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.

floridawilbur | @floridawilbur | Nov 9, 2020

Hello, I'm hoping to find some understanding, how to better discuss this with my doctor.
Background: I'm 64, 20 years ago I was put on Coreg (generic Carvedilol 12.5 mg 2 x day) and Tevetin by my primary care doctor for high blood pressure. I was otherwise in good health, but battle weigh. About 4-5 years ago no longer able to get Tevetin, the doctor replaced it with Losartan Potassium (50 mg 1xday.) I did well. My heart rate was in the 60s maybe low 70s. Unfortunately this year my doctor passed away. --I scheduled a check up with a Cardiologist because I turned 64 and wanted a consult. We discussed exercise intolerance because I find it harder /slower to walk up hills. He said the Coreg might be 'putting the breaks' on my heart and switched me to Chlorthalidone 25 mg 1x day. I didn't taper off the Coreg, made the change the day after I picked up the prescription

My Problem: I don't feel right, I don't know if I have anxiety, or if I'm feeling the higher heart rate. It's a very uneasy feeling and gets worse from stress or if I dwell on it. I asked the cardiologist and the new family doctor, they both said Coreg was unusual for high blood pressure, the new combination is good. Instructed me to keep checking my BP and heart rate and as long as they are in normal ranges I was ok. (I had a stress test and there are no follow-ups) It's been 1 month, I was feeling a little better last week but its worse in the last 2 days.
What is this feeling? I don't know what triggers it. I'm wondering if I came off Coreg too abruptly and how long it will take to get use to being off it. Thank you for any insights.

Dana, Volunteer Mentor | @danab | Nov 4, 2020

In reply to @lmaxj "Hello, I was prescribed many drugs all at the same time and now that I have..." + (show)

@lmaxj, Yes its true we do need to be or own advocates these days. I learned early on when my PCP prosribed a version of a drug that did not work well with my Heart meds. So now before i take anything prescribed by a doctor that is not my Transplant team i check with them.first before starting. I also listen closly now to my pharmacist, who actually even doctors turn to, about any issues between drugs and im sure to let them know any over the counter drugs and supplements also.
As a now Heart Transplant paient i also found that not all doctors are farmilure with Heart issues so you may ask when you looking for another PCP you may be wise to seek a new doctor. I know its the job of your PCP to be aware of all aspects of your health to ensure they can direct you in the right direction. Sounds like your on the right track to get this taken care of. Ill be interested to hear how it goes with the Cardiologist?
Dana

lmaxj | @lmaxj | Nov 4, 2020

In reply to @danab "@lmaxj Im so sorry about your plight. I too was on that for many years and..." + (show)

Hello, I was prescribed many drugs all at the same time and now that I have done more research they were high doses. My primary care physician was throwing everything my way...and I was getting worst and worst: Carvedilol 50MG 2 times a day, Hydrochortiozide 25 mg, Losartan 100 mg, Doxazosin 4 mg, and Hydralazine 25 mg as needed for BP that went above 160/90....and it did go above that number several times a day! If you count that's 6 to 7 pills a day---all day...I was popping pills like eating M&Ms. Then he gave up after I kept calling and referred me to a cardiologist because he could not understand why my body was not responding to the drugs. Well, the reason I was not responding is that they were all the wrong drugs! It's important to get on the computer and try to figure out what these drugs are and how they could affect your body. I Googled the fact that African Americans respond to Calcium Channel Blockers and Ace Inhibitors ... come on!!!! I have been through 3 months of hell because no one seemed to realize this. My former doctor passed away and went to a new doctor. Sad to say, I don't believe he is the doctor for me.

Dana, Volunteer Mentor | @danab | Nov 2, 2020

In reply to @lmaxj "Hi, This drug has been a nightmare for me. I will never let another doctor prescribe..." + (show)

