Medication question!

[Spookygal]

Hi everyone- hope you had a great weekend/Monday!

So last week my new cardiologist switched me to Losartan 25mg from Lisinopril 20mg and added metoprolol 25mg .. long story short I’m terrified of starting new meds! Last night I finally took my first does of losartan (felt a little weird this AM but nothing too bad) but haven’t gotten the courage to start the metoprolol yet. I went down a rabbit hole on the internet and people seem to hate this stuff! I’m worried I’m going to get bad side effects/feel like a zombie..

Has anyone ever had this cocktail of meds? Any info?

I’m waiting on my doctor to call me back, I asked if I could split my dose in half but apparently 25mg is already a pretty low dose… well see.

Thanks!

 

[Chuck C]

Hi everyone- hope you had a great weekend/Monday!

So last week my new cardiologist switched me to Losartan 25mg from Lisinopril 20mg and added metoprolol 25mg .. long story short I’m terrified of starting new meds! Last night I finally took my first does of losartan (felt a little weird this AM but nothing too bad) but haven’t gotten the courage to start the metoprolol yet. I went down a rabbit hole on the internet and people seem to hate this stuff! I’m worried I’m going to get bad side effects/feel like a zombie..

Has anyone ever had this cocktail of meds? Any info?

I’m waiting on my doctor to call me back, I asked if I could split my dose in half but apparently 25mg is already a pretty low dose… well see.

Thanks!

Yes, 25mg is a very low dose.

When I was released from the hospital after my aortic valve surgery, I was prescribed metroprolol. 150mg/day; to be taken as 75mg in the morning and 75mg in the evening. It was a little too much. I got lightheaded walking down the stairs and almost fainted. Checked my BP and my BP and pulse were pretty low. I called my surgeon's office and he immediately dropped my dose in half- 75mg per day, to be taken 25mg, 3x per day. I was fine after that.

I would not expect any major effects from just 25mg per day. Of course, you are also taking Losartan, but 25mg is also a low dose of Losartan. My mom is currently on 50mg/day of Losartan and it's not getting her BP low enough. They will probably be bumping her up to 100mg/day.

Please let us know how it goes.

 

[dick0236]

I have taken 50mg Losartin for the past few years, and before that was on Lisinopril. I never noticed any changes when I made the switch. I do not believe I have ever taken Metropolol......or it's been so long ago I've forgotten..

 

[pellicle]

but haven’t gotten the courage to start the metoprolol yet.

Literally metoprolol saved my life
I'm using metoprolol tartrate to control my tachycardia. Works beautifully and I'm unaware of any side effects

 

[Woodcutter]

I have had that specific cocktail. I was prescribed the 25 mg Losartan immediately after my first surgery (Mitral Valve Repair). This actually works very well for me (to lower blood pressure) and I remain on this medication and dose today (~ 10 years after commencing). My problem was that I'm a runner and the repair resulted in my mitral being too small. Hence, under exertion (exercise) my heart would attempt to race. The metoprolol was prescribed to lower the heart rate under exertion. It did that successfully but the consequence was I was unable to exercise. Hence in my case, the metoprolol was a problem. I needed the repair induced stenosis addressed (which required my subsequent Mitral Valve Replacement surgery) vs. needing my heart slowed.

Losartan lowers blood pressure and metoprolol slows the rate. A risk with either of them is fatigue or dizziness due to low blood flow. I get this occasionally with just the Losartan if/when I get dehydrated. Specifically, after a good (i.e. sweaty) workout or after working outside on a hot/sunny day, I have measured my bp below 80/60 when I have felt dizzy. Hydrating quickly fixes this for me.

 

[slipkid]

You asked about this in another thread & I gave some brief comments but will expand a little here.

I've not been on that combo per se but have been on metoprolol and had really horrible experiences on it. Hope to never have take that drug again.

I guess I should say that everyone is different and maybe you will have no adverse effects from metoprolol (or that cocktail) at all. As Pellicle said above he is on metoprolol and has no adverse effects.

I literally could not function in any capacity when I was on it though. Severe exhaustion/sleepiness/difficulty thinking hit me within about 15 minutes of taking it for the first time. Which continued the entire time I was on it. Yeah, I was zombified 4sure.

In addition I had horrible nightmares that were quite vivid, woke up screaming some nights. Had no idea any drug could do that nightmare bit but after googling the adverse effects later saw many people complaining of nightmares from it.

I just looked it up and the type of meto & dosage I was on as per the pharmacy info I was given was "Metoprolol Succ ER 25mg" once a day. Think that means Metoprolol Succinate Extended Release (?). There are other forms of it.

