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.

Thanks for the update. The increase in heart rate when exercising is seemingly normal or at least that is what I have noticed.

Have you tried climbing stairs? We have them close by and there are some at work. You will likely notice your heart rate increases with stair climbing. I am more able to get up the 31 steps to my shop since I have begun reducing my dose. I still am slightly winded when I get to the top, but not like I was previously. I had to stop on the midpoint landing and take a few deep breaths a few weeks ago.

The aches in your stomach and back might be simply muscles working, not sure as I don’t get that sensation, but then I am not in really great shape. I can walk fairly fast over short distances, but notice my heart rate climbs after about 100 feet.

Let me know your progress as you seem to be doing very well. AND, yes getting off some meds can be really hard.

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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Don’t be discouraged @randypape. The body reacts gradually to a change in Coreg dosing. Four days is like overnight. Fourteen days experience is a good period to guage your response. Why do you think the medication is responsible for faster heart rate with sweats and slight back aches from walking exercise? Can you talk this over with a cardiologist?

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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@predictable The body does react slowly. Fourteen days is rather fast to clear out Coreg and its effects. The time it is still active in the body can be as long as 30 days, so must be tapered off very slowly. Coreg suppresses the heart rate severely and so an elevated heart rate while exercising is quite normal as the heart must work harder to deliver the needed oxygen to the muscles using it while exercising.

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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I agree @eileena. I was thinking of 14 days for accommodating a reduction in Coreg dose from 25mg per day to 12.5 per day. Clearing Coreg out altogether would probably take longer — maybe six weeks.

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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@predictable I am on a 3.125 X2 dose. When my Cardio agreed to removal of the coreg he wanted me to go directly off the stuff. Migraines came back within 2 weeks. Next he told me to take half the dose, they came back in 5 days. I have been slowly weaning off (1 less dose per week) for the last 4 weeks and have had absolutely no effects, negative or positive. This is why it is so very important to do this very slowly. It is probably as bad a drug as Amioderone which was never tested by FDA, but was backdoored after it first gained popularity in Europe, then South America and then was introduced here.

AND…25 mg/daily is a very high dose compared to what I take, altogether 6.250mg split into 2 doses of 3.125.
https://www.verywell.com/the-strange-history-of-amiodarone-1745987

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First off thanks for the replies, I appreciate it. I was taking carvedilol 12.5mg 2x/day then on Thursday my EP
doctor reduced my dosage to 6.25mg 2x/day. I’ve had some weird reactions since doing this. Blurry vision and stomach pain, sweats and higher heart rates. I believe this is all due to these pills. When we know for sure my ablation worked then totally wean off these pills.
I will be patient because once off the pills then out comes the ICD, yeah.

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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@eileena my experience is a contrast to yours. My nephrologist started me on 6.25×2 daily dose, largest recommended by the FDA as a starter. Over several months, the dose was gradually increased to 25×2 daily, where I have been almost a year. I have had mild symptoms of the kind you and others report, although never a headache. Even when I miss a 25mg dose in the evening, I don’t recognize any special symptoms; I attribute that to the carryover that is common from Coreg and is the reason for gradually adjusting dosage to allow the body to accommodate revised levels. My heart rate has stabilized around 80 bpm compared with a pre-afib rate of 50 bpm. I think a lot of the bad vibes people get from Coreg can be traced to prescribers who don’t take time to recognize the outspoken advice from the FDA and the manufacturer to always change the dosage gradually and never drop it abruptly from any level other than your 3.125mg.

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@randypape

So its been 4 days since my carvedilol was cut in half to 6.2.mg. 2x/day.i see my heart rate slightly higher at rest and gets higher when we walk. A couple times I’ve broken out in the sweats and slight aches in my stomach and back. I’m thinking this is from lowering the dosage. It looks like it won’t be fun getting totally off these.

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@predictable my cardio put me on the lowest dose 2X daily. I am not sure why, but it could be his extreme caution about many things. Except for the low heart rate I have experienced for the last 2+ years and the restart of the migraines when I attempted to wean off the coreg in the past I have had no problems. He also has me on a very small dose of Losartin 25 mg as my BP fluctuates quite a bit during the day. My GP has me on a very small dose of Levothyroxin as well as my response to it, dropping from a 27 TSH to a 3.15 with just that small dose, caused that doc to also err on the side of caution.