@lmaxj Im so sorry about your plight. I too was on that for many years and i find it interesting it affected you that way. I am curious tho was there any other med changes about the same time? You mentioned vivid dreams and my first thought was when i was quiting smoking and took chantix. The dreams were horrible and i had to stop that drug. But 10 years and no issue then over night it got real bad. I prey you get relief soon.
Blessing
Dana

lmaxj | @lmaxj | Nov 2, 2020

Hi, This drug has been a nightmare for me. I will never let another doctor prescribe a Beta Blocker for me. I actually found this blog because I was searching the side effects of weaning off this drug. I have been feeling horrible since July 31 when I had to go to urgent care because I developed an allergic reaction to the BP medicine I had been on for 10 plus years. Just to let you know I have the same symptoms that you have. My right-hand tremors, a break into sweats, my heart is jumping around and unsettled in my chest, the fatigue is horrible, I have vivid dreams and I am praying for these symptoms to go away. It's also hard for me to concentrate to do my job. I have rushed the weaning process because I just can't put this drug in my mouth again. I also learned that Beta Blockers are not the best treatment for African Americans, which I am. I had to request a Calcium Channel Blocker from the cardiologist. I was taking a high dose of the drug twice a day and feeling like a zombie when I awoke in the mornings with blood pressure numbers still uncontrolled and running high. I just pray that when I awaken in the morning I will start to feel normal again. I hope that you feel better soon too. God Bless.

maddie3211 | @maddie3211 | Oct 29, 2020

Hi! My name is Maddie and I can testify that Coreg is a heart failure medication that can destroy a bodies funtion. Coreg came out around 2006-2007. At that time, my cardiologist decided to put me on Coreg. He and his partners were so excited about this new beta blocker. It was going to change the world. However, it almost destroy my life: physically and mentally. Your symtoms concerning your side of effects from this medication is the same side of effects I experienced.

In addition, I was raising 2 children, as you, as a single mother, besides going to radiation treatments each day and physical heart theraphy, at the same time. You see, I was diagnosis with cancer two days after doctors discovered I had cardiomyopathy.

Of course, after being a heart patient since 2005, I have found cardiologist's are not educated enough on the side of effects of heart medications they prescribed and how much to prescribe to a patient. And the best person to go to is your pharmacist, which I did.

He worked with me to back me off the medication to see if my symptoms would regress and they slowly did. It took about two months to really begin to notice the difference. My heart that was beating like a drum, slowly disappeared. Besides fuzziness and light headedness. In 3 months, the depression went away and within 6 months I was beginning to feel human.

The best person to handle this kind of crisis is yourself. We know how our bodies are accepting new medications that doctors prescribed and working with a good pharmacist is someone everyone needs on there heart team , not just a good cardiologist.

Today, I am on Metoprolol and have no side of effects. It took me 10 years to find the right doctor to listen to me and build a great relationship with him. What I found, be direct at your first meeting, like an interview and ask them directly, how much do you know about the side effects of the heart medications you are prescribing and how often do you review those medications.. And finally, reach out to your pharmacist they are a GREAT resource everyone should have in their back pocket. I know, my family practice has a pharmacist on staff which I can call if I have issues with any medications I am taking..its great..

In other words, you have to your own advocate when it comes to your own health, because you know how your body is accepting those medications. And don't be afraid, to walk away and get a second opinion or new Doctor. We only have one life!

In closing, the very best to you and your family, with Gods Warm Blessings, Maddie

Martin Jensen, Volunteer Mentor | @predictable | Oct 15, 2020

In reply to @nelle49 "I have been taking 50 mg (2 -25 mg TID, 1 -40 mg Telmisartan and 6.25..." + (show)

Hi, Nelle (@nelle49), I'm responding to Amanda's invitation to share my experience with Carvedilol. Your medication was almost identical to mine before you began phasing down Coreg -- 50mg in two doses daily, 40mg of Lisinopril (a cousin of Telmisartan), and 10mg of a diuretic (mine is Amiloride). I'm also taking Coumadin (5mg) and Atorvastatin (10mg), but they're not relevant to my blood pressure or pulse rate. Overall, I don't find your pulse rate -- including its rises during exercise -- to be much different from mine, even though it has risen as your dosage of Coreg has been reduced. Your wise choice of scaling Coreg down over time with guidance from your doctor was a smart move. I'm not into that, because my BP remains steady at the top of the recommended maximum for people my age (85). I'd give a buck to be able to reduce (or change) my BP meds, but that's not in the cards. Your situation probably differs from mine and is well understood by your doctor, but since you're concerned about it, you might benefit from an exchange of views in a personal discussion with your doctor. Anxiety is an important symptom of hypertension and deserves to be addressed as much as your physical readable symptoms. A steady daily exercise regimen is another objective of my medical team (which includes me). And we periodically discuss whether and how to change my medication. Over the past 25 years, my doctors have prescribed a variety of 12 different meds, and I have acquiesced because the changes were upgrades to match changes in research results. I hope you and your doctor can move into a state of stability and comfort with minor adjustments indicated by your situation. Martin