Finally after being on it around a week or two my Dr(s) told me to cut the pills in half. At least with that lowered dose of only 12.5mg I could function but still had some issues on it I did not like. Thankfully was able to get off it entirely after about a month. It is also a drug which you cannot just stop cold turkey, have to wean off it to avoid problems.

We have talked about meto here in a couple threads, found some of those now where I spoke in more detail about my meto-misery below. You might get some useful info from those threads, not necessarily from me but from other folks' experiences...

https://www.valvereplacement.org/threads/metprolol-tartrate-side-effects.888984/

https://www.valvereplacement.org/threads/to-metoprolol-or-not-to-metoprolol.889192/


Hope you do OK on your cocktail. I suspect your Dr will tell you to just try it and see what happens. If you still feel leery about it see if you can delay starting everything until you have some days off where there would be no danger of having to go out/drive/doing anything requiring much effort.

 

[pellicle]

As Pellicle said above he is on metoprolol and has no adverse effects.

I literally could not function in any capacity when I was on it though.

which my dear @Spookygal is exactly why you should try something and then discontinue it IF its not working.

Just because you start something does not make it a permanent feature (unlike, say, a tattoo). Given that it is on the WHO list of essential medicines its clearly good for most people (we don't yet know if its good for you).

Again I will stress that succinate and tratrate forms are different, I don't know if I've ever been on succinate (can't recall exactly what I was on post OHS#3

Best Wishes

 

[Spookygal]

which my dear @Spookygal is exactly why you should try something and then discontinue it IF its not working.

Just because you start something does not make it a permanent feature (unlike, say, a tattoo). Given that it is on the WHO list of essential medicines its clearly good for most people (we don't yet know if its good for you).

Again I will stress that succinate and tratrate forms are different, I don't know if I've ever been on succinate (can't recall exactly what I was on post OHS#3

Best Wishes

It’s been a few weeks and I’m happy to report aside from some headaches in the beginning (which I am prone to anyway, migraines etc) I’ve been feeling good with no side effects from my new med cocktail!

Thank you so very much

 

[pellicle]

from my new med cocktail!

shaken or stirred

..

 

[Spookygal]

shaken or stirred

View attachment 889995


..

Shaken!!

 

[3mm]

'm using metoprolol tartrate to control my tachycardia. Works beautifully and I'm unaware of any side effects

Pellicle - I thought you once said that you wait until after your morning walk to take your metoprolol tartrate because it limited your maximum heart rate while exercising? I think I have seen that effect myself.

 

[slipkid]

Shaken!!

Of course...

https://screenrant.com/james-bond-martini-shaken-not-stirred-reason/

 

[Amy]

I was started on 25 mg of metoprolol post-op and it was wayyyy too much, it was awful being so out of it/half asleep/feeling like a huge fat person was sitting on me. I think I ended up taking a half pill, then a quarter, so just 6.25 mg, for months. When I decided to come off of it, i thought I could just stop, being on such a low dose; but I had scary tachycardia and had to slowly over weeks take a bit less than a quarter pill, then an eighth, then the tiniest sliver....

All this is to say that if your body is sensitive to it, 25 mg can be a very high dose. And be careful about weaning yourself off it.

I do miss the nice, low resting heart rate (40-45 bpm!!) and the feeling so calm... anything could happen and I wouldn’t give a damn, lol. But the knowing I was reliant on something so powerful wasn’t for me; and ultimately it was a good thing I could come off it after a year.

 

[slipkid]

I was started on 25 mg of metoprolol post-op and it was wayyyy too much, it was awful being so out of it/half asleep/feeling like a huge fat person was sitting on me. I think I ended up taking a half pill, then a quarter, so just 6.25 mg, for months. When I decided to come off of it, i thought I could just stop, being on such a low dose; but I had scary tachycardia and had to slowly over weeks take a bit less than a quarter pill, then an eighth, then the tiniest sliver....

All this is to say that if your body is sensitive to it, 25 mg can be a very high dose. And be careful about weaning yourself off it.

I do miss the nice, low resting heart rate (40-45 bpm!!) and the feeling so calm... anything could happen and I wouldn’t give a damn, lol. But the knowing I was reliant on something so powerful wasn’t for me; and ultimately it was a good thing I could come off it after a year.

