Suggestions on increasing Coreg

[offwego]

Hi Guys

Had my second Mitral Valve repair in October 2011. Surgery went very smoothly and I was actually amazed the surgeon was able to repair the valve, he had told me it had doubted he would be able but he'd do his best. He said, "It was easy". Haha.. ok!

I did have follow up visits with my cardiologist and the surgeon and was given Toprol to help with some duration between beat issue that I was assured was normal..

A few weeks ago, I felt really horrible after a long walk the night before and long story short an Echo showed EF was around 40% and BP was high. My doctor says the BP is not related to the heart issues and prescribed getting my lazy self to the gym (learned my lesson finally) and to take Diovan 320mg (max dose), and slowly increase Coreg to 25mg 2x a day.

I've just completed 2 weeks at the gym, fast walking mixed with 2-3 minute runs for a total 40 minutes including warm up and cool down.It's rough of course to start but I am doing it.

I increased the Coreg yesterday to 18.75 2x and took it again this morning...and feeling light headed.

My question is this...I go to sleep very late, often past 2am and I sleep late too. My schedule is predictable but not typical.

Any suggestions on when to take the medication to make it a bit easier to tolerate? I'm considering taking it late at night (with food I learned) and then 12 hours later..

My doctor gave me general guidelines but I actually passed out in his office two weeks ago, indicating umm..I was taking too much ...that was really embarrassing and disturbing!

ANy suggestions on how to increase the dosing is appreciated.

On a good note, I had an EKG when I was at the doctor and he said, he would bet the EF is already improved..Also said he saw improvement in the duration issue..

I don't know why he wants me on max dose of Diovan and Coreg but do know it's necessary to calm down the heart a bit, lowering resting HR (it's high now around 85-90) while building the muscle up with aerobic exercise 4x a week.

He predicts EF will increase to normal or close but it will take 6-12 months then he said he will slowly wean me off and see where it is..

My other doctor friend (cardiologist) said he doubts I will ever be off the meds completely.

I am exhausted from the Coreg but committed to giving it time.

thanks for reading this rambling post!

 

[Eva]

You did not mention the dose you were taking before you increased your Coreg to 18.75 mg 2x (or I may have missed it if it was mentioned in another post)?!

Normally one experiences side effects like light headedness with a dose increase. But this can be managed until your body adjusts to the new dose. But if the side effects persist or increase, and since your doctor left it up to you to manage, you may readjust the dose.

I personally cannot stay up late several nights in a row...I would feel extremely fatigued, edgy, foggy brain, and my pulse increases. When we go to bed to rest, our body starts to work...each of our organs try to repair itself from the day wear, and secretes new enzymes to prepare us function well again the next day, etc. etc. All this is best accomplished between 11 pm and 3 am!

good luck. Keep us posted.

 

[offwego]

You did not mention the dose you were taking before you increased your Coreg to 18.75 mg 2x (or I may have missed it if it was mentioned in another post)?!

Normally one experiences side effects like light headedness with a dose increase. But this can be managed until your body adjusts to the new dose. But if the side effects persist or increase, and since your doctor left it up to you to manage, you may readjust the dose.

I personally cannot stay up late several nights in a row...I would feel extremely fatigued, edgy, foggy brain, and my pulse increases. When we go to bed to rest, our body starts to work...each of our organs try to repair itself from the day wear, and secretes new enzymes to prepare us function well again the next day, etc. etc. All this is best accomplished between 11 pm and 3 am!

good luck. Keep us posted.

Oh, sorry I missed that! I was on 12.5 milligrams and have been for about a month..I spoke to my doctor and he suggested I stay on the 18.75 and that I should stabilize on it in a few days..I have felt lightheaded a couple of times today and hate that feeling...It triggered off anxiety at the doctor last week and I blacked out...so bad..ugh...

I am on a crazy schedule and have been for about a year..I got to sleep at 3-4am and sleep 8-9 hours...I recently sold my business and am not working right now, although I think I better start doing more! But I am serious about finally working out and getting getting my youngest to college in a week. Oh no! :eek2:

Perhaps you are right about the sleep schedule...It's ok now in the summer but in the winter, I can't miss so much sunlight or I'll go crazy.

I'm determined to stick it out with 18.75 and then see my doctor in a week or two and I know he will yet again want to bump it to 25mg..

I am trying not to hate that I am on such massive doses of medication...i'm not happy about it and mad at myself to be honest. I feel I should have goten surgery sooner and and...oh, what's the use?

I am happy I got it repaired and the repair seems fine..I just hope heart gets stronger as the doctor feels certain it will...and I hope someday I can reduce these meds a great deal and feel ok.

sorry for venting! and thank you for the response!

 

[AgilityDog]

I found it took me a long time to adjust to the Coreg - as in months. For a while, I was at 25 mg 2x daily, but really could not tolerate it. Too much fatigue, and it prevented me from running agility. By the 10th obstacle I could not MOVE. These days I take 12.5 x2.

I also experienced light headedness, and severe visual disturbances.

Go slowly, whatever you do.

 

[Eva]

Oh, sorry I missed that! I was on 12.5 milligrams and have been for about a month..I spoke to my doctor and he suggested I stay on the 18.75 and that I should stabilize on it in a few days..I have felt lightheaded a couple of times today and hate that feeling...It triggered off anxiety at the doctor last week and I blacked out...so bad..ugh...

I am on a crazy schedule and have been for about a year..I got to sleep at 3-4am and sleep 8-9 hours...I recently sold my business and am not working right now, although I think I better start doing more! But I am serious about finally working out and getting getting my youngest to college in a week. Oh no! :eek2:

Perhaps you are right about the sleep schedule...It's ok now in the summer but in the winter, I can't miss so much sunlight or I'll go crazy.

I'm determined to stick it out with 18.75 and then see my doctor in a week or two and I know he will yet again want to bump it to 25mg..

I am trying not to hate that I am on such massive doses of medication...i'm not happy about it and mad at myself to be honest. I feel I should have goten surgery sooner and and...oh, what's the use?

I am happy I got it repaired and the repair seems fine..I just hope heart gets stronger as the doctor feels certain it will...and I hope someday I can reduce these meds a great deal and feel ok.

sorry for venting! and thank you for the response!

offwego,

Do not apologize for venting. It is good to vent out and we are here for each other. I personally give you credit for being able to manage with the medications and their side effects despite your crazy time schedules and all the accomplishments you need to meet soon. Good luck ...you deserve a pat on the shoulder.

Coreg is a great medication. I encourage you to stick to it as long as your cardio recommends it and as long as you can manage with its side effects!. Your patience will pay off sooner rather than later. I regret NOW l was not patient enough to tolerate its side effects a bit longer as my cardio wished.

Good luck and keep us posted

 

[mainframe]

I've taken it since my surgery in 2009. Think I started at 12 1/2 (2x a day) for a month or two, then 25 (2x a day) for awhile now 37 1/2 (2x a day). Cardio said the max is 50 (2x a day) but I'm not there yet. My EF hasn't shown much improvement the last couple of years, a MUGA scan last November showed I was still at an EF of 30. I do feel light headed now and then but not sure if it's the Coreg, Lisinorpil, Aldactone or ???. Gotta be the 81 mg. baby aspirin.

 

[offwego]

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