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.

incrediblemulk98 | @incrediblemulk98 | Jan 30, 2017

I was prescribed it for undiagnosed angina by my PCP just to see if it would help. I am relatively healthy other than smoking 3 cigarettes a day at most. I am only 25 and the ER doc yanked me off it immediately which I thought would have caused a rebound of some kind and not a continuation of the effects since the half life for this drug is only supposed to be 10 hours so virtually none of it should still be in me.

incrediblemulk98 | @incrediblemulk98 | Jan 30, 2017

I had to go to the er three days into coreg therapy at 3.125 mg twice a day. My heart rate was hovering at 50 and would not go up. It is now 48 hours since my last dose and I am still having this issue. I am not athletic at all and am beginning to worry. How long till my hr goes back to normal?

Kanaaz Pereira, Connect Moderator | @kanaazpereira | Oct 30, 2016

In reply to @auntdd "I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed..." + (show)

Hi @auntdd.
It must be so scary to have such a reaction! However, you have come to a good place at Connect, where you will find great support and advice.

I'm tagging @teatime, @murryone @neeci @sittingscribe1 and @momma78 on this discussion, as they have mentioned that they are taking Carvedilol (Coreg) too.

@cynaburst and @predictable are absolutely right; you should see your PCP and/or cardiologist soon and seek their advice.
There are many approved indications (by the FDA) for prescribing Carvedilol (Coreg), and one of them is high blood pressure (hypertension). However, since it is a beta blocker, it does this by slowing your heart rate and reducing blood pressure
You can read more about this dug on the Mayo Clinic site, here:
http://mayocl.in/2fiR9dF
@auntdd, can you tell us why you were prescribed Carvedilol? Was it for high blood pressure only, or did you have any cardiac issues?

Martin Jensen, Volunteer Mentor | @predictable | Oct 29, 2016

In reply to @auntdd "I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed..." + (show)

@auntdd, I think it is vital that you get on the phone with your primary care physician and ask for all the help you can get tracking down the cause of that blood pressure spike. I don't say that to give you a scare, but to emphasize that these unexpected symptomatic episodes are a benefit when they get your attention and that of your medical team, and you will not want to lose the opportunity that yours provided.

In particular, ask your PCP to explain whether Carvedilol (brand name Coreg) could cause your problem earlier this week. You had been on a relatively low dose of that medication for two years (I'm taking 25mg Carvedilol twice a day without any peaks or valleys in my BP). What dose are you on now after your episode earlier this week? Did your "panic attack" send you to the ER, or was it another set of symptoms? I'd suggest that you ask your PCP about a referral to a nephrologist, as well as a cardiologist, because your BP spike might be related to a kidney episode. In my case, Carvedilol was prescribed by my nephrologist as a beta blocker that interacts well with reduced kidney function. Ask also about having an electrocardiogram (EKG) to supplement your blood tests and x-rays done by the ER.

There may not be any better reassurance for you now than you can get from personally controlling your medical diagnosis and treatment -- and insisting that your medical team listen to your concerns and communicate fully with you. Keep us posted so we can continue to talk these things through.

Cynaburst, Alumna Mentor | @cynaburst | Oct 29, 2016

In reply to @auntdd "I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed..." + (show)

I think you should see a cardiologist and get advice about whether Coreg or some other drug is best to treat high blood pressure. Coreg is a drug that is often used for those who have some degree of heart failure, so I am curious as to whether you have something else going on too. Otherwise there are many other drugs that would work to reduce your BP. It sounds like you do have a tendency toward high BP and probably do need to be on something. The question is whether you are on the right drug and right dose.

auntdd | @auntdd | Oct 29, 2016

I was placed on carvidiol on Aug 2014, at 3.25 increased to 6.125 where I stayed until Aug 5 of 2016. On that date after very slowly decreasing my dose over time I stop taking carvedilol. For 2 and a half months my BP did great, no problems but just 4 days ago my BP spiked to where I went to the ER. After blood tests and exrays nothing was found. I did not have a heart attack or heart damage but because my BP was 165/75 the er doctors told me to start my carvedilol again. I was so panic that I did and have felt terrible since. Last night I took my BP and it was a low 109/62 with a house of 45 . I never got that low. I never had any symptoms of a heart attack more like a panic attack. I was kept being asked if I had a heart attack eailer when I was put on the medication and no doctor ever told me I did. Although I must have in order to be on this drug, right? Is it normal/usual to have a blood pressure spike so long after being off carvedilol? And do I start it all up again. As for my PCP I have yet to see her, tried to make contact but still no response. I just don't know what I should do. Please any advice?

crhp194 | @crhp194 | Sep 30, 2016

In reply to @hopeful33250 "@teatime @predictable @cynaburst @barnes123 @neeci I realize that I'm coming into this discussion as a newbie..." + (show)

I too had trouble with a beta blocker but my doctor cut the dosage in half for 2 weeks, then had me take the regular dose. This worked wonderfully and I felt totally normal. So my personal thought is that it is the amount of the drug that makes the difference. Hope you soon feel better and good luck to you.

Teresa, Volunteer Mentor | @hopeful33250 | Sep 29, 2016

In reply to @hopeful33250 "@teatime @predictable @cynaburst @barnes123 @neeci I realize that I'm coming into this discussion as a newbie..." + (show)

@predictable Hi Marin: Thanks for your thought reply. You have some good thoughts. No, I was never taken off the ACE Inhibitor. Metropolol was "in addition" to that. l did talk to the pharmacist and she only said to take it at a different time that the ACE inhibitor but no other suggestions were given. If I have ever am prescribed a beta blocker again, I'll certainly ask more questions and plan on a different dosing plan. I will be going to U of Michigan for a second opinion on the valve replacement in mid-October and then I'll make a decision on when and where to have the surgery. Thanks for your good wishes.

Martin Jensen, Volunteer Mentor | @predictable | Sep 29, 2016

In reply to @hopeful33250 "@teatime @predictable @cynaburst @barnes123 @neeci I realize that I'm coming into this discussion as a newbie..." + (show)

Teresa, I have no such adverse symptoms with Carvedilol, my beta blocker for the last several months. I'll speculate a bit about what caused your bad experiences: It sounds like your cardiologist had you go off Metropolol abruptly; that would be a mistake (https://www.drugs.com/cdi/metoprolol-succinate-extended-release-tablets.html). Perhaps he should have had you taper off over five days or more. Did your doctor take you off the ACE inhibitor when he put you on a beta blocker? That too can cause a problem if done abruptly. Taking your beta blocker twice a day -- breakfast and dinner -- with food might have been advised by your pharmacist.

Your situation and mine differ in several ways: I have high blood pressure and a slow pulse while you had low blood pressure and tachycardia that Metropolol can help, and my a-fib has not been surgically addressed while you had a catheterization.

I sense that all of that is behind you now that you have found a measure of comfort and stability, that's great! I hope your other indicators are getting aligned so that your valve replacement goes without unusual incidents.
Martin

Teresa, Volunteer Mentor | @hopeful33250 | Sep 29, 2016

In reply to @hopeful33250 "@teatime @predictable @cynaburst @barnes123 @neeci I realize that I'm coming into this discussion as a newbie..." + (show)

Hi @barnes123 I was wondering if you check your BP numbers when you have the symptoms of head pressures, etc. When I've done that, I've found my BP numbers extremely low. I try to compensate by taking in extra fluids which is supposed to help. You might try giving your BP a check and see what your numbers are and if they correlate with your symptoms. Let us know how you feel as you continue to work with the meds.

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