I have been very short of breath and fatigued - not quite comatose, but feeling awful. Had a stress test and all is well on that front. I have been taking 200 mg of Toprol XL since April. I started feeling bad about a month later, but I take a lot of medication and didn't put the two together until yesterday. He decided to cut my Toprol XL dose in half. From now on I will only take 100 mg per day. He said it may take a couple weeks before I notice any changes. The down side is my blood pressure was 148/100 yesterday - too high for an aneurysm. I will be monitoring my bp for the next two weeks and send him the readings. He will then decide if I will need to add Norvasc to the other 3 bp medications I am already on. There is a great website for Toprol XL that may help answer your questions. When I cut the 100 mg back when my dose was lower, my doctor told me to stop cutting them and gave me a new prescription. I always took it twice a day before, but this time he told me to take 100 mg once a day. Leny

 

[PJmomrunner]

Thanks for the info Leny.

Just yesterday I saw my cardio. I have been very short of breath and fatigued - not quite comatose, but feeling awful. Had a stress test and all is well on that front. I have been taking 200 mg of Toprol XL since April. I started feeling bad about a month later, but I take a lot of medication and didn't put the two together until yesterday. He decided to cut my Toprol XL dose in half. From now on I will only take 100 mg per day. He said it may take a couple weeks before I notice any changes. The down side is my blood pressure was 148/100 yesterday - too high for an aneurysm. I will be monitoring my bp for the next two weeks and send him the readings. He will then decide if I will need to add Norvasc to the other 3 bp medications I am already on. There is a great website for Toprol XL that may help answer your questions. When I cut the 100 mg back when my dose was lower, my doctor told me to stop cutting them and gave me a new prescription. I always took it twice a day before, but this time he told me to take 100 mg once a day. Leny

 

[PJmomrunner]

Well, folks, I'm convinced that it's not a good idea to split Toprol XL tablets. Saturday night I switched to a whole 100mg tablet. My BP is the same and I no longer have any dizziness.

 

[BIGHEARTED]

More on Toprol XL

More on Toprol XL

Hi PJ - It has been a week since my Toprol XL dose was halved! What an amazing difference!!! I had no idea how lousy I felt until I started feeling better!!! No more shortness of breath - I can actually walk up steps and not have to sit down for 10 minutes!!! I'm glad you stopped cutting the pills - I do think it makes a big difference. One word of caution - try not to miss any doses - Last Saturday, only a couple days after my dose was decreased, I forgot to take it in the morning. By 3:00 pm my heart was beating 133 bpm and my blood pressure was 154/105!! I took the Toprol and within an hour was feeling fine again. It probably went wacky because I had just cut the dose and then missed a dose - too big a drop in medication too quickly. Before I went for the stress test last week, I was very worried that my valve was getting worse and the aneurysm was getting larger, but it turned out to be just the amount of medication. So I will remain in the waiting room with you for awhile longer!! Hope all is well with you and the dizziness is gone for good. Leny