1. < Heart & Blood Health

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.

clarise b | @clariseb | Jul 8, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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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Thank you Martin. I plan to see another doctor to get a second opinion. I want to do what is best for my heart. Also, my doctor agreed to prescribe the coreg, instead of carvedilol, which may be giving me the extreme problems. I will post a follow up when I get a second opinion. Thank you very much.

REPLY
michelep1964 | @michelep1964 | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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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I have dialated cardiomyapathy with ejection fraction of 30. I am on lisiniprol only right now. Even this makes me feel crappy but i can function

REPLY
Kanaaz Pereira, Connect Moderator | @kanaazpereira | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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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Welcome to Connect, @michelep1964,

Thank you so much for sharing your experience with Coreg; the "one size fits all" concept does not always apply when it comes to medication, right?
The way a person responds to a drug is affected by many variables, like genetic makeup, age, other diseases, drug interactions. Since so many factors affect drug response, doctors have to choose a drug appropriate for each person. Mayo Clinic advises that people consult with their current care provider before making any changes to their existing medication or treatment plan.

We look forward to getting to know you, @michelep1964; may I ask what brings you to the Heart & Blood Health group on Connect? What alternative medication(s) did your cardiologist suggest?

REPLY
Martin Jensen, Volunteer Mentor | @predictable | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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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@clariseb, can you arrange for another "doctor" (cardiologist perhaps) to review your medical records and give you a second opinion? Can I help you with that? Your case seems ready-made for it. Your low blood pressure reading of 116/66 and your lowest possible daily dose of Coreg align with each other and suggest that hypertension is not the target of the medication. Something else may be, and you deserve a full advisory conversation on that, your prospects, and a longer-term plan for managing your symptoms. Martin

REPLY
clarise b | @clariseb | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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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I have asked, he says this is the best medicine. He tells me I have "heart disease", I am not sure what this means. when I asked the nurse, she said because I had clogged arteries. Does Carvedilol help that, I don't see it anywhere. It is mainly for heart failure and I think my doctor may be using it for high blood pressure. My blood pressure this am was 116/66. ( I am taking 3.125 mg carvedilol at night, tried several times during the day and cant do it).

REPLY
Martin Jensen, Volunteer Mentor | @predictable | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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.

Jump to this post

This is a response to @clariseb and @michelep1964, both of whom had severe side effects from Coreg (Carvedilol), although their doses were relatively small. I have taken Carvedilol for more than a year in doses of 25mg twice daily (with breakfast and dinner). Clarise says she is taking 3.125mg in the morning only. Her experience takes me by surprise, since I don't have any significant adverse symptoms from a daily dose of more than 15 times as much. Coreg seems to be what I need to manage my a-fib and hypertension, but comments here on Mayo Connect from a few individuals make it clear that they can't tolerate Coreg, and because of withdrawal symptoms, they have to work with their medical without delay to transition to a medication they can tolerate. Don't delay!
Martin

REPLY
michelep1964 | @michelep1964 | Jul 7, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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.

Jump to this post

All i know when i was on coreg i could not function at all. It was the worse drug i ever took. I wanted to die. Terrible side effects. I told my heart doctor i wasnt taking it and he went with me.

REPLY
Kanaaz Pereira, Connect Moderator | @kanaazpereira | Jul 6, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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.

Jump to this post

Hello @clariseb,

We're so glad that you've joined us here on Connect; you are advocating for your health by seeking more information, and I think that is very commendable!

There are a few other discussions taking place on Connect, which you may wish to view:
– Carvediol Bad side Effects - advice & getting weaning off http://mayocl.in/2tOX5kC
– Side effects of heart medicine carvedilol joint pain and stiffness, http://mayocl.in/2nTvsB6
– High blood sugar due to Coreg? http://mayocl.in/2tn8Iy7

I'm confident that the members in this discussion will join in and share their experiences, but I'd also like to introduce you to a few others to seek their insights about Coreg; please meet @incrediblemulk98 @myra @bergordon @l8dybug5 @teatime @murryone @neeci @momma78 @constanceann, and our Mentors, @hopeful33250 and @predictable.

If you would like to get a second opinion from Mayo Clinic, the contact information for Minnesota, Arizona and Florida can be found here: http://mayocl.in/1mtmR63.

@clariseb, have you asked your doctor for an alternative to Coreg? What explanation has he/she provided for your present symptoms?

REPLY
clarise b | @clariseb | Jul 6, 2017
In reply to @colleenyoung "Hey @teatime and everyone else on this thread. Because there were so many questions raised in..." + (show)
@colleenyoung

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.

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thank you for this

REPLY
clarise b | @clariseb | Jul 6, 2017
In reply to @cynaburst "I think that it is a bit strange that they would prescribe Coreg for hypertension in..." + (show)
@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.

Jump to this post

I was also prescribed Coreg.(3 years ago) I was 66 had shortness of breath. Had heart cath, they discovered two blockages, 99 percent. I was not in heart failure, I understand I had blockages, but is Coreg good for this? My EF is 84. My last stress test was great. I am ok taking the 3.124 mg at night, but cannot take it in the day. the quality of life is 0, my heart rate drops into the low 50's, dizzy, feel like I will pass out. The cardiologist insist that I need to take this, I hate to argue with a heart doctor, but there is a catch in my spirit that says something is not correct. (my Cholestoral when I had the stents put in was 138). I exercise regularly, eat low carb. I started meds for BP when my pressure shot up because of headaches. BP has been good for over six months, yet I am still on BP meds. I would like to take as few meds as possible, but don't want to do harm to my body, by not taking those that I should.
I am told that my heart doctor is a very good one, I have no reason to doubt this, but feel I would like more information. Thanks for your info. I might seek a second opinion, but I don't know how to pick out another doctor.

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