Metoprolol and seniors

i am currently contacting my cardiologist about metoprolol problems. i have been a competitive runner and mountain biker for some years now. i’m 82 and experienced atrial flutter a couple months ago. was prescribed 100mg metoprolol which was immediately reduced to 50mg because i take prozac. still i experience fatigue and leg pain constantly. my resting pulse which has always been low (upper 40’s) now sits at 38-39. it is difficult to run or bike due to constant washed out feeling and leg pain. this appears to be a common problem.

I had the same issue, I’m 70. I now take 12.5 mlg once in the morning and once at night. Feeling great now but took a year to figure it out

@zeke2u I take Metoprolol ER 25 mg (extended release) tablet in the evening. I thought the ER tablet , somehow, releases the active ingredient slowly overtime. Did you find that taking half in the morning and the other half at night make a difference? Or are you taking the regular dose, not ER. Thank you.

Yes, I was taking the one tablet every morning but really was too much later in the day, 40bpm😬
Cut it half and one half morning and one half evening. Made a big difference.

@k09 I had fatigue with Metoprolol too. There are options to try. Everyone, I’m told, reacts differently to the many meds available. Try other beta blockers in differing dosages, given at different times of day, slow release or not. I eventually settled on a calcium channel blocker called Verapamil, slow release capsule taken Am and Pm which did not create fatigue but did lower my heart rate, which was the goal. The trial and error is a long road but worth it to get your energy back. Good luck!

@zeke2u
Great thread.
I've been on atenolol (another beta blocker) for some years now, but when first prescribed, for a combination of arrhythmias and high blood pressure, the first time I took a 25mg pill it was way too much for me. The prescription was 25mg twice a day, and I wasn't going to take that second one. Called the doctor and went down to 12.5 mg (half the already small pill!) per day, and later 12.5mg twice a day.

Also I had already been taking amlodipine (calcium channel blocker) and olmesartan (ARB). The amlodipine was kind of zombifying me, whether it was mental or physical I don't know, but it still wasn't sufficiently doing its primary job either, keeping blood pressure down. I cut it off without even discussing it with the doctor. It takes a couple of weeks to clear from the body. I felt better immediately, and no discernible effect on my blood pressure.

I think a lot of drugs may be better in smaller doses. Many factors, not just your condition but your genetics and even your diet and activity levels, factor into what works and what doesn't.

I also started taking magnesium supplements somewhere along the line and have been taking magnesium glycinate for a couple of years now. Solaray brand. It also contains a little peperine, btw, they say to help absorption, which is a bit questionable for use with glycinate, since glycinate is already well absorbed, but turns out to be good for blood *glucose* control. The capsules are big, a full 375mg dose requires four capsules, but I've settled on one in the morning and one in the evening. (also, of all the prescription and supplement pills I take, this is the only one that sometimes sticks in my throat, no idea why, but it discourages me from taking more of them).