Stopping Carvedilol (Coreg): When will the effects wear off?

Posted by teatime @teatime, Apr 28, 2016

Hi everyone,

I am glad to be a part of this community. Please foregive the long post. I was wondering if anyone has had a hard time while being on and going off Carvedilol (Coreg).

I am an active 45 year old mom of a young child. I have always tried to eat healthily and keep in shape (I do yoga, pilates and, run about 5k 2x per week). My BP has always been pretty good, but since my 40´s it has gone up a bit (heredity factors play a role). My BP and heart rate also "spike" when I get stressed or anxious, but for the most part are pretty level during normal times. I do have anxious moments, but I would not say anxiety has been a major life problem. At my last check (Feb 2016), and after wearing a 24 hour BP monitor, my cardiologist suggested I start Carvedilol 6.25 1x per day (quite a low dose) for the spikes and to keep the heart from getting too excited. I agreed that maybe it was a good idea and started over two months ago. Other than stimulating rapid bowel movements, I did not notice any side effects at first. I would say about three to four weeks into taking the Carvedilol, I began not sleeping well. I also noticed my heart pounding, like a bass drum, slowly and steadily, at times. Then the heart pounding began to wake me up at night (it turns out my HR was down in the high 40s at night). Some nights I even felt my chest muscles vibrate, as if a phone on silence mode was on top of my chest. I started to notice this more and more and then I would have a few normal nights, so I figured I would just talk about this at my next cardio check (booked out in June). I also noticed I was getting more and more anxious. I wasn't too sure why little things were beginning to bother me. I thought it was hormones, PMS, whatever, and started looking for someone like a therapist to talk to.

The previous week was bad. I woke up from a few nightmares and I started to panic in bed, just woken up from sleep. I had three nights of waking up to panic attacks and body shakes. The experiences made me very nervous. At this point I started looking into the side effects of Carvedilol and I was seeing not only chest pounding, but in rare cases reported effects of nightmares, visual disturbances, tremors, anxiety. I also know one does not simply stop a beta blocker, so we talked about tapering down. I tapered down for four days, and then I got in to see another cardiologist on Monday and he said just stop immediately. The effects are rare, but they have been noted. Going off this medication has been frightening. I feel weak and shaky all the time, and I get sporadic periods of pounding and muscle tremors in my legs, anxiety and fuzzy vision. I frequently get so cold I begin to shake. Yesterday I went back to the clinic for an EKG (normal) and some blood tests (including thyroid) and everything was normal. I am just assuming this is my body reacting and readapting itself after being on beta blockers. It has only been five days, but I am wondering if anyone out there has had similar experiences. How long did it take you to feel normal again? I ran a 5k just two weekends ago and yesterday I could hardly take a walk. Thanks for listening.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

@jdgreene2008

Weaning off carvedilol 3.125mg twice daily for 90 days
Hi. I was given carvedilol shortly after Bentall procedure and have been on it for 90 days. I recently got a new prescription but my provider only sent me one for 15 days. I am concerned that I will run out of my meds before next renewal.

I've been on 3.125mg taken twice daily for 90 days and aside from occasional dizziness have been tolerating it wonderfully. At such a low dose, are there any risks to abruptly stopping just in case I run out? I considered breaking the pills in half and trying to extend how long they last but at that strength the pills are not made to be taken in half a dose.

After reading about the side effects of suddenly stopping a beta blocker I'm concerned if it runs out. I've already notified my cardiologist and am awaiting a response.

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I was prescribed carvedilol last month after a bad experience with metoprolol (it exacerbated post covid asthma at night). At 3.125mg 2x/day carvedilol seemed ok but a week later cardiology increased it to 6.25 2x daily. It exacerbated asthma with exercise. Really really bad, like couldn’t breathe, wheezing - horrid.
Cardiologist stopped it immediately. I asked if I needed to wean off and I was told that metoprolol required a weaning period but not carvedilol. I stopped abruptly and it was a good thing for me. Post covid asthma hasn’t magically gone away like I’d hoped but it at least it isn’t flaring into attacks.

