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.

@incrediblemulk98

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?

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No he was a PCP and he just shrugged off my concerns saying aww 50 isn’t THAT low. I didn’t even know my hr was so low till I went to the er. My chest just felt like your limbs do when they fall asleep and I was close to fainting just standing around at a family gathering. I monitor my vitals and my hr is generally like 75 to 80 with a BP of 110/68. It plummeted to 50 with a BP of 90/52. At the er my EKG and blood work were all normal. I was complaining about chest discomfort so he wanted to see if a low dose beta blocker would help haha quite the opposite. I never had apparant cardiac problems until now so I’m wanting to chop it up to the lingering alpha/beta blocking affects of the medicine. If it’s not better by tomorrow Im debating going back to the er. I don’t want to faint at work tonight but it feels like I’m headed that way. I should have seen a cardiologist.

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@incrediblemulk98

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.

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@incrediblemulk98, your message an hour ago and the earlier one 42 minutes ago make me wonder whether Coreg was your problem at all. Removing it didn’t change your symptoms.

The sharp decline in your blood pressure needs to be explored as something Coreg might not have caused. If you choose the ER as your next step, don’t let them off the hook by simply responding to something you suggest — make them look into your heart and ask for help from cardiology.

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@incrediblemulk98

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.

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It well seems like something worth exploring. Noninvasively testing I’ve heard isn’t the way to go with the heart unless you’re already three sheets to the wind. Hopefully I’ll push through my shift tonight and can go see a proper doctor in the morning.

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Hi @incrediblemulk98,
Following up on your messages. Did you return to see your doctor and get a referral to a cardiologist? Sure sounds like proper and thorough investigation would be advisable.

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@colleenyoung

Hi @incrediblemulk98,
Following up on your messages. Did you return to see your doctor and get a referral to a cardiologist? Sure sounds like proper and thorough investigation would be advisable.

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He decided it had to be muscles so he gave me steroid shot and painkillers. I’ll start a new thread.

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Interesting Thread. 58yo and I have CHF with a great prognosis from my cardiologist a few days ago. I’ve been on Carvedilol 25mg twice a day for two years – Never had a problem. He gave me my latest blood analysis as fantastic. The only reason why I went in to see him is because I started hyperventilating whenever I went into high speed, really heavy freeway traffic (70 mph+). This is no joke. So the last couple of days, I have stayed off the freeway.

But tonight broke the bank for me. Driving county roads and thorofares, (can’t spell right now – I’m freaked) after dark, with traffic caused the hyperventilation incidents to re-occur. (What I think is, basically the pre-cursor to a full blown panic attack, yet not knowing what it really was).

The first time this happened (Wednesday) I pulled off at an exit and had my son pick me up and take me to my cardiologist, where he gave me my previous blood test results and had no explanation for the hyperventilation incidents. Blood work was perfect.

At first, I thought perhaps it was coffee doing me in, because the two times I experienced this, 30 mins prior I had had coffee house coffee, you know the black stuff that keeps you going every day. Well that idea didn’t work.

I really thought it may have been coffee. Tonight kinda proved me wrong on that with no coffee, driving city and county streets in the dark. This is not something that happened over years, it’s only started in the last week.

I’m just talking here, and I am no source of real information – this is just my opinion (perhaps fake news) and this is why I think I created this problem, based on other people’s experience with this drug. There are a lot of reports on google with anxiety/panic issues connected to Carvedilol – by taking it. Me, I never EVER had a problem taking a 25mg dose twice a day. What happened was, and I really think this is it – I ran out of Carvedilol 9 days ago and was holding off refilling it until my Lisinopril needed to be refilled too.

I think I made a HUGE mistake by not refilling my rx right away by itself.. Getting off of Carvedilol (Coreg) of this magnitude (50mg) may be a challenge! Wow. I have talked with other people that I know that have panic/anxiety attack issues, but none of them match my situation – and I’ve never had one myself until now. I really appreciate the crap that people that have to suffer this type of condition more than ever.

Anyways folks thanks for this forum. One thing I’ve figured out yet again – is that I’m not the smartest bulb on the planet. If your meds work and you have no problems, keep them refilled and keep taking them. Carvedilol has worked for me really well, never had a problem, until I didn’t refill it when it was supposed to be. That is what I THINK is causing my psycho issues atm.