Yeah, 25mg was way too much for me. I think I decribed my being on it as feeling like I was on a planet with a gravitational pull 100x that of Earth, along with being given knockout drops making me only be able to sleep all the time. I like your description as being sat on by a fat person! I could not function on any level on that at all. And as usual my ***** Drs at first insisted I was just lazy/delusional nothing to do with the meds. Don't get me started but I hate Drs and have lost all faith in them completely at this point....

 

[morellib]

Yeah, 25mg was way too much for me. I think I decribed my being on it as feeling like I was on a planet with a gravitational pull 100x that of Earth, along with being given knockout drops making me only be able to sleep all the time. I like your description as being sat on by a fat person! I could not function on any level on that at all. And as usual my ***** Drs at first insisted I was just lazy/delusional nothing to do with the meds. Don't get me started but I hate Drs and have lost all faith in them completely at this point....

Nine months post SAVR I was still on 25mg Metoprolol Tartrate twice a day because of some post-surgery aFib and even though I had no aFib episodes after a month post surgery, my cardiologist wanted me to be on it prophylactically. It was really causing leg pain and drastically negatively impacted my cycling. We agreed on a plan to wean me off of it and my exercise tolerance improved immensely. Also, no recurrence of aFib….

 

[Elcarim]

I'm on 95mg of metoprolol, started on half that. My resting heart rate sits around 58. I also Googled it before I took it and I was a bit freaked out. Apparently because it is fat soluble it can cause neurological issues, and is quite prone to causing hallucinations in elderly patients.

I had really bad anxiety for years, and metoprolol made a huge difference to this. I felt the effects within half an hour of taking my first dose. My sister said she could see the effect it had on me in the beginning, and although I have got used to it, I still feel like my mental cogs are turning a bit slowly at times.

Probably most interestingly, when I started on the metoprolol I gave up drinking almost overnight. I guess I had been self-medicating my anxiety. I would still have a glass of wine or a cider now and then, but I have since given that up as well. Now even one or two drinks makes me feel yuck and gives me a supercharged hangover.

I'm also on Entresto (sacubitril/valsartan) but I don't notice any effects from that.

 

[Dunwanted]

I was on a high dose of metoprolol succinate (prolonged release)after surgery which was 200 mg (100mg on the morning and 100mg before bed) I couldn't really feel any side effects now I am on 100mg a day (50 mg in the morning and 50mg in the night) still I have been lucky to have no aide effects even though I would like to have a lower dose o none at all lol.

I do not know if there is a big difference in the side effects of metoprolol succinate vs tartare but I'd said just give it a try most of the medicine prescribed is usually helpful and to prevent worse things, so If you're Doctor prescribed it atleast give it a try.

 

[Joseph]

I had an episode of afib/tachy prior to vacation last month (gory details in another thread) and doctors prescribed 25mg metoprolol succinate twice per day. I definitely felt some negative effects (sluggishness, low HR, cold feet) but it was not as bad as the tartare I had been on a few years back. After returning home and meeting with my cardiologist and EP they agreed to cut my dose to 25mg once per day and then 12.5mg once per day.

Last night my HR was floating around 50-55bpm even during exercise. I emailed my EP about weaning off of the drug and am waiting for a response. I don't like the idea of slipping into afib/tachy but I also don't like my heart underperforming and my pacemaker having to step in constantly to keep my rate up.

I haven't read the literature (or many posts) on the impact of discontinuing metoprolol but it sounds like there are varied experiences (@slipkid, @Eva, @Superman, and @pellicle reported different results of being on or off). Reading some posts makes me wonder if I'm just starting to feel the effects and have night terrors and other issues waiting around the corner.

 

[pellicle]

Hi Jo
have you recently started metoprolol?

Reading some posts makes me wonder if I'm just starting to feel the effects and have night terrors and other issues waiting around the corner.

I've only seen slipkid mention the bad dreams, but perhaps there was somone else invlolved in that.
Personally I'm inclined towards the tartrate version for reasons which seem (even as I write them) a bit hard to be clear about.

 

[Joseph]

Hi Jo
have you recently started metoprolol?

I've only seen slipkid mention the bad dreams, but perhaps there was somone else invlolved in that.
Personally I'm inclined towards the tartrate version for reasons which seem (even as I write them) a bit hard to be clear about.

I started five weeks ago following the trip to the ER for afib/tachy. I seem to be in the group that has some adverse reactions to the medication. The succinate initially did not have noticeable side effects but over the past couple of weeks I've experienced symptoms consistent with its use. My cardiologist said I could discontinue and to just monitor my heart activity as usual. Unsure how long succinate stays in your system, I thought I saw something about 24 hours but will see.