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@jdgreene2008

Weaning off carvedilol 3.125mg twice daily for 90 days
Hi. I was given carvedilol shortly after Bentall procedure and have been on it for 90 days. I recently got a new prescription but my provider only sent me one for 15 days. I am concerned that I will run out of my meds before next renewal.

I've been on 3.125mg taken twice daily for 90 days and aside from occasional dizziness have been tolerating it wonderfully. At such a low dose, are there any risks to abruptly stopping just in case I run out? I considered breaking the pills in half and trying to extend how long they last but at that strength the pills are not made to be taken in half a dose.

After reading about the side effects of suddenly stopping a beta blocker I'm concerned if it runs out. I've already notified my cardiologist and am awaiting a response.

Jump to this post

Hi, @jdgreene2008. I hope I can be helpful. I've been taking Carvedilol for several years after a diagnosis of A-fib along with hypertension. Like you, I took it seriously that dropping use of the drug would be risky, and I have exchanged information with several dozen members here with experience with Carvedilol. It's puzzling that your "new prescription" would call for 15 days of pills (30 pills of 3.125mg?). Was that prescription newly written by your cardiologist or did you mean new delivery under your health insurance? Either way, I hope you can contact your pharmacist and your cardiologist for explanation of what is going on with your use of Carvedilol. I suspect that you'll be advised that stopping use of this medication (with a dosage of only 3.125mg) is unlikely to risk serious side effects (my dosage has been 25mg twice a day for many months, now reduced to 12.5mg twice a day). But don't act on the basis of my experience; be sure your cardiologist is in step with what you want to do. Martin

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@colleenyoung

Hi @jdgreene2008, welcome. I moved your question about weaning off carvedilol 3.125mg twice daily to this existing discussion:
- Stopping Carvedilol (Coreg): When will the effects wear off?https://connect.mayoclinic.org/discussion/hi-everyone-i-am-glad-to-be-a-part-of-this-community/

I did this so you can connect easily with other members like @maryd @juliebrown @eileena @jfperrone @ronsharp @friz @piperscot @wgoodman @predictable who may be able to offer thoughts on your concern about running out of medication.

Did you hear back from your cardiologist, @jdgreene2008? If you're concerned about running out of medication before hearing back from your doctor, your pharmacist should be able to provide you with an extension prescription for a few days.

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Thanks. In CVS portal it looks like one of my providers has requested a refill to be activated tomorrow.

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@predictable

Hi, @jdgreene2008. I hope I can be helpful. I've been taking Carvedilol for several years after a diagnosis of A-fib along with hypertension. Like you, I took it seriously that dropping use of the drug would be risky, and I have exchanged information with several dozen members here with experience with Carvedilol. It's puzzling that your "new prescription" would call for 15 days of pills (30 pills of 3.125mg?). Was that prescription newly written by your cardiologist or did you mean new delivery under your health insurance? Either way, I hope you can contact your pharmacist and your cardiologist for explanation of what is going on with your use of Carvedilol. I suspect that you'll be advised that stopping use of this medication (with a dosage of only 3.125mg) is unlikely to risk serious side effects (my dosage has been 25mg twice a day for many months, now reduced to 12.5mg twice a day). But don't act on the basis of my experience; be sure your cardiologist is in step with what you want to do. Martin

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Original prescription was written by the PA of my heart surgeon, for 4 month supply with the entire prescription set to expire in 1 year. But then in CVS the same prescription was listed under my general practitioner and apparently his request was for the 15-day supply. Tomorrow I'll know for sure what I'll get. For me, the treatment is for high BP and also some enlarged heart. Surgeon says it should help my cardiomyopathy or whatever the term is for enlarged heart, improve.