Amanda Burnett | @amandaa | Oct 15, 2020

In reply to @nelle49 "I have been taking 50 mg (2 -25 mg TID, 1 -40 mg Telmisartan and 6.25..." + (show)

Hi @nelle49, welcome to Mayo Clinic Connect. Congratulations on effectively managing your blood sugar with proper diet and exercise and getting your blood pressure under control. I'm sorry to hear about your current issue with your elevated pulse due to the Carvedilol tapering. @ashby1947, @wigreenthumb, @predictable, @fireguy8891, @rois4richo and @jfperrone have all used or currently use Carvedilol and I invite them to share their experiences with you.
Did you decide to contact your physician? If so, did she recommend anything?

nelle49 | @nelle49 | Oct 8, 2020

In reply to @kanaazpereira "Hello @eileena, I'm so sorry that you are upset! You are an important part of this..." + (show)

@kanaazpereira

Hello @eileena,

I'm so sorry that you are upset! You are an important part of this community and you contribute to making it welcoming. I can see that very clearly from reading your past posts on your profile page. Please allow me to clear any misunderstanding or confusion, @eileena.

I am absolutely confident that Mentor @predictable was only replying, in detail, to @shawn2018 about the effects of stopping or weaning off from Carvedilol. I acknowledge that @predictable's post had a cautious undertone, but that is because as a Mentor, he recognizes that Connect is about health, first and foremost.
Connect Mentors are knowledgeable, compassionate, active members in the community; they are patients, caregivers and family members who have first-hand experience with a health condition(s). Our community members should feel safe, which is why Moderators and Mentors monitor the conversations and, more importantly, rely on community members like yourself to share insights through your experiences. That is also what Connect is about.

When we consider a medication like Coreg (Carvedilol), how we start is very important. But how we stop is just as important, As you've mentioned in previous posts, it’s so important to taper off gradually, with help from your doctor/healthcare provider, rather than stopping abruptly to avoid any confusing, unpleasant symptoms. However, it is a well-established fact that sometimes people, myself included:( undermine common sense, get impatient with the weaning process, and decide to stop, cold turkey!
Hence, I sincerely believe that @predictable was merely ensuring that @shawn2018 had enough information, as well as emphasizing the importance of "following Dr's orders"– and showing care and concern for a community member.
If you go to the first page of this very conversation, https://connect.mayoclinic.org/discussion/hi-everyone-i-am-glad-to-be-a-part-of-this-community/ you will see how perceptive and accurate (and cautious), both you and @predictable have been in sharing your knowledge with community members.

I hope this helps show another side of the situation, @eileena? Please keep talking, and thank you, sincerely for all your support and participation.

Jump to this post

I have been taking 50 mg (2 -25 mg TID, 1 -40 mg Telmisartan and 6.25 HCTZ for about five years. I’ve gotten my Blood sugar normal thru low carb diet, lost weight (eating at home for months) and exercising more. My BP came down dramatically. My doctor has been weaning me from Carvedilol for weeks. From taking half for two weeks, to 1/4 for two weeks to 1/8 for two weeks. She was mostly worried about my pulse going up. And it has been somewhat faster. High 70s low 80s. This week she had me stop the 3.125 TID. I only took the 3.125 at night for 3 nights then 3 nights ago stopped it. So no Carvedilol for three days. I’m not happy with my pulse. E.g. sitting here it’s 89. If I go up one flight of stairs it will be 115. If I walk into another room it’s 105. I get a little out of breath. No heart disease that I know of. The pulse does come back to the 80s quickly when I sit. Will this adjust and come down to high 70s low 80s or should I call her and see if I should go back on at least one 3.15 once a day? Or is there another beta blocker that’s milder than Carvedilol. My blood pressure is still very good. Seldom over 120/80 and usually more like 110-115/70.

Colleen Young, Connect Director | @colleenyoung | Apr 16, 2020

In reply to @latishabritt "Thank you for your post. I am taking a 12.5 twice a day but it has..." + (show)

Hi @latishabritt, welcome to Mayo Clinic Connect. Has the half dose made a difference these past few days? Did you have anxiety before starting this drug as well?

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