Metoprolol. 50mg

[OldManEmu]

TheGymGuy I was on Metoprolol for a year after my first surgery and I credit it with helping shrink my heart back to normal. Fortunately with my second surgery my heart was normal going in so I was only on it for 3 months while my heart recovered from surgery. While I found the side effects of Metoprolol bad they were mild compared to the effects of Carvedilol that I was briefly placed on after my first surgery and refused to continue with. I found my short term memory completely shot on Carvedilol and my sleeping was so disturbed that I may as well never gone to bed in the first place. At least Metoprolol only made me feel permanently fatigued.

 

[TheGymGuy]

OldManEmu, I hear ya and agree. There are always worse things to be on. You are right, other feeling a bit sluggish metoprolol did not have many other side effects and really kept the heart rate in check.

 

[clay_from_nj]

I was curious as to why a lot of people seem to be on metroprolol rather than carvedilol (Coreg) which is what I take. I didn't really find exactly what I was looking for, but did come across this, which was an interesting comparison, looking at not just the effects of the drugs but taking cost into account as well. Really, aside from the oft expressed idea that each person is different and reacts differently to a given medication, I could only find a couple of studies, generally giving an edge to carvedilol over metroprolol. Relevant to this thread, it seems that carvedilol has a slightly less effect on heart rate during exercise. The one thing to remember is that if a given drug is not working for you or is causing unacceptable side effects, you can probably find an alternative that is better for you, and if something does work well, you probably want to leave it be. (For me, that seems to be carvedilol, 6.25mg twice a day, and lisinopril, 2.5mg once a day, in addition to the warfarin.)

 

[Agian]

I'm on Atenolol 50mg daily. It's slowed my heart rate from 90 to 65. I don't feel any different. No problems.

 

[mbeard]

I am on Atenolol 25 mg daily. I can't miss it by 15 minutes, or my heart races and thuds. It has helped me tremendously.

 

[epstns]

You might want to leave it be. . . or you might want to try another combination. I'm still taking 25 mg/day of metoprolol and it doesn't keep my blood pressure as low as we want. I don't want to increase the metoprolol dosage, so if my BP stays higher than optimal, we will try adding another med purely for BP management. Life is just another cocktail!

 

[jyg]

epstns,

Most of what I've read has noted that historically the BP meds work best in combination.

I do feel like I responded better to Losartan+Propranolol (waiting room) better than just Metoprolol (post-op). If I have to be on BP meds for the rest of my life, I'm going to ask if I can take a trial once again with the previous combo once I'm 100% recovered from surgery (as 100% can be...)

 

[MarcoPolo]

I've never been on BP medication before but I'm on 150mg Metoprolol twice daily since I left the hospital four weeks ago after AVR. Is this a drug one is on long-term?

 

[epstns]

I've never been on BP medication before but I'm on 150mg Metoprolol twice daily since I left the hospital four weeks ago after AVR. Is this a drug one is on long-term?

It may be -- depending upon why it is prescribed. I'm on it for the long haul, because immediately after surgery I had all sorts of heart rhythm issues - afib, a-flutter, bradycardia, tachycardia, loooong pauses (up to 20 seconds). My in-hospital cardio said that my heart ". . . tried all the possible rhythms and didn't like any of them." Our theory is that the A-V node, which transmits the rhythm signal from the atrium to the ventricle, was damaged in the valve surgery. I ended up with a pacemaker and metoprolol. The pacer keeps my heart rate above 60 BPM and makes sure my ventricles beat each time the atria do, while the metoprolol keeps my heart rate from going too high. So far, as we've balanced the dosage and pacer settings, it is working fine.

Your metoprolol dosage is much larger than mine. When I first came home from surgery, I was taking 100 mg/day of the timed-release metoprolol. I felt like I was always dragging around a sled full of rocks. We tried reducing my dosage to 50 mg/day and I got some relief, but it wasn't until we reduced it to 25 mg/day when I really felt like myself. We didn't make this reduction until I was over a year out from surgery, to ensure that my heart would stay in normal sinus rhythm.

So, keep the dialog open with your doc and as time progresses, you may want to discuss a trial at a reduced dosage.

 

[Paleowoman]

I'm not on metoprolol but on Atenolol 25mg per day. I'm wondering too how long I'll have to be on this. I don't even know why I'm on it as, as far as I know, I didn't did A-fib or high blood pressure or anything like that after my AVR (though now I get palpitations, ie strong awareness of my heart beat, very loud and 'banging'). My GP thinks it's a long term thing just given after AVR. I will ask my cardiologist when I see him tomorrow and report if there's anything interesting about these beta blockers.

I see in a comparison study between Atenolol and Metoprolol that 25mg of A seemes to be the equivalent of 50mg of M: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1498463/

 

[mike dab]

I was with my cardiologist yesterday complaining about my Metoprolol side effects. My blood pressure is good, but they put me on it after my AVR and stents as a precaution. It is driving me crazy with dizziness and light headedness. I was originally on 25mg twice a day, went down to 25mg once a day, and lately have been on the 25M extended release to try and even it out. No help, I still feel terrible. So my cardiologist said that the side effects were outweighing the benefit and I'm going to stop taking it.

Will keep you posted.

 

[epstns]

Anne - I think sometimes they also prescribe metoprolol to ensure that the heart rate stays low enough to allow the heart to fully contract with each beat. I also think that they feel that this facilitates remodeling after valve replacement. In my case, there were several reasons, and that may be why I started out on such a high dose.

I am tempted to ask to try a different beta blocker, but I'm afraid that any of the others might have different side effects and I would be starting all over again to try to balance theraputic effect versus side effects.

 

[ottagal]

Anne - I think sometimes they also prescribe metoprolol to ensure that the heart rate stays low enough to allow the heart to fully contract with each beat. I also think that they feel that this facilitates remodeling after valve replacement. In my case, there were several reasons, and that may be why I started out on such a high dose.

I am tempted to ask to try a different beta blocker, but I'm afraid that any of the others might have different side effects and I would be starting all over again to try to balance theraputic effect versus side effects.

I agree with Steve's comments as to why metropolol is prescribed post-op. I had very low low blood pressure post-op, but was still put on metropolol for the reason's Steve explained as well as post-op tachycardia (which I understand happens regularly).

Steve, I am now on bispropolol and actually prefer it over metropolol. I only have to take it once a day and although I am on a very low dose don't seem to have the same side effects that I had with the metropolol. Of course everyone's situation is different, but it might be worth a discussion with your cardio.

 

[Paleowoman]

I'm doing a 24 hour ECG right now and the cardiologist will let me know about whether I should stay on the beta blocker or come off based on the results of the ECG. He asked me if I felt it, the beta blocker, made a difference, but I really couldn't say as I was put straight on it post op so have no idea what it's like without ! I was fine before the op as regards blood pressure and heart rate.