I've seen conflicting information online regarding side effects. So I'm going to stick with what the surgeon says. I even read that stopping it suddenly could lead to a heart attack since your beta receptors get flooded with adrenaline they're not used to processing anymore.

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@jdgreene2008

Original prescription was written by the PA of my heart surgeon, for 4 month supply with the entire prescription set to expire in 1 year. But then in CVS the same prescription was listed under my general practitioner and apparently his request was for the 15-day supply. Tomorrow I'll know for sure what I'll get. For me, the treatment is for high BP and also some enlarged heart. Surgeon says it should help my cardiomyopathy or whatever the term is for enlarged heart, improve.

I've seen conflicting information online regarding side effects. So I'm going to stick with what the surgeon says. I even read that stopping it suddenly could lead to a heart attack since your beta receptors get flooded with adrenaline they're not used to processing anymore.

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I would add that you appear to be on the right track -- sticking with what your cardiac surgeon recommends. The literature as well as comments from patients who write about their experiences are like two blunderbusses of information, because the range of conditions is so great and the range of options for diagnosis and treatment are similarly multiple. There is hardly any area of health care in which your own health care team -- including yourself -- is paramount to overcoming problems. Your questions to them and their answers to you are targeted to your unique situation and, in that, more promising than informal advice from others and literature. Good luck with your next consultation and decision. Martin

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I share your experience coming off Carvedilol. I went from Carvedilol to candesartan in one day. Although my bp rebounded for a few days everything seemed fine until about three weeks later my heart would spike up to about 165-170 bpm during my daily walks. Ave heart rate is typically 107. Then one morning I noticed my Fitbit showed a spike in my heart rate for about 5 minutes where my heart rate was about 170. I’m a65 yr old male, who prior to my surgery to repair an aortic aneurysm 8 weeks ago was in excellent health/fitness. I’m being fitted today with a heart monitor. Any similar experiences would be greatly appreciated.

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I have just gotten off Carvedilol three days ago. Thirteen years ago, I was diagnosed with bad heart failure I was in good shape and was at a gym when the incident happened. I was put on this drug the next day. I immediately began having nausea several times per week. I was put on Phenergan for several years, which helped but made me tired. I was still able to work and worked out a little. I also gained over 100 pounds. I was always a small person before this. Also, I was dizzy when I stood up, sat down, and when I was walking.

I started having palpitations with the Phenergan and got off of it. I tried many (if not all) of the nausea medications. Finally I used cannabis, which works most of the time but makes me high. My son was only 12 at the time of my diagnosis and I was told (every time I went to my Cardiologist) that I was on this for life. My son is now 25 and he gave his consent (along with my husband) to get off the Carvedilol They knew my quality of life was not good. I am just waiting to see what will happen. I hope to get on another medication.

My Cardiologist started packing to go when I told him (seriously) that I was wanting to get off. He said to call him if I need him, but he sent information for me to leave his care.

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After a bout with covid in 2022, I experienced low oxygen levels which lead to a flair up of a heart condition diagnosed in 2014. At that time I was placed on Carvedilol 3.125 and stayed on till 2016 when I successfully went off and managed my BP by lifestyle changes.
With the low oxygen my heart didn't work right and I developed severe edema. My PCP put me on Carvedilol (3.125) and lasix. It took a week or so but once I got on oxygen 24/7 I did start to improve.
I saw a cardiologist who upped the carvedilol to 6.25 and added Entresto as well. All went well for a few months, until a new cardiologist put me on Metoprolol. Ok for about a month then I started having chest discomfort, really low BP and pulse in the low 40's. I told my cardiologist and asked if I could go back to carvedilol and the NP agreed.
That was a month and a half ago and a follow up appointment they wanted to up the dose of both carvedilol and Entresto adding Spironolactone.
Now, I have been having unusual symptoms, tingling in the hands, joint pain, pins and needles feeling in the arm and feet. Blood test all say everything looks good. Just saw my primary who said how well my blood test looks and see ya in 6 months. I read how this side effect plus others symptoms I experienced but put off to my age, are signs that I can't tolerate carvedilol. I wasn't sure if maybe it was the Entrusto, so I had stopped that several weeks ago. I even went back to the low dose of 3.125 on Carvedilol but the symptoms continued and are steadily getting worse.
My doctor (cardiologist) notified me just yesterday when I
told him what was going on that he wants me to half my dose of carvedilol for 5 to 7 days and stop for 5 to 7 days and to watch my BP and let him know.

