1. < Heart & Blood Health

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.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

CABGX6MAZE517 | @cabgx6maze517 | Jun 1, 2017
In reply to @barnes123 "I quit taking coreg about a month ago I feel like myself again I think it..." + (show)
@barnes123

I quit taking coreg about a month ago I feel like myself again I think it would have killed me if I had not. I could not hardly walk from room to room with out shortness of breath. Now I can do anything and not have any problems. It took me a year to convince my doctor that was what it was. I am not on any thing now. I go back to my doctor in May I guess we will go from there. But my blood pressure has been great.

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My primary care physician also is not in doubt that Carvedilol is the culprit, as well as the prescribing physician being in denial of the adverse effects. Our current path toward remedy is simply: determine the status quo> reduce the swelling of the extremities, using a reduced quantity of Lasix continue with but increase the Metoprolol and observe, repeat and observe with blood work to monitor kidney and liver function. Continued as outpatient while within the VA system.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jun 1, 2017

How did your appointment go today, Tom? Any clarity?
I wish you a sleepful night tonight.

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2 replies
Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Jun 2, 2017
In reply to @barnes123 "I quit taking coreg about a month ago I feel like myself again I think it..." + (show)
@barnes123

I quit taking coreg about a month ago I feel like myself again I think it would have killed me if I had not. I could not hardly walk from room to room with out shortness of breath. Now I can do anything and not have any problems. It took me a year to convince my doctor that was what it was. I am not on any thing now. I go back to my doctor in May I guess we will go from there. But my blood pressure has been great.

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@cabgx6maze517 Hi Tom: I'm glad to hear that you received some confirmation about your thoughts regarding the Carvedilol and that you have a "plan of action" to help with your symptoms. I wish you well and do hope that the swelling begins to be reduced and you begin to recover from this experience. Best wishes and please keep in touch with Mayo Connect. We value your sharing of your experiences and look forward to hearing from you again. Teresa

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CABGX6MAZE517 | @cabgx6maze517 | Jun 3, 2017
In reply to @barnes123 "I quit taking coreg about a month ago I feel like myself again I think it..." + (show)
@barnes123

I quit taking coreg about a month ago I feel like myself again I think it would have killed me if I had not. I could not hardly walk from room to room with out shortness of breath. Now I can do anything and not have any problems. It took me a year to convince my doctor that was what it was. I am not on any thing now. I go back to my doctor in May I guess we will go from there. But my blood pressure has been great.

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I am not a newbie when it comes to surgery, For I had my first double bilateral carpal tunnel releases in early 1985 the left hand radial and ulnar, with a repeat of the left hand before the year was over. By a surgeon whom I occasionally had lunch with at a DC area hospital where I worked as a Bio~med Tech in the clinical engineering department for a couple years, with a 2yr tech degree from Penn State University. I did an internship, paid off my student loans working is a couple diff facilities and left the field.

With the guidance of my PCP and cardiologist, I went cold turkey off the Carvedilol and have returned to pre surgery Metoprolol lowest level and increased to regular dosage, which has helped my body regain control of my BP swings. We have on two occasions used Lasix to reduce edema in lower legs and feet ( especially the left), with positive results , including wearing compression sox to reduce swelling.

I am keeping daily record of BP HR and Po2, and the only issue to address is a minor inconsistent Sinus rhythm, which I am watching trend toward higher numbers from low, and waiting to hear from arrhythmia specialist to guide toward specific technique for control.

things have settled down quite a bit for my body, mind and soul. Peace of mind has begun to set in. Time is again on my side.

I am looking for the happy medium between Haste and Hesitation, It would be a waste if I missed it.

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CABGX6MAZE517 | @cabgx6maze517 | Jun 5, 2017
In reply to @colleenyoung "How did your appointment go today, Tom? Any clarity? I wish you a sleepful night tonight." + (show)
@colleenyoung

How did your appointment go today, Tom? Any clarity?
I wish you a sleepful night tonight.

