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Diltiazem
I've been slowly having fatigue for a few years now, but the last year it has been getting worse.
I was diagnosed with obstructive HCM a year ago and started metoprolol back in November 2024 after an incident of sepsis in the hospital. My fatigue was getting worse since then, so my cardiologist had me back off to half my dose in February after seeing my resting heart rate is between 40-50bpm.
The fatigue hasn't gotten better so he wants me to stop taking metoprolol and see if the fatigue goes away. He said if it does, the backup would be Diltiazem to try next.
Has anyone had this medication and/or gone through this process of trying different medications?
I have some angina, but mostly just fatigue (which could be related to anything). My heart rate has been weirdly all over the place lately. It was fairly low/stable from November through March and then started getting weird the last month. Simple task of getting up to walk to the fridge could go from a 50bpm to 120bpm. No dizziness but feel my heart racing so I check.
My cardiologist is local to me, but I'll be seeing a second opinion in June in a more specialized heart center at Kaiser (Santa Clara) with a cardiologist that was at Stanford's HCM center.
Part of me is wondering if I just wait to make any changes until then but I had not heard of this medication so was wondering of others experience.
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I've never heard of this medication. When I was first diagnosed with HCM, and it wasn't obstructive yet (it is now), cardiologist put me on metoprolol. They started me at 50mg daily and went up to 100mg daily. When I first started the 100mg daily, I was exhausted at all times. I needed that dosage so they told me to try taking it 25mg in the morning and 75mg at night. This helped with the fatigue. I would never make any adjustments without cardiologist approval. And if I had your symptoms, I would get in to see a cardiologist asap, or potentially go the emergency room. Good luck!
Hi @mmicahk . Boy does THAT sound familiar! A decade or so ago - well before I was diagnosed with oHCM, I was put on Metoprolol. Don't remember the dosage. Within a very short time I was literally falling asleep at my desk, dozing off while driving... No matter how much sleep I got, I would last about 6 hours and then be completely unable to stay awake. Even had to go on reduced hours at work. I was moved from Metoprolol to Diltiazem within a couple months and that problem went away immediately. Fast forward about 8'ish years and I was finally diagnosed with obstructive HCM (after about 16 years of fruitless investigations), and put on the brand-new Camzyos. Still on Diltiazem along with the Camzyos with zero negative effects. As I've posted here previously (ad nauseum, sorry folks), especially in the discussion below, I had symptoms exactly like what you describe, and within less than 2 weeks ALL of the symptoms were 100% gone. Now I'm back to being the poster-child for lazy with no excuse for lack of activity. Pre-Camzyos I could barely walk to the end of the block but this summer, at age 61, we're looking at a 3 week train & backpack-hiking trip around parts of Europe. Some folks here have not fared as well with Camzyos but it's been life changing (excuse the hyperbole) for me. It may be worthwhile for you to visit camzyos.com to learn about this relatively new medication. Good luck chasing this all down. Take the time to scroll through the many discussions here at Mayo Clinic Connect about HCM, Camzyos, and related topics. This place is a wealth of information and the people here are wonderful about sharing their experiences.
https://connect.mayoclinic.org/discussion/camzyos-mavacamten-prescription/?commentsorder=newest&signin=true&pg=1#chv4-comment-stream-header