I've stopped carvedilol before in 2016 and it was really hard. Panic attacks, elevated BP, experiencing anxiety and fears. I didn't really wean off but just stopped at that time. It was like all my negative emotions was on and firing for a couple of weeks. Not something I am looking forward to going through again but if I can not tolerate a medication my body is telling me it does not like it and to stop. I need to listen to what my body is saying.

As for my oxygen situation, I no longer need it doing great at 98/96 with out and my heart is as good as it was before getting covid. But once my lungs started giving my body the oxygen it needs that was when that my body started rejecting the medications.

Has anyone else had problems with carvedilol, Metoprolol, or even entresto? And does anyone have any suggestions to help me as I taper off carvedilol. I figuring reducing my stresses, and no salt or processed foods is a good start.

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@debbee59

After a bout with covid in 2022, I experienced low oxygen levels which lead to a flair up of a heart condition diagnosed in 2014. At that time I was placed on Carvedilol 3.125 and stayed on till 2016 when I successfully went off and managed my BP by lifestyle changes.
With the low oxygen my heart didn't work right and I developed severe edema. My PCP put me on Carvedilol (3.125) and lasix. It took a week or so but once I got on oxygen 24/7 I did start to improve.
I saw a cardiologist who upped the carvedilol to 6.25 and added Entresto as well. All went well for a few months, until a new cardiologist put me on Metoprolol. Ok for about a month then I started having chest discomfort, really low BP and pulse in the low 40's. I told my cardiologist and asked if I could go back to carvedilol and the NP agreed.
That was a month and a half ago and a follow up appointment they wanted to up the dose of both carvedilol and Entresto adding Spironolactone.
Now, I have been having unusual symptoms, tingling in the hands, joint pain, pins and needles feeling in the arm and feet. Blood test all say everything looks good. Just saw my primary who said how well my blood test looks and see ya in 6 months. I read how this side effect plus others symptoms I experienced but put off to my age, are signs that I can't tolerate carvedilol. I wasn't sure if maybe it was the Entrusto, so I had stopped that several weeks ago. I even went back to the low dose of 3.125 on Carvedilol but the symptoms continued and are steadily getting worse.
My doctor (cardiologist) notified me just yesterday when I
told him what was going on that he wants me to half my dose of carvedilol for 5 to 7 days and stop for 5 to 7 days and to watch my BP and let him know.

I've stopped carvedilol before in 2016 and it was really hard. Panic attacks, elevated BP, experiencing anxiety and fears. I didn't really wean off but just stopped at that time. It was like all my negative emotions was on and firing for a couple of weeks. Not something I am looking forward to going through again but if I can not tolerate a medication my body is telling me it does not like it and to stop. I need to listen to what my body is saying.

As for my oxygen situation, I no longer need it doing great at 98/96 with out and my heart is as good as it was before getting covid. But once my lungs started giving my body the oxygen it needs that was when that my body started rejecting the medications.

Has anyone else had problems with carvedilol, Metoprolol, or even entresto? And does anyone have any suggestions to help me as I taper off carvedilol. I figuring reducing my stresses, and no salt or processed foods is a good start.

Jump to this post

From eirrol— for me cardvedilol was a nightmare. I was on it for 3 weeks with no problem. Then bang, suddenly I felt nauseated,dizzy, head burned, heart literally hurt. Thought I was going to pass out. Managed to lie down. An hour later I took my bp and it had soared but heartbeat was down to 49. Emailed my doc. He told me to immediately stop it. He said I could not gradually come off because it was doing more harm than good. Anxious days. A month later I wen to a cardiologist and had echo cardiogram. Technician and doctor said my heart is strong and so are valves. I will never take Carvedilol again and that was the tiniest dose. That was my experience.