Jump to this post

I have seen my Primary care provider and made some adjustments to my meds. We have increased my Metoprolol to pre surgical norm of 25 mg twice daily and my blood pressure has stabilized, hovering about 120 / 75 +_ 5. Damn near perfect, but still fluctuating. And we have reintroduced Multaq ~ Dronedarone 200 mg which has lowered my heart rate from 90s to 80 and below. We took another look at Lasix for a day and removed 2 more Liters from accumulated fluids. But ended up back in the ER for opioid induced constipation, so I have to lay off the Oxy 5mg acetomenaphen 325. And set aside the anxiety drugs as well.

I still have a little blurred vision. And a low level whole body burning has replaced the tingling and numbness in my fingers and toes.
I no longer get dizzy and light headed every time I eat. The knots in my stomach have untied a little, and I can breathe a little deeper each day that pass, my resting 02 has risen to 94 generally, where my active o2 has remained higher, while not sitting.
But here in Vegas the daytime temps as indicated on my truck dash board have risen up to 109 degrees.

All in all I know the day the nurse called out that my BP was 200/100 and rising, the Cravedilol saved my life, but the following three weeks have been living hell. Here it is 4am and I did get a couple hours (3) sleep so far. I need to get off here and try to get some more. So I guess at 26 days post surgical CABGx6 w Maze I am doing fairly well and I should stop complaining and get some more sleep...

Gnite

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Mentor
Teresa, Volunteer Mentor | @hopeful33250 | Jun 5, 2017
In reply to @colleenyoung "How did your appointment go today, Tom? Any clarity? I wish you a sleepful night tonight." + (show)
@colleenyoung

How did your appointment go today, Tom? Any clarity?
I wish you a sleepful night tonight.

Jump to this post

@cabgx6maze517 Hi Gnite: Thanks for the update after your appointment. It does sound like things are in the process of getting back to normal. I am very pleased for you! Keep in touch with us at Mayo Connect as you need encouragement and support in your continued recovery from the procedure as well as the medication problems. (Stay cool as the temperatures rise!) Teresa

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clarise b | @clariseb | Jul 6, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@cynaburst

I think that it is a bit strange that they would prescribe Coreg for hypertension in the first place. Coreg is a special type of beta blocker with extra properties that make it particularly useful in heart failure and which make the heart pump a little stronger. For someone who was not in heart failure, it seems to me that would be the wrong drug to use though I am not a doctor. Toprol (metoprolol succinate) is one that would seem to be more suitable for that purpose. There are also other classes of drugs that are used to manage hypertension that might be appropriate as well. I might seek a second opinion and see whether that approach was the correct one from the get-go.

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I was also prescribed Coreg.(3 years ago) I was 66 had shortness of breath. Had heart cath, they discovered two blockages, 99 percent. I was not in heart failure, I understand I had blockages, but is Coreg good for this? My EF is 84. My last stress test was great. I am ok taking the 3.124 mg at night, but cannot take it in the day. the quality of life is 0, my heart rate drops into the low 50's, dizzy, feel like I will pass out. The cardiologist insist that I need to take this, I hate to argue with a heart doctor, but there is a catch in my spirit that says something is not correct. (my Cholestoral when I had the stents put in was 138). I exercise regularly, eat low carb. I started meds for BP when my pressure shot up because of headaches. BP has been good for over six months, yet I am still on BP meds. I would like to take as few meds as possible, but don't want to do harm to my body, by not taking those that I should.
I am told that my heart doctor is a very good one, I have no reason to doubt this, but feel I would like more information. Thanks for your info. I might seek a second opinion, but I don't know how to pick out another doctor.

