Stopping beta blockers.

[Ovie]

I've been on metoprolol (spelling? It's one of those days, sorry) for about 7 months. My surgeon told me to stay on it 3-6 months. However my cardiologist told me it wouldn't hurt to remain on it for the rest of my life. Well he ended up dropping his clinic patients and now I see a new one. I asked if I could stray off of it because I feel it messes with my vision. He said sure, took me off and instead put me on something that would make the walls of my aortic valve stronger. I ask because him and my former cardiologist are worlds apart on just about everything.

Anyone have input on whether I'm good to get off it. It's been about a month, I feel like my vision is better, BP is fine. Only noticeable difference is my pulse is frequently higher, and I feel my heart beating much harder more often then before. The pulse could be due to added to the stress I've been under, but the beating is very annoying. I feel if my surgeon told me 6 months I should be ok, I just didn't know if any of you valvers on Warfarin have stopped taking your beta lockers.

On another note, it's been forever since I've posted, I hope everybody is doing well!!

 

[Bina]

The post op high HR drove me nuts so i have been on regular Meto for the past 7 years. I hate it. So now I have just started taking
Bisoprolol which is another BB but it is longer acting. Of course last night i had a freaky dream and woke up at 5:30 a.m. with a racing
HR that was hard to get back down, so I took my pill 3 hours early. Crappola.

Anyway, which med are u taking now?
There are some c/v meds that strengthen the aorta walls if i am not mistaken...(?)
Around here it seems to be pretty much 50/50 as to who has stopped and stayed on the BBs.

 

[epstns]

Hi, Ovie, and it is good to hear from you!

I've been taking metoprolol since my surgery in Feb. 2011. I started out at 100 mg/day for about 6 months, then reduced to 50 mg/day for about another year. Just last week we reduced my dosage to 25 mg/day. So far, I seem to have a bit more energy. I'll find out today when I get to the gym what it does for my exercise tolerance. I feel better, but may never get off the metoprolol entirely. Also, so far, my BP is holding within range, but if it begins to rise, my cardio has said he will add another med to control that without the BB.

I hope it continues to work for you not to take the BB. These things can be a pain once you don't really need them anymore.

 

[DanielB]

Hi Ovie,

I too was given Metoprolol after my AVR last October. Initially, my cardio said I would have to wait and see how long I would be on it, potentially for life. I was on it until my heart block drove my heart rate down into the upper 30's and I was diagnosed with Bradycardia, so it was ordered stopped by my Electrophysiologist prior to a pacemaker implant in July (seven months post surgery). I came off it fine, twice actually, once beofre my pacer implant, where my HR jumped a bit for a day or two, then I had to get off it again after the yahoo doctor on the recovery floor in the hospital started me on it after my pacer implant. My electrophysiologist put a stop to that, but I had to taper off it again. Again, no issues. I have been told my heart, though I have a pacemaker, does set my HR - the pacer is 'filling in the blanks'. So, I would assume that being off the BB has left me with a good HR (low 70's sitting around). My BP is okay, but they do have me taking a diuretic (with potasium) to help keep that in check.

I too hope that it continues to work out for you being off BB's - I don't miss them at all.

 

[scott.eitman]

Let me start with listen to your Cardio, however recognize that there can be differences in opinions and practices between each. After my 1st AVR, it took awhile until I found a Cardio that was willing to go against another Drs. order to take me off of Lisinipril. That Cardio read a new study that showed no difference between Lisinipril and a 82mg aspirin. This is just a story to say remember, they are "practicing" medicine. It is not an exact science.

As for Metroprolol, I took it for a few months after the 2nd AVR. I begged and was taken off it. After about 6 months, I was put back on. After a posting here, I realized that it gave me low stamina and again begged and came off it. I just felt lousy on it.

 

[bocco]

Metoprolol seems to be the drug of choice for valve replacements. I went from metoprolol to atenolol and then finally stopped all together. I am at six months post op. Just had a visit to the cardiologist and she was fine with me off the BP meds because my BP is at a good level. And I check my BP regularly. My resting pulse rate is still a little high but max rate is never over 130.

Gary

 

[Mom2izzy]

I've been on 25 mg/day metoprolol since my mitral valve repair 7.5 months ago. I saw my cardio at 2 months post op, and he thought it might be best to stay on this low dosage forever. I see him again in a few weeks, so I will probably ask again. I don't notice any problems/side effects from the metoprolol, but then I've pretty much always been lazy (not into exercising). I do have LOW BP (90/60), so I occasionally get a little dizzy. I also feel like my metabolism has slowed since surgery. I would love to see how I do without it, but I did have some anxiety issues before and heard the BB has an anti-anxiety effect...not sure I'd want to get rid of that. I have felt way less stressed out since surgery...

