Toprol-Xl

[Granbonny]

I saw my PCP ..a few days ago..My b/p has been fine since my surgery.. but he was concerned it was high..140/85..I know it was white=coat B/p/ Leaving home and driving 1 hour and his nurse taking it..with no rest between.. However, with all the stress I have had this summer..helping daughter with 2 new Grandchildren, ect.... I agreed to take a B/p med..this toprol-xl...100 mg..He gave me enough samples for 2 weeks.. took 1 this A.M...drove down and spent a great day with kids..however, got very sleepy coming home.. I read that it is a time-release med..should I take it at night? took my b/p when I got home..130/75 and a pulse of 65.....Any help with this med? Bonnie

 

[ALCapshaw2]

One cardiologist told me that 100 mg was the "minimum theraputic dose" but at 100mg I was really 'dragging *ss'.

Another cardiologist worked with me to find the "minimum EFFECTIVE dose" that would control my arrhythmias but reduce the side effects.

He told me to cut my dose in half for two weeks and see how that worked. I felt better and still had no sypmptoms. He then told me to cut it in half again for two weeks. Same result. He finally told me to quit and sure enough, a few days later, my symptoms returned so he had me go back to the 25 mg level which worked quite well for 2 years before I developed another type of arrhythmia that required a change in medication.

I realize your issue is BP and not arrhythmias, but I suspect the same protocol would also work for you WITH YOUR DOCTOR'S APPROVAL.

NEVER just quit cold turkey when taking Beta Blockers because that can cause a rebound effect. NOT GOOD.

Hope you can find a good balance between the desired effect and the side effects. Ask your doctor (or pharmacist) about taking it at night vs. during the day.

'AL Capshaw'

 

[liza]

I've been taking Toprol XL for the past few months to control my tachycardia. I can attest to the fact that you shouldn't quit taking it cold turkey! I ran out of my prescription and thought since I was doing so well I could stay off of it. Well, 2 weeks later I was hospitalized with a heart rate of 125. I'm back on it and doing well. I'm taking 25 mg, and I take it at night since it does seem to cause some drowsiness. I hope it helps you feel better!

Liza

 

[PJmomrunner]

Hi Bonnie:

I also take Toprol XL, but I take 50mg twice a day. It is an extended release formula though, and is meant to be administered once a day. I went looking (Googling) for info as to why my doctors (three different ones--2 cardiologist and a surgeon) have prescribed it (as my dose has been changed upward) to be taken twice a day. I found a link that, if I understand it correctly, seems to say that the highest concentration of the drug in one's blood is in the first two hours after taking it and that is also when the heartrate is slowed the most. ( http://www.toprol-xl.com/HCP/8_pharmacologya.asp ) After that the concentration begins to diminish and the heartrate rises, although not nearly as markedly as the non-time released version. So, it would seem to make sense to administer it in two (or more?) lower doses to achieve an even more steady concentation of the drug in the blood, I guess.

Thanks for asking the question, because now I know why I feel sleepy every morning! I get up to help my teens get ready for school, drive them there and I have to really fight to stay awake after that. And I'm only taking 50mg (and at 5' 10" 160 lbs. I'll bet I'm bigger than you too). Taking it at night would lower your heartrate most when it is already at its natural lowest, so would kind of defeat the purpose of taking the drug at all. I also wonder just how low your heartrate would go--might be dangerous to take it at night. I hope Allodwick will weigh in on this.

 

[Georgia]

I started on Toprol XL - when our copays went up I asked if I could try metropolol (generic, non-time-release version of Toprol) instead - and I've had a good result with it. And it's much cheaper. I take 50 mg twice a day.

I think you're going to have a problem of getting tired with beta blockers regardless of when you take them or the brand. Certainly it's worse when you're getting the largest dose (the first two hours). Over the years I've been on various beta blockers (for tachycardia and arrythmia) and the exhaustion was always an issue. Oddly enough, now that I'm on a slew of meds it doesn't bother me as much - but I think the bar's set lower now for me (I don't NEED the energy I required when my kids were little).

I didn't have the tiredness with calcium channel blockers; would that be an option for you, Bonnie, since you're taking these for blood pressure?

 

[Granbonny]

Took another one at 7 a.m. this morning.. Made me so sleepy .took b/p 2 hours later..130/75..Pulse 58.. took a shower to wake up..Felt fine all day..but, he gave me samples..I see him in 4 weeks for woman thingy..and will tell him to look at another b/p med...I told him about Grandchildren, ect. he has a son in my Granddaughter's daycare..I think he was wanting to give me something for stress....something that would slow me down......and, this med does.. But no way I can take it..if I have to take care of sick Grandkids..early in the a.m.. I need to do some research on a b/p med..with no side affects...At age 65..mech. valve..and very active..I know I probably need to be on something....Bonnie

 

[hensylee]

Bonnie, go buy a blood pressure monitor, then take your bp morning and evening for the next couple of weeks - or til you see him in 4 weeks. Write it down in the booklet provided with the unit, or make your own, and take it with you. They may not be interested in looking at it, but you can show them anyway what your list says - and YOU will know if it's white coat syndrome or not. Everything can affect your blood pressure - from standing, sitting, lying down, to driving, or getting excited. Everything! To be sure you have high bp, it needs to show consistently high. He probably has your records before him each time you go in and he can check the past and compare if it is rising (over time) and know when to rx. Do your own homework so you know what you are talking about when you go see him.

The bp monitor shows upper/lower readings of bp plus your heart rate - list them all.

 

[tantekay]

HI Bonnie! I'm taking Toprol XL too. I take 50mg/day and mine is prescribed to take in the morning. I take it because I have pac's and prone to atrial fibs. I don't notice too much difference in how I feel since I'm on such a small dose. What everyone else says makes sense, I never thought too much about the morning thing though. So, I've learned something as well. Howeve, I do take extra when I need it -- sometimes twice a day. But overall, I've found that it does work better when I take it regularly every morning. Good luck with it.

 

[Paul_N]

Bonnie,

I too take Toprol and have since surgery almost 2 years ago. I'm not on nearly the dose that you are, but I was encouraged to take it at night before bed. The Dr. told me it would make me a little tired. That's the only symptom I'm aware with the stuff ... at least in my case.

Paul

 

[BAV Pt's daughter]

White Coat Syndrome

White Coat Syndrome

I saw my PCP ..a few days ago..My b/p has been fine since my surgery.. but he was concerned it was high..140/85..I know it was white=coat

Always a good idea to keep a home record of your BP's as well as corresponding heart rates. Get a good quality BP monitor and keep a record. Not a bad idea to check daily or every other day. Dont make yourself crazy with it though. And make notes with it also, so you know if something was going on in your life that day to cause a fluctuation. (What crisis had just happened to make it sky-rocket?) Doctors do expect (for the most part, anyway) that patient's will have a rise in their pressures when they walk in the door. Most do get a little nervous just by seeing those "white coats" all around. Plus, you have a report card to show the doc, and it gives him a great idea of what your real norm is, instead of what it just happens to be on that day. They tend to like this. Good luck!