Stopping Carvedilol (Coreg): When will the effects wear off?

Posted by teatime @teatime, Apr 28, 2016

Hi everyone,

I am glad to be a part of this community. Please foregive the long post. I was wondering if anyone has had a hard time while being on and going off Carvedilol (Coreg).

I am an active 45 year old mom of a young child. I have always tried to eat healthily and keep in shape (I do yoga, pilates and, run about 5k 2x per week). My BP has always been pretty good, but since my 40´s it has gone up a bit (heredity factors play a role). My BP and heart rate also "spike" when I get stressed or anxious, but for the most part are pretty level during normal times. I do have anxious moments, but I would not say anxiety has been a major life problem. At my last check (Feb 2016), and after wearing a 24 hour BP monitor, my cardiologist suggested I start Carvedilol 6.25 1x per day (quite a low dose) for the spikes and to keep the heart from getting too excited. I agreed that maybe it was a good idea and started over two months ago. Other than stimulating rapid bowel movements, I did not notice any side effects at first. I would say about three to four weeks into taking the Carvedilol, I began not sleeping well. I also noticed my heart pounding, like a bass drum, slowly and steadily, at times. Then the heart pounding began to wake me up at night (it turns out my HR was down in the high 40s at night). Some nights I even felt my chest muscles vibrate, as if a phone on silence mode was on top of my chest. I started to notice this more and more and then I would have a few normal nights, so I figured I would just talk about this at my next cardio check (booked out in June). I also noticed I was getting more and more anxious. I wasn't too sure why little things were beginning to bother me. I thought it was hormones, PMS, whatever, and started looking for someone like a therapist to talk to.

The previous week was bad. I woke up from a few nightmares and I started to panic in bed, just woken up from sleep. I had three nights of waking up to panic attacks and body shakes. The experiences made me very nervous. At this point I started looking into the side effects of Carvedilol and I was seeing not only chest pounding, but in rare cases reported effects of nightmares, visual disturbances, tremors, anxiety. I also know one does not simply stop a beta blocker, so we talked about tapering down. I tapered down for four days, and then I got in to see another cardiologist on Monday and he said just stop immediately. The effects are rare, but they have been noted. Going off this medication has been frightening. I feel weak and shaky all the time, and I get sporadic periods of pounding and muscle tremors in my legs, anxiety and fuzzy vision. I frequently get so cold I begin to shake. Yesterday I went back to the clinic for an EKG (normal) and some blood tests (including thyroid) and everything was normal. I am just assuming this is my body reacting and readapting itself after being on beta blockers. It has only been five days, but I am wondering if anyone out there has had similar experiences. How long did it take you to feel normal again? I ran a 5k just two weekends ago and yesterday I could hardly take a walk. Thanks for listening.

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@auntdd

I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed until Aug 5 of 2016. On that date after very slowly decreasing my dose over time I stop taking carvedilol. For 2 and a half months my BP did great, no problems but just 4 days ago my BP spiked to where I went to the ER. After blood tests and exrays nothing was found. I did not have a heart attack or heart damage but because my BP was 165/75 the er doctors told me to start my carvedilol again. I was so panic that I did and have felt terrible since. Last night I took my BP and it was a low 109/62 with a house of 45 . I never got that low. I never had any symptoms of a heart attack more like a panic attack. I was kept being asked if I had a heart attack eailer when I was put on the medication and no doctor ever told me I did. Although I must have in order to be on this drug, right? Is it normal/usual to have a blood pressure spike so long after being off carvedilol? And do I start it all up again. As for my PCP I have yet to see her, tried to make contact but still no response. I just don't know what I should do. Please any advice?

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I think you should see a cardiologist and get advice about whether Coreg or some other drug is best to treat high blood pressure. Coreg is a drug that is often used for those who have some degree of heart failure, so I am curious as to whether you have something else going on too. Otherwise there are many other drugs that would work to reduce your BP. It sounds like you do have a tendency toward high BP and probably do need to be on something. The question is whether you are on the right drug and right dose.

