Losartan

Hi. You don’t say why you are on Losartan, but out of the gate, that’s more targeted to regulating blood pressure than abnormal heart rates. And although metoprolol is used for BP as well, it is often used by EPs as a medication to alleviate or suppress PVCs and PACs or atrial flutter.

Were you having issues with metoprolol? I for one, could not take it. It made me a complete zombie… so bad I could barely stand up or speak or think! I had extreme vertigo. And they kept increasing the dose despite the side effects because it wasn’t working to regulate my multiple arrhythmias. I was taken off Losartan because between the two, my blood pressure was too low.

I was then switched to Diltiazem. That seemed to help a little bit more, and regulated my blood pressure. But it did not work to help keep Afib from occurring and I ended up in ER with HR of 170, afib, and PVC/PACs.
I was electrocardioverted and even that didn’t work. They put me on a continuous drip of diltiazem and that finally did the trick.

Needless to say, and for a variety of reasons, like being told I was over reacting to constant PVC/PAC activity, and not sleeping for three years because of the symptoms, I changed my EP and cardiac clinic.

Best thing I ever did. My arrhythmias are now managed by Flecainide and Diltiazem twice daily.

Hope things go smoothly for you and you are happy with the whatever results they are aiming to achieve via the Losartan.

Great question. Thanks for pointing out the incomplete narrative.

My rhr was too low under metoprolol - high 40’s, low 50’s. Losartran doesn’t slow hr as much as metoprolol while still controlling bp, I’m told by the NP. That’s why they switched me - bp management without the too-low rhr.

Do these beta blocker/bp management actually prevent afib or only treat associated hr and bp conditions?

Thank you for your response.

Just GOOGLE Losartan. It can give you the list of common and serious side effects. In my pea brain opinion, I would investigate it before buying the prescription and/or swallowing. I wouldn't take it.

Hello Zacklucy, I have had A-fib for probably 20 years and have been on Verapamil for almost the whole time. I'm also on Losartan + HCTZ (100 MG + 25 mg). I've been on the highest dosage of Verapamil for the last few years (240 MG, 2 pills q evening). About a year ago I finally agreed to take Xarelto 15 MG (due to a family history). Overall, my A-fib rarely acts up. If it does, I can take a half a pill plus .5 of Ativan and it calms down.
I've had no problems with the Losartan. And I have an Echo done once a year.
So, sometimes it just takes some experimenting a bit with the meds (your doctor, that is) to find the right med or combination of meds to get it right.

Thank you, @phyllisden.

I have been taking Losartan for over three years with a back up of bisoprolol (Low-dose) because they work on different things to keep your blood pressure low. Within the last 3+ months, I started to become very zombie like and lost interest and energy both. Did some research on the medication and found the side effects to bisoprolol are pretty wicked. I was only taking 5 mg once a day so I cut it to 2 1/2. I continued to feel wonky. My doctor told me to stop at all together, which I did. I had about a three day time frame where I felt pretty good and thought that was going to be the answer but then the lethargy came back. I am now wondering if the Losartan is doing the same thing?? Overtime, your body gets used to blood pressure medications and they often need to be changed. I’ve only been taking them since 2020 and I’ve tried at least six of them. It’s very much a trial and error drug. Sometimes you’ll know quickly if it’s not for you, and sometimes your body will tell you it’s time to move on. I found the losartan to be one of the easiest to take, hence the longer period of time on it than others. Another FYI, I would never take another beta blocker again. I know all medications come with side effects, but the BB ones were untenable for me. Good luck! Blood pressure medication is no joke!

I’m not a pharmacist or EP, so my answer is only from my own experience with calcium channel and beta blockers.

Having said that, for me personally, neither metoprolol or Losartan did anything to prevent me from going into full blown afib or atrial flutter. What finally helped is a dedicated anti arrhythmic.

The one I am currently on is also used as “pill in the pocket,” and when prescribed in that manner, you take it only when you feel yourself go into tachycardia or afib. However, many people don’t even feel their out of rhythm heart until other more serious symptoms occur—dizziness, exhaustion, nausea, sweating, etc. And with my individual case, it was decided between my EP and I to take Flecainide daily.

It was a good decision as far as I’m concerned. But I still worry about the medication not doing its job well enough after a while. I’ve already had to have a dosage increase as it quit managing things on the lowest dose. I started in February after my last ER visit with Afib where they performed electrocardioversion. (And that didn’t work either.)

As one very kind ER nurse told me, Afib is hard to get a grip on.

The way I look at it now is these drugs are all going to affect each one of our genetic makeups differently. And unfortunately, experimentation on dosing and types are all we can do at this point if ablation hasn’t worked or you are not a candidate for surgical intervention.

Thanks for your thoughtful response. Do you know whether these metoprolol and losartan are supposed to prevent a-fib? I thought they only regulated heart rate and blood pressure.

Sometimes Metoprolol is used to regulate heart arrhythmias and lower the HR, in hopes of preventing an Afib incident. That’s what they tried with me.
The Losartan was prescribed by my GP for BP. It’s documented that sometimes that two of these things can work better together than one.

I started out great with losartan. Was taking 100 mg a day and blood pressure was well under control. That was almost 2 years ago. Recently, I have experienced lower leg and foot discomfort and incredible fatigue. I have a cardiologist appointment in a few weeks. I am wondering after this length of time if it’s time for a medication change. That seems to be the way it goes with meds, at least for me. I started with amlodipine and was great for three months with that one until I woke up one day and both my feet were enormously swollen and I had hives all over them as well as my lower legs. I definitely have some difficulty with medications. I am in that 1 to 2% group that will get a side effect if it can happen. I would say overall, it’s a good place to start. Possibly you will not experience what I’m going through now. Possibly I shouldn’t even be blaming losartan on what I’m going through now, but it’s the only medication I take. I have weaned off the bisoprolol and my statin. The quality of life with those two was unbearable. Good luck!