Cardiologist doubled my metoprolol to treat PVC

Hello Shorisha,
My cardiologist thought about it, but even at the lowest dose, my resting heart rate goes from 50-60 to the mid 40s..and again, that is at the lowest dose possible..12.5mg. Increasing to 25 or 50 is only going to make me more tired. My cardio/EP keeps telling that an evening resting heart rate of 40s is fine. When I sleep, my heart rate can get to 38...and again...my cardio tells me that this is fine. I am not sure what do anymore.
RR

I'm ignorant in medicine. But maybe get a second opinion? Is that too low? What do I know...

The most important thing with metoprolol is to keep constant track of your heart rate so it doesn't go too low.
How much is too low? Even Dr. Google didn't give me a definite answer.
My average HR is 45-50. I check my HR and make a decision whether to take my next dose of metoprolol or to skip it. My Very Good Family Doctor likes it about 55. My first clueless cardiologist didn't think about it at all, that is why I went to an EP cardiologist. Decide on what tools you want to use to check your HR, but don't rely on one.

That's still a modestly low dose. When they get above 150mg, now we're talking about some serious medication. For those NOT IN heart failure, the maximum dose is 200mg per day. Or so I was told by my interventionist. Those in HF can apparently be prescribed up to 400mg.

The advice above about self-monitoring, is good advice. You don't want a resting HR below about 45 ideally, although 50 and below is considered 'bradycardia' territory. If you have a recent history of fitness activities, I wouldn't worry about HR's near 40. If you're aged, a bit frail, not much muscle mass, then it should not go below 50. You are not likely to do well in a fall if you faint upon standing.

I do not understand why MDs do NOT run a person's genetic phenotype of the CYP450 enzyme pathways. I was tested many years ago so I and my doc can understand how I will metabolize a drug. Metoprolol is an excellent example. Metoprolol is metabolized via the 2D6 pathway(the are other pathways like 2C19, 2C9, 2D6 to name a few. I am an intermediate metabolizer of drugs that uses the 2D6 pathway. What this means is if I was to take metoprolol I would probably need more drug for it to be effective because I do not metabolize all of the drug. It just passes through my liver. But if I was a fast metabolizer of this drug I would need less of it and maybe take it more often as a fast metabolizer will dump more into your blood faster than you need and then leave you without metoprolol between pills. 50% of all prescription drugs use the CYP450 pathway and are all affected by an individual's genetic profile.

Hi. I'm on 100mgs.

I'm on 100mg of metoprolol and 50 losartin with potassium. My PVCs aren't frequent but notice when I have them some feel like very uncomfortable in the chest and cause indigestion. Been to ER, had trays, blood work and ekg EP said that my EKGS haven't changed or gotten worst. Going next week to have a loop recorder placed under my skin so EP can see what I'm feeling. And yes I feel everything when the PVCs hit. I'm scared of these PVCs especially when they make my chest feel uncomfortable. I haven't been told about taking supplements such as magnesium. Anybody else's PVCs are uncomfortable?

Yes, my cardiologist did the same. Now on heart monitor again to see if it’s working. Also on Lisinopril, ampLodiPine, and Isosordide Monentrate ER. All for lowering BP be relaxing arteries. FYI I don’t ever feel the PVC!

I started an Olive Leaf extract once a day 500mg and after 6 weeks of taking it once a day my PVCs went down from 20 per minute resting to 0 resting and rare during exercise at cardio re-hab when working out. I can't take beta blockers due to allergies so this came up in a comment by a gentleman using this support group. Toniiq LLC is the distributor. Absolutely, no side effects. I am sold on it.

Do you get the ultra high concentration of this as pictured on Amazon?