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@auntdd

I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed until Aug 5 of 2016. On that date after very slowly decreasing my dose over time I stop taking carvedilol. For 2 and a half months my BP did great, no problems but just 4 days ago my BP spiked to where I went to the ER. After blood tests and exrays nothing was found. I did not have a heart attack or heart damage but because my BP was 165/75 the er doctors told me to start my carvedilol again. I was so panic that I did and have felt terrible since. Last night I took my BP and it was a low 109/62 with a house of 45 . I never got that low. I never had any symptoms of a heart attack more like a panic attack. I was kept being asked if I had a heart attack eailer when I was put on the medication and no doctor ever told me I did. Although I must have in order to be on this drug, right? Is it normal/usual to have a blood pressure spike so long after being off carvedilol? And do I start it all up again. As for my PCP I have yet to see her, tried to make contact but still no response. I just don't know what I should do. Please any advice?

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@auntdd, I think it is vital that you get on the phone with your primary care physician and ask for all the help you can get tracking down the cause of that blood pressure spike. I don't say that to give you a scare, but to emphasize that these unexpected symptomatic episodes are a benefit when they get your attention and that of your medical team, and you will not want to lose the opportunity that yours provided.

In particular, ask your PCP to explain whether Carvedilol (brand name Coreg) could cause your problem earlier this week. You had been on a relatively low dose of that medication for two years (I'm taking 25mg Carvedilol twice a day without any peaks or valleys in my BP). What dose are you on now after your episode earlier this week? Did your "panic attack" send you to the ER, or was it another set of symptoms? I'd suggest that you ask your PCP about a referral to a nephrologist, as well as a cardiologist, because your BP spike might be related to a kidney episode. In my case, Carvedilol was prescribed by my nephrologist as a beta blocker that interacts well with reduced kidney function. Ask also about having an electrocardiogram (EKG) to supplement your blood tests and x-rays done by the ER.

There may not be any better reassurance for you now than you can get from personally controlling your medical diagnosis and treatment -- and insisting that your medical team listen to your concerns and communicate fully with you. Keep us posted so we can continue to talk these things through.

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@auntdd

I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed until Aug 5 of 2016. On that date after very slowly decreasing my dose over time I stop taking carvedilol. For 2 and a half months my BP did great, no problems but just 4 days ago my BP spiked to where I went to the ER. After blood tests and exrays nothing was found. I did not have a heart attack or heart damage but because my BP was 165/75 the er doctors told me to start my carvedilol again. I was so panic that I did and have felt terrible since. Last night I took my BP and it was a low 109/62 with a house of 45 . I never got that low. I never had any symptoms of a heart attack more like a panic attack. I was kept being asked if I had a heart attack eailer when I was put on the medication and no doctor ever told me I did. Although I must have in order to be on this drug, right? Is it normal/usual to have a blood pressure spike so long after being off carvedilol? And do I start it all up again. As for my PCP I have yet to see her, tried to make contact but still no response. I just don't know what I should do. Please any advice?

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Hi @auntdd.
It must be so scary to have such a reaction! However, you have come to a good place at Connect, where you will find great support and advice.

I'm tagging @teatime, @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too.

@cynaburst and @predictable are absolutely right; you should see your PCP and/or cardiologist soon and seek their advice.
There are many approved indications (by the FDA) for prescribing Carvedilol (Coreg), and one of them is high blood pressure (hypertension). However, since it is a beta blocker, it does this by slowing your heart rate and reducing blood pressure
You can read more about this dug on the Mayo Clinic site, here:
http://mayocl.in/2fiR9dF

@auntdd, can you tell us why you were prescribed Carvedilol? Was it for high blood pressure only, or did you have any cardiac issues?

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I had to go to the er three days into coreg therapy at 3.125 mg twice a day. My heart rate was hovering at 50 and would not go up. It is now 48 hours since my last dose and I am still having this issue. I am not athletic at all and am beginning to worry. How long till my hr goes back to normal?

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I was prescribed it for undiagnosed angina by my PCP just to see if it would help. I am relatively healthy other than smoking 3 cigarettes a day at most. I am only 25 and the ER doc yanked me off it immediately which I thought would have caused a rebound of some kind and not a continuation of the effects since the half life for this drug is only supposed to be 10 hours so virtually none of it should still be in me.