Take care all.
PS: I will continue to pursue this issue. The only real thing that worries me is that I may have to stop driving, which would kill everything in my life dead. And btw, my Carvedilol rx will be refilled tomorrow first thing. All this drug stuff makes me fell so stupid. If I’m right on this, (and it may take a number of days for this freak show to stop once back on it), well either way I will post a report – about Missing a dose of Carvedilol. Keywords: Getting off Carvedilol Anxiety, Hyperventilation, Driving, Night driving, Freeway Driving. Carvedilol has been good for me. Hello Google Search Results!

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@doug_58

Interesting Thread. 58yo and I have CHF with a great prognosis from my cardiologist a few days ago. I’ve been on Carvedilol 25mg twice a day for two years – Never had a problem. He gave me my latest blood analysis as fantastic. The only reason why I went in to see him is because I started hyperventilating whenever I went into high speed, really heavy freeway traffic (70 mph+). This is no joke. So the last couple of days, I have stayed off the freeway.

But tonight broke the bank for me. Driving county roads and thorofares, (can’t spell right now – I’m freaked) after dark, with traffic caused the hyperventilation incidents to re-occur. (What I think is, basically the pre-cursor to a full blown panic attack, yet not knowing what it really was).

The first time this happened (Wednesday) I pulled off at an exit and had my son pick me up and take me to my cardiologist, where he gave me my previous blood test results and had no explanation for the hyperventilation incidents. Blood work was perfect.

At first, I thought perhaps it was coffee doing me in, because the two times I experienced this, 30 mins prior I had had coffee house coffee, you know the black stuff that keeps you going every day. Well that idea didn’t work.

I really thought it may have been coffee. Tonight kinda proved me wrong on that with no coffee, driving city and county streets in the dark. This is not something that happened over years, it’s only started in the last week.

I’m just talking here, and I am no source of real information – this is just my opinion (perhaps fake news) and this is why I think I created this problem, based on other people’s experience with this drug. There are a lot of reports on google with anxiety/panic issues connected to Carvedilol – by taking it. Me, I never EVER had a problem taking a 25mg dose twice a day. What happened was, and I really think this is it – I ran out of Carvedilol 9 days ago and was holding off refilling it until my Lisinopril needed to be refilled too.

I think I made a HUGE mistake by not refilling my rx right away by itself.. Getting off of Carvedilol (Coreg) of this magnitude (50mg) may be a challenge! Wow. I have talked with other people that I know that have panic/anxiety attack issues, but none of them match my situation – and I’ve never had one myself until now. I really appreciate the crap that people that have to suffer this type of condition more than ever.

Anyways folks thanks for this forum. One thing I’ve figured out yet again – is that I’m not the smartest bulb on the planet. If your meds work and you have no problems, keep them refilled and keep taking them. Carvedilol has worked for me really well, never had a problem, until I didn’t refill it when it was supposed to be. That is what I THINK is causing my psycho issues atm.

Take care all.
PS: I will continue to pursue this issue. The only real thing that worries me is that I may have to stop driving, which would kill everything in my life dead. And btw, my Carvedilol rx will be refilled tomorrow first thing. All this drug stuff makes me fell so stupid. If I’m right on this, (and it may take a number of days for this freak show to stop once back on it), well either way I will post a report – about Missing a dose of Carvedilol. Keywords: Getting off Carvedilol Anxiety, Hyperventilation, Driving, Night driving, Freeway Driving. Carvedilol has been good for me. Hello Google Search Results!

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Hi @doug_58, some immediate reactions to your quandary from someone else taking 25mg tablets of Carvedilol twice a day.

First and foremost, do I understand that you stopped taking Carvedilol abruptly when you ran out of pills? Gradual withdrawal from the medication is recommended in order to avoid a range of symptoms. Second, you didn’t mention your blood pressure at the time of the hyperventilation attacks; perhaps you’d benefit from a portable BP meter when you’re out for a drive. Third, you might need a paper sack in the car with you, allowing you to exhale into the sack and breathe in the carbon dioxide you exhaