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teatime
@teatime

Posts: 14
Joined: Apr 28, 2016

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

Posted by @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.

REPLY

Welcome @teatime,
Great first post! What a shock to go from running a 5k two weeks ago to hardly able to take a walk yesterday. I’m tagging @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too. I’d also like to introduce you to @cynaburst @lynnkay1956 @PatMattos @Sensation @ronaldpetrovich @FrancineFafard @lepadelford

May I ask what heart condition you’re taking the medication for?

@colleenyoung

Welcome @teatime,
Great first post! What a shock to go from running a 5k two weeks ago to hardly able to take a walk yesterday. I’m tagging @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too. I’d also like to introduce you to @cynaburst @lynnkay1956 @PatMattos @Sensation @ronaldpetrovich @FrancineFafard @lepadelford

May I ask what heart condition you’re taking the medication for?

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I had to be taken off Coreg. It was too hard on my heart. I had a very scary reaction, which is odd because I had been on it for a couple of years. I am now taking propanolol – 4 times a day.
Thank you and I would like any further comments.

@colleenyoung

Welcome @teatime,
Great first post! What a shock to go from running a 5k two weeks ago to hardly able to take a walk yesterday. I’m tagging @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too. I’d also like to introduce you to @cynaburst @lynnkay1956 @PatMattos @Sensation @ronaldpetrovich @FrancineFafard @lepadelford

May I ask what heart condition you’re taking the medication for?

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Sorry, I failed to mention that my condition is a form of dysautonomia.

@colleenyoung

Welcome @teatime,
Great first post! What a shock to go from running a 5k two weeks ago to hardly able to take a walk yesterday. I’m tagging @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too. I’d also like to introduce you to @cynaburst @lynnkay1956 @PatMattos @Sensation @ronaldpetrovich @FrancineFafard @lepadelford

May I ask what heart condition you’re taking the medication for?

Jump to this post

Hi @colleenyoung, thank you for your reply. The original diagnosis was “reactive hypertension” (after talking to a cardiologist in an office visit and wearing the 24 hour BP halter) which was why I started the Carvedilol.

Hi @neeci, I am sorry you had a scary reaction, too. How long did it take you to feel better (or readjusted) after stopping the Coreg?

I have found that I need to take it really slow when I am going from one med to another. It took me about 2 months to wean myself off. After about a month, I was feeling better.

@neeci

I have found that I need to take it really slow when I am going from one med to another. It took me about 2 months to wean myself off. After about a month, I was feeling better.

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Wow, that is a long time. It is indeed a powerful medication, especially when one doesn’t respond well to it.

I think that it is a bit strange that they would prescribe Coreg for hypertension in the first place. Coreg is a special type of beta blocker with extra properties that make it particularly useful in heart failure and which make the heart pump a little stronger. For someone who was not in heart failure, it seems to me that would be the wrong drug to use though I am not a doctor. Toprol (metoprolol succinate) is one that would seem to be more suitable for that purpose. There are also other classes of drugs that are used to manage hypertension that might be appropriate as well. I might seek a second opinion and see whether that approach was the correct one from the get-go.

@cynaburst

I think that it is a bit strange that they would prescribe Coreg for hypertension in the first place. Coreg is a special type of beta blocker with extra properties that make it particularly useful in heart failure and which make the heart pump a little stronger. For someone who was not in heart failure, it seems to me that would be the wrong drug to use though I am not a doctor. Toprol (metoprolol succinate) is one that would seem to be more suitable for that purpose. There are also other classes of drugs that are used to manage hypertension that might be appropriate as well. I might seek a second opinion and see whether that approach was the correct one from the get-go.

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Thanks @cynaburst, I actually went back to a different cardiologist in the group on Monday. I could tell by the look on his face he didn’t agree with the Carvedilol either, although it is indeed prescribed for hypertension. We talked about starting Cozaar after all the effects wear off. I am following up the end of next week.

Thanks @cynaburst and @neeci for chiming in. Really useful feedback.

@teatime – I love your avatar. I wish I could see it larger. Please let us know what you learn at the follow-up.

Liked by teatime

Is it your heart or is stress no salt for you good luck.I use tranqilers
for stress but when I did yoga I was much more relaxed?

@mrsdeecee

Is it your heart or is stress no salt for you good luck.I use tranqilers
for stress but when I did yoga I was much more relaxed?

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Thanks, Deena. I´ve been resting at home for a few days and reading a lot about diet, especially the DASH diet. I´m feeling inspired to make some changes. Yoga helps immensely with the elevated stress, too.

Hey @teatime and everyone else on this thread. Because there were so many questions raised in this discussion about prescribing carvedilol and about weaning of the medication, I thought I’d involved one of our Mayo Clinic pharmacists. Here what she wrote:

“While carvedilol can be a very good medication for hypertension, it does have rare (0.1 to 1% of patients experiencing) side effects of abnormal thinking, aggravated depression, emotional instability, nervousness, and terrifying dreams. Unfortunately it sounds like you (@teatime) may be part of this subset of patients.

Carvedilol has a shorter half life than some of the other beta blockers which tends to make weaning off of it a little more difficult as the withdrawal side effects are more pronounced. A typical taper off of carvedilol would include taking the usual dose once a day for one week, then taking every other day for one week, then stopping. Some people will wean down more slowly or extend the taper if they are experiencing the withdrawal side effects. A longer form of the taper could be to take the usual dose daily for a week, then a half dose daily for a week, then a half dose every other day for a week, then stop.

The body’s adrenergic receptors are upregulated in response to a person taking a beta blocker, which is why it is important to taper off of the medication and allow those receptors time to adjust to not having that beta blocker circulating in the body. After stopping the medication it can take about a week or more for those receptors to go back to normal, so it is not uncommon to continue to notice some side effects even after stopping the medication completely.

For most people, the side effects from the medication or from weaning off the medication are tolerable, but the symptoms you describe seem severe. It is good that you are continuing to follow up with your health care team during this process so they can monitor your heart and blood pressure closely.”

I hope this helps.

Liked by teatime

Thanks so much @colleenyoung ! This seems to match my experience. I really appreciate this feedback! Please thank the pharmacist from me for his/her thoughtful response.

It is me again! It has been ten days off the Carvedilol. while I don’t feel 100%, I am doing a lot better- maybe 85%. Weaning off of this drug was difficult. I am sleeping a lot better. My cardiologist prescribed me a mild anti anxiety pill to get over the first few nights (only half a dose for five nights) and that improved sleep quality and got me over the hump of unease at nighttime. My resting pulse is back up to about 60-62 which is more me (it was 50-52 while on Carvedilol and even lower at night). I felt that took the longest to stabilize. The night poundings have stopped. I have actually gone for two (albeit short) runs this week and have been doing a bit of yoga again. We are following up with a 24 hour halter test (I am doing that today) and an EKG (normal). I am monitoring my BP, which is pretty good. The cardiologist had originally prescribed Cozaar but is now open to trying a few months of lifestyle and diet changes and keeping a BP log- as long as I don’t spike again (I had to buy a cuff for home use). I am quite anxious to try another medication at this moment after this experience. I would like to give it a real chance to see if I can keep my BP down more naturally while I am still in my 40s.

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