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Hi there, there is so much here, but none of it is quite where I'm at. So, forgive me if I repeat something that has already been addressed and I missed it.
I am a very fit 48 yo woman. I ran a minimum 5 mi every day and I have an excellent diet (not a single processed anything and I grow all my own vegetables, have nothing but local grass meat, no added sugar or grains of any stripe, etc). After having Covid about a year ago, which I barely noticed, I started having slight chest pain. I figured it was long covid, but my life was also really intense and getting more so. Nov '22 my life went nuclear and Feb '23 I started having attacks upon waking that were absolute textbook heart attacks. After several I tried to get some help with docs, but was just told over and over that it was anxiety. I finally popped into the right ER and just happened to stay long enough for them to decide I was having a heart attack. Even then, I don't think anyone thought there was going to be anything real serious because I never was bad (even doing laps around the ward with my IV pole. Haha), but when they did the cath I had a 95% blockage and got me a shiny new stent. They gave me a RX for baby aspirin in the am, 6.25mg/2x day carvedilol and 90/2x day brilinta. I was actually discharged before they had even taken my IVs out, and never saw the cardio doc or was told anything other than, follow up with your doc. For about 3 days after getting out I felt magnificent, but that went downhill quickly. I was (am) nauseous all the time. I struggled to keep the pills down and have no appetite. So weak I couldn't stand for more than a few minutes, forget running. When I'd go upstairs, it felt just like times I had done step ups with 200lbs on my shoulders. My legs shake with the effort. But, the worst for me was the heart wiggle. I will get these moments when my heart just feels like something is stuck in it and it punches me when it starts, sometimes hard enough to see my whole chest move. This can be every other beat for hours. Pounding at night, but that's not a big deal to me. 3 weeks after my stent I got to see a cardio who gave me a month long holter, but after two weeks I told them I couldn't bear the heart thunk and felt like I was going to die. They doubled my carvedilol to 12.5/2x day and the thunking stopped for a little bit, but then back at it. I ended up getting switched from brilinta to plavix at my request, and thought it might be good to check my BP. Lo and behold, my BP was running at 90/50, HR anywhere from 55 to 120. When I picked up the plavix (and a calcium channel blocker that the doc thought might help to add) I asked the pharmacist of any tricks to bring my BP up (other than taking up smoking) and as we talked, because it was the weekend, he said he didn't think I should take the carvedilol when my BP was so low. I finally got to my doc after one day off the Carvedilol, and they agreed I should be off it until my bp was up. But, no one said anything about tapering. Second day off I felt like myself and was actually so giddy I was dancing. So grateful just to not feel like crap. But, end of the night the thunking was there, but I munched some salt and was feeling better. The next day, felt freaking amazing, until I went to bed and that was the first night I really thought if I fell asleep I wasn't going to wake. My heart was doing it's thunking, but then other weird things that are hard to describe because I was having a hard time staying awake. I was going to take one of the 6.25 carvedilol, but my BP was 105/60 and I was afraid I'd make the wrong choice and get worse. I chugged some gatorade I'd found in a suitcase and got some sleep, but that scared me good. I am so tired of feeling so bad. I meet these people smoking and drinking their cokes telling me about how good they felt after their stent and I just want to burst into tears.
So, I'm wondering if anyone can say "that's the way it goes, but it will get better" or sees something right away that's a red flag. I am literally willing to try anything to just not feel like I'm dying every freaking day. And, my poor beleaguered cardiology nurse, she really wants me to feel better, but I just don't think they really have a lot of experience with fit, healthy, norm BP, pre-menopausal woman with a stent. So, any advice will be eagerly accepted. Thank you!

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