 

[TheGymGuy]

To those that are on it, and do not necessarily need it, ask you Cardio if they would be willing to put on half-doze of what you take right now. If you are taking 25mg and go down to 12.5 for 2-3 weeks or so and your heart-rate stays happy and maybe just 5 heart beats higher, you could probably get off of it completely. THe heart-rate will come back down within a month or so with ample exercising/walking, etc.

 

[RTZdad]

I had my six month check up with my cardiologist and he kept me on 25 mg of Metropolol. He told me that I might a well stay on it since I haven't had any problems with it. He didn't want to take me off of it and see my heart rate go up, only to out me back on something. He suggested that I don't need to see him again for another year, so it looks like I will be staying on it for a while.

Tom

 

[normofthenorth]

I was on Warfarin and Metoprolol (2 x 12.5 mg/d? twice that? My "Norm's Story..." post remembers, me Not So Much) for 3 months post-AVR. The Warfarin was initially to keep me safe from clots from my MV repair, then I had a couple of bouts of AFib, and both drugs are indicated for that. At 3 months, I seemed to be free of AFib, and stayed free of it for a 48-hour Holter, so I got to drop them both.

My resting HR was elevated for many months, then it went too low (sometimes with ectopic beats like PACs), then it finally settled down in the ~58-68 range, usually ~58-61, where it was pre-op for +/- all of my life. Haven't returned to either drug, and I don't miss them. I'm "crazy active", playing competitive beach and court volleyball (4-on-4 and 2-on-2) a couple of times a week with the 20-40-year-olds (at 67) and keeping up pretty well.

I just did another routine (annual?) 48-hour Holter, haven't heard anything back. I noticed the PACs and bradycardia, but I never did notice the AFib (except once when it produced tachycardia that got me an ambulance ride to ER!), so I guess ya' never know, though everything seems to be working fine.

 

[epstns]

I'm about a week into the newest reduction of my metoprolol dose. As mentioned, I'm now at 25 mg/day, down from 100 mg after surgery. The high post-op dosage was a precaution against afib that I had post-op, and they wanted to keep my HR down for a while. Also, immediately post-op I was in complete heart block, so the metoprolol didn't have much effect on my HR -- the pacemaker was doing its thing, regardless of what meds were in my bloodstream. Now, 19 months post-op, I'm self-paced half or more of the time, so the metoprolol became more noticeable. (I really think I'm self-paced more of the time, since the pacing percentage probably includes my sleep time, as my resting HR is probably below the 60 BPM minimum the pacer is set for. Will have to discuss at next pacer check.) Now, after about a week at the reduced BB dosage, I haven't noted an extreme increase in my exercise ability, but even pushing just a bit harder than before still feels better than it did before. I also seem to have a bit more energy later in the day. Looks like things are looking up.

 

[Ovie]

I had been on 12.5 mg since a month or so after my surgery, so after 6 months of a low dose I just asked if I really needed it. I'll post the one he put me on tomorrow, I'm curious to if others are familiar with it.

 

[bstew7890]

I was having trouble thinking straight on metoprolol. I was in a fog and couldn't seem to prioritize anything to save my life! I made a phone call to my cardiologists office and was switched to diltiazem. My head was clear in a few days, but now I can't seem to figure out why I'm on it; diltiazem treats high blood pressure but I can't find where it affects heart rate. I just checked my pulse sitting here at the computer and it's 72. BP yesterday was 134/80.

 

[UWMike]

After surgery I was sent home with a months supply of metoprolol at 100mg/day. Three weeks later I asked my cardiologist about it and she told me to finish taking the ones I had and then she put me on 50mg/day. At 6 weeks post-op I met with the surgeon and asked his opinion on it. He said that the reason the beta blockers are prescribed is to suppress the possibility of atrial fibrillation which is apparently a fairly common symptom after valve replacement. However he also said that this is generally only a problem within a 1 month window post-op so his advice was that I didn't need to keep taking it but that I could if I wanted to. Right now my plan is to finish my current supply which should last me for about another 2 weeks and then to stop and see how I feel (and see what my blood-pressure stabilizes at). Granted, I'm still young at 22 so I'm at a far lower risk of developing atrial fibrillation or related symptoms than someone twice or three times my age which could also be a factor in their lack of concern.