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@emo44 I have also been taking 12.5 mg of metoprolol for a year and four months. I just had a left and right atrial flutter ablation last Thursday and yesterday the nurse called and told me to start taking it as needed. Now I am wondering how I am supposed to know if I need it. Everything I have read says you should slowly wean off of it, but 12.5 already is the lowest dose. So I haven’t stopped it yet and I am going continue to take it until I see the EP on Feb 5.. I tried cutting a 12.5 in half but it didn’t cut evenly.

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Replies to "@emo44 I have also been taking 12.5 mg of metoprolol for a year and four months...."

@walalah
Hi. You had been on it for over a year, and nurse told you to start taking it? Had you stopped taking it? I wonder if nurse was relaying to you what doctor had told her. I hope so. Good luck.

@walalah This is a bit confusing. You were called and told to start up the metoprolol after a pause of a few days? Why? Or maybe the 'as needed' is the important criterion. Except, how would you know when it is needed if you are asymptomatic and don't/won't know if you're back in flutter?
I agree that the dose is very low, half a pill once a day essentially? It is unlikely that you will have any adverse effects if you have been ablated, maybe/probably cardioverted prior to release from the cath lab, and you had stopped taking metoprolol for a few days by now. If you feel well, if your heart rhythm is strong and reliable, then I don't see the need for resuming taking metoprolol....at all. It would be okay to take it if you have a return of symptoms and/or you have some way of detecting AF or flutter...in order to keep your rate as low as possible. But so soon after an apparently successful ablation, I would not take anything except maybe Eliquis if that was to continue. Leave well enough alone, and only resume metoprolol at that previous low rate if you KNOW you have reverted to flutter. Note that I am not medically qualified to give advice, so take what I say with a grain of salt. Really what I'm saying is that the nurse left you in the driver's seat on this...take it IF you need it. For me, the question is, how would you know?

@walalah I have recently switched from taking metoprolol daily to taking it as needed, and here is my experience

A couple of days after stopping the regular metoprolol, I did experience an a rhythm most possibly the beginning of an an Afib episode. I took one 25 mg dose of metoprolol tartrate and within an hour I was back to regular rhythm.

About four days later, I sensed an arhythm and immediately took another 25 mg dose of metoprolol and again I was back to regular rhythm within an hour

I feel that I can sense when an arhythm is starting I feel anxious and then I feel my pulse and if I feel an irregular pulse, I will take the metoprolol otherwise if the pulse is strong and regular, I feel that I’m OK

After being on metoprolol on a daily basis for over two years and stopping it, the quality of my life has significantly improved

Again, this was my experience and I hope the best for you

@walalah The nurse that called you with instructions to stop taking the metoprolol as a regular dose and start taking it "when you needed it" should have explained to you what they meant by "when you needed it". I'd guess it might mean if/when you felt the arrhythmia or flutters coming on, but they should clarify that for you.

I don't see an issue with your staying on the 12.5 mg/day of the metoprolol till you see your EP can check with him/her, but that nurse should have clarified the instructions for you.

At that low a dosage you probably don't need to taper it off when you stop taking it.