Why double metoprolol if already have low BP

Posted by dajohnson54 @dajohnson54, Apr 9 1:25pm

My heart failure group doctor increased my metoprolol and added losartan when I was already having low BP. Is this normal action?

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I am very much inexpert in all of this, just a patient myself who was only too glad to finally be off metoprolol. My own experience is this:
I was on it uneventfully for about three years before my AF began to come on more frequently. I was on metoprolol, about 12.5 mg BID (bis in die, or twice daily). They kept upping it until I had my first ablation at which I was taking 100mg BID. I was getting desperate because of the symptoms, and it didn't help that people told me I looked grey. But the worst was that, starting about six weeks before my ablation, I was getting a weird swelling feeling in my head and I'd experience tingling all up and down the back of my neck and scalp. This would happen while I was operating a vehicle, which we all know was not......good. Long story short, the metoprolol at that dose was slowing my heart so much when I was in NSR that I was experiencing long pauses between beats.
Bradycardia, and its associated problems with dizziness, breathlessness, etc, is a known problem for some patients with some conditions or responses to the drug. All patients should read the information pamphlet when issued with it the first time, and maybe refresh their memories once a year or more.
Metoprolol does have the side-benefit of helping with incipient hypertension. I can't say why the Losartan in addition to the metoprolol unless you have occasional supraventricular tachycardia or atrial fibrillation, but this is something your doctor/cardiologist ought to have explained at the time of issuance of your prescription. Other than that, my only suggestion to you is to continue as directed and monitor your blood pressure AND your heart rate several times each day, record the results, and present them to your cardiologist or GP if you suspect that you are being overmedicated.

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@dajohnson54 I try to never leave the doctor's office (or hang up the phone if the change was made in a phone call) without understanding medication changes or next steps.
This is one of those times when you have to not worry "What will the doctor think if I question them?" Be your own advocate and ask why when things are done that seem odd to you. They may have a very good explanation, maybe a recent study or article says more is better in certain circumstances, maybe something in your bloodwork or heartbeat indicated a need for the higher dose. Or, if this isn't your "regular" cardiologist, they may follow a different protocol than the others.
Please give the doctor a call or post a question (sometimes called an e-visit) on your patient portal.
Will you let us know what you find out?

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After my heart attack I was given metoprolol RX Which I take once a day in the morning and it’s12.5 mg.
I was told it helps lower my heart rate so my heart it’s easier. I also have a low blood pressure count. Before the heart attack, my average top number was 117 but while I was in the hospital, it was usually in the 90s and a couple of times it dropped down into the 70s.
I was told at one of my follow up appointments with the cardiologist that soon she will put me on another medication, didn’t tell me the name of it, but said that somebody should stay with me for the first week in case I have any side effects, which is kind of scary to think of. I don’t know why they have to put you on so many meds. I know a lot of them interact with each other and there are so many side effects from every medication that you take.

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