They are just very cautious except for when they did the quad bypass, there they went full out. Prior to my ablation in 2015 I had up to 20 PVCs a minute, now I get none.

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@randypape

First off thanks for the replies, I appreciate it. I was taking carvedilol 12.5mg 2x/day then on Thursday my EP
doctor reduced my dosage to 6.25mg 2x/day. I’ve had some weird reactions since doing this. Blurry vision and stomach pain, sweats and higher heart rates. I believe this is all due to these pills. When we know for sure my ablation worked then totally wean off these pills.
I will be patient because once off the pills then out comes the ICD, yeah.

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Randy, I read that one of the side effects of Coreg can be the stomach pains. Maybe that was on WebMd.com. Can’t recall.

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Hello, I’m doing better now and since we cut the meds in half, the hard to breathe issue went away. I’m getting better every day. Thanks

Liked by Lisa Lucier

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48 years old. Had cardiac stent put in a year ago. Just stopped Plavix. Was on 3.125mg carvedilol twice a day for a year and still on it. Also on 80 mg valsartan. Have should and back pains when moving. Have had low BP issues and low heartrate more recently. Lost 35 pounds and eat healthy and run 2 miles a day. I think it is possible I do not need to be on the carvedilol any longer. Doc agreed this morning and told me to stop it and monitor BP. Anyone else have similar situation?

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@ajm027

48 years old. Had cardiac stent put in a year ago. Just stopped Plavix. Was on 3.125mg carvedilol twice a day for a year and still on it. Also on 80 mg valsartan. Have should and back pains when moving. Have had low BP issues and low heartrate more recently. Lost 35 pounds and eat healthy and run 2 miles a day. I think it is possible I do not need to be on the carvedilol any longer. Doc agreed this morning and told me to stop it and monitor BP. Anyone else have similar situation?

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Hi, @ajm027. Welcome to Mayo Clinic Connect. I’m a volunteer mentor here to help people with an interest in medical care to find their way around our web site and provoke some conversations with others of a similar bent.

I also have some similarities with your medication regimen — I’m on Carvedilol, Lisinopril (a relative of Valsartan), and Coumadin (similar to Plavix). More than anything else, though, I wish I were as successful with my exercise regimen as you are! I have high blood pressure and atrial fibrillation, but have not had a stent inserted.

As to your medications, some people have discomfort when they stop Carvedilol abruptly, but since you were on the lowest dose normally prescribed, you may not encounter any trouble. However, I’d encourage you to talk to your doctor (cardiologist?) again soon about whether the quick-stop may produce some discomfort problems. Incidentally, you may wish to raise a question about your dosage on Valsartan; I assume 80mg means a 40mg pill twice a day, which is a common high dosage for high blood pressure and kidney protection.

I look forward to hearing from you again and catching what others may add in the days ahead. Martin

Liked by ajm027

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Hello @ajm027,

I’d like to add my welcome, and thank you for joining Connect. @predictable has shared some great insight, and I’d like to add that both Carvedilol and Valsartan can cause low blood pressure, since both are prescribed to treat hypertension, amongst other conditions. Here’s some information from Mayo Clinic that you may wish to read:
http://www.mayoclinic.org/drugs-supplements/valsartan-oral-route/description/drg-20067355
http://www.mayoclinic.org/drugs-supplements/carvedilol-oral-route/description/drg-20067565

I’m certain that @teatime @randypape @eileena @zany @doug_58, and others in this group will return to share their thoughts and experiences.

@ajm027, may I ask if the low blood pressure is causing any symptoms or discomfort?

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@ajm027

48 years old. Had cardiac stent put in a year ago. Just stopped Plavix. Was on 3.125mg carvedilol twice a day for a year and still on it. Also on 80 mg valsartan. Have should and back pains when moving. Have had low BP issues and low heartrate more recently. Lost 35 pounds and eat healthy and run 2 miles a day. I think it is possible I do not need to be on the carvedilol any longer. Doc agreed this morning and told me to stop it and monitor BP. Anyone else have similar situation?

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Thank you so much. I take 1 80mg tablet with breakfast every morning.

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Nothing other than tired sometimes. I will see how this goes as I wean off the Carvedilol.

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