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clarise b | @clariseb | Jul 6, 2017
In reply to @colleenyoung "Hey @teatime and everyone else on this thread. Because there were so many questions raised in..." + (show)
@colleenyoung

Hey @teatime and everyone else on this thread. Because there were so many questions raised in this discussion about prescribing carvedilol and about weaning of the medication, I thought I'd involved one of our Mayo Clinic pharmacists. Here what she wrote:

"While carvedilol can be a very good medication for hypertension, it does have rare (0.1 to 1% of patients experiencing) side effects of abnormal thinking, aggravated depression, emotional instability, nervousness, and terrifying dreams. Unfortunately it sounds like you (@teatime) may be part of this subset of patients.

Carvedilol has a shorter half life than some of the other beta blockers which tends to make weaning off of it a little more difficult as the withdrawal side effects are more pronounced. A typical taper off of carvedilol would include taking the usual dose once a day for one week, then taking every other day for one week, then stopping. Some people will wean down more slowly or extend the taper if they are experiencing the withdrawal side effects. A longer form of the taper could be to take the usual dose daily for a week, then a half dose daily for a week, then a half dose every other day for a week, then stop.

The body’s adrenergic receptors are upregulated in response to a person taking a beta blocker, which is why it is important to taper off of the medication and allow those receptors time to adjust to not having that beta blocker circulating in the body. After stopping the medication it can take about a week or more for those receptors to go back to normal, so it is not uncommon to continue to notice some side effects even after stopping the medication completely.

For most people, the side effects from the medication or from weaning off the medication are tolerable, but the symptoms you describe seem severe. It is good that you are continuing to follow up with your health care team during this process so they can monitor your heart and blood pressure closely."

I hope this helps.

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thank you for this

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Kanaaz Pereira, Connect Moderator | @kanaazpereira | Jul 6, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@cynaburst

I think that it is a bit strange that they would prescribe Coreg for hypertension in the first place. Coreg is a special type of beta blocker with extra properties that make it particularly useful in heart failure and which make the heart pump a little stronger. For someone who was not in heart failure, it seems to me that would be the wrong drug to use though I am not a doctor. Toprol (metoprolol succinate) is one that would seem to be more suitable for that purpose. There are also other classes of drugs that are used to manage hypertension that might be appropriate as well. I might seek a second opinion and see whether that approach was the correct one from the get-go.

Jump to this post

Hello @clariseb,

We're so glad that you've joined us here on Connect; you are advocating for your health by seeking more information, and I think that is very commendable!

There are a few other discussions taking place on Connect, which you may wish to view:
– Carvediol Bad side Effects - advice & getting weaning off http://mayocl.in/2tOX5kC
– Side effects of heart medicine carvedilol joint pain and stiffness, http://mayocl.in/2nTvsB6
– High blood sugar due to Coreg? http://mayocl.in/2tn8Iy7

I'm confident that the members in this discussion will join in and share their experiences, but I'd also like to introduce you to a few others to seek their insights about Coreg; please meet @incrediblemulk98 @myra @bergordon @l8dybug5 @teatime @murryone @neeci @momma78 @constanceann, and our Mentors, @hopeful33250 and @predictable.

If you would like to get a second opinion from Mayo Clinic, the contact information for Minnesota, Arizona and Florida can be found here: http://mayocl.in/1mtmR63.

@clariseb, have you asked your doctor for an alternative to Coreg? What explanation has he/she provided for your present symptoms?

REPLY
michelep1964 | @michelep1964 | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@cynaburst

I think that it is a bit strange that they would prescribe Coreg for hypertension in the first place. Coreg is a special type of beta blocker with extra properties that make it particularly useful in heart failure and which make the heart pump a little stronger. For someone who was not in heart failure, it seems to me that would be the wrong drug to use though I am not a doctor. Toprol (metoprolol succinate) is one that would seem to be more suitable for that purpose. There are also other classes of drugs that are used to manage hypertension that might be appropriate as well. I might seek a second opinion and see whether that approach was the correct one from the get-go.

Jump to this post

All i know when i was on coreg i could not function at all. It was the worse drug i ever took. I wanted to die. Terrible side effects. I told my heart doctor i wasnt taking it and he went with me.

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