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@incrediblemulk98

I had to go to the er three days into coreg therapy at 3.125 mg twice a day. My heart rate was hovering at 50 and would not go up. It is now 48 hours since my last dose and I am still having this issue. I am not athletic at all and am beginning to worry. How long till my hr goes back to normal?

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@incrediblemulk98, I have been taking Coreg (Carvedilol) in much larger doses (25mg twice daily) for many months without incident or worrisome symptoms. It became the drug of choice to treat high blood pressure after I developed atrial fibrillation 18 months ago. My first prescription was 6.25mg twice daily; that was doubled to 12.5mg and again to 25mg after it became clear that the drug (a beta blocker) did not slow my heart rate too much.

In my case, I had a natural slow heart rate of 48-50bpm based on a fairly athletic youth and adulthood. When a-fib started at age 80, my heart rate raised to 70-75 -- still not particularly worrisome. At my current dosage, my heart rate hovers around 65 bpm, which raises no eyebrows either. My medical team includes both a cardiologist and a nephrologist, both of whom endorsed Coreg for use in managing high blood pressure with an irregular heart beat, which I had for years but never saw it show up on an EKG before 2015.

Was your prescribing doctor a specialist? Why was Coreg prescribed for you? What symptoms sent you to the ER? Can you call your doctor today and ask how you should deal with your current symptoms? Don't answer these questions here if you don't feel comfortable doing so, but raise them with family or close friends and especially your medical team as soon as you can -- not because another emergency is in the offing, but because you'll sleep a lot better if you can understand your situation better.

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@incrediblemulk98

I had to go to the er three days into coreg therapy at 3.125 mg twice a day. My heart rate was hovering at 50 and would not go up. It is now 48 hours since my last dose and I am still having this issue. I am not athletic at all and am beginning to worry. How long till my hr goes back to normal?

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No he was a PCP and he just shrugged off my concerns saying aww 50 isn't THAT low. I didn't even know my hr was so low till I went to the er. My chest just felt like your limbs do when they fall asleep and I was close to fainting just standing around at a family gathering. I monitor my vitals and my hr is generally like 75 to 80 with a BP of 110/68. It plummeted to 50 with a BP of 90/52. At the er my EKG and blood work were all normal. I was complaining about chest discomfort so he wanted to see if a low dose beta blocker would help haha quite the opposite. I never had apparant cardiac problems until now so I'm wanting to chop it up to the lingering alpha/beta blocking affects of the medicine. If it's not better by tomorrow Im debating going back to the er. I don't want to faint at work tonight but it feels like I'm headed that way. I should have seen a cardiologist.

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@incrediblemulk98

I was prescribed it for undiagnosed angina by my PCP just to see if it would help. I am relatively healthy other than smoking 3 cigarettes a day at most. I am only 25 and the ER doc yanked me off it immediately which I thought would have caused a rebound of some kind and not a continuation of the effects since the half life for this drug is only supposed to be 10 hours so virtually none of it should still be in me.

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@incrediblemulk98, your message an hour ago and the earlier one 42 minutes ago make me wonder whether Coreg was your problem at all. Removing it didn't change your symptoms.

The sharp decline in your blood pressure needs to be explored as something Coreg might not have caused. If you choose the ER as your next step, don't let them off the hook by simply responding to something you suggest -- make them look into your heart and ask for help from cardiology.

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@incrediblemulk98

I was prescribed it for undiagnosed angina by my PCP just to see if it would help. I am relatively healthy other than smoking 3 cigarettes a day at most. I am only 25 and the ER doc yanked me off it immediately which I thought would have caused a rebound of some kind and not a continuation of the effects since the half life for this drug is only supposed to be 10 hours so virtually none of it should still be in me.

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It well seems like something worth exploring. Noninvasively testing I've heard isn't the way to go with the heart unless you're already three sheets to the wind. Hopefully I'll push through my shift tonight and can go see a proper doctor in the morning.

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Hi @incrediblemulk98,
Following up on your messages. Did you return to see your doctor and get a referral to a cardiologist? Sure sounds like proper and thorough investigation would be advisable.

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