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.

@hopeful33250

Hello @shersh

I'm a little confused in that you said, "I don't have a cardiologist because I don't have any heart problems at all." However, you do take carvedilol which is a beta-blocker med which is generally used for heart failure and other serious heart problems.

Here is a link to Mayo Clinic's website that explains the use of Carvedilol, https://www.mayoclinic.org/drugs-supplements/carvedilol-oral-route/side-effects/drg-20067565?p=1 Please read this link.

I would suggest that you see a cardiologist if you feel that the med is not working well for you. Many of us have had problems with beta-blocker meds. I was taking a different one (Metropolol) but I also would wake up at night with very vivid dreams and not feel well during the day. My cardiologist switched me to Atenolol and I felt much better. It could be that a different med would work better for you.

Will you consider consulting with a cardiologist?

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@shersh I don't understand why is your Dr. giving you a heart medicine for thyroid ? Isn,t there any other Dr. you can see even a PCP would be better then the one you have seems like he is doing more harm then good unless he knows Coreg will help your thyroid I never heard of this and I,ve been in the medical profession for 35 yrs.

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It is my PCP. The nearest endocrinologist is several hours away and they don't take my insurance. Basically I'm stuck with the doctor I have for the time being

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@teatime

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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Thank you for your post. I am taking a 12.5 twice a day but it has been horrible. I actually have higher BP and anxiety attacks more it seems while on this drug. I called the doctor and he suggested taking half a dose for now. I'm trying to slower get off it but I feel all of the side effects just like everyone else. I'm so happy it's not just me. Praying for you all. I'm going to do the same as you and just make lifestyle changes. No more drugs while I'm in my 40's . Coreg was by far too strong for my heart. Thanks again everyone for these post. They do help others.

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@latishabritt

Thank you for your post. I am taking a 12.5 twice a day but it has been horrible. I actually have higher BP and anxiety attacks more it seems while on this drug. I called the doctor and he suggested taking half a dose for now. I'm trying to slower get off it but I feel all of the side effects just like everyone else. I'm so happy it's not just me. Praying for you all. I'm going to do the same as you and just make lifestyle changes. No more drugs while I'm in my 40's . Coreg was by far too strong for my heart. Thanks again everyone for these post. They do help others.

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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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@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.

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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.

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@nelle49

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.

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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?

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@nelle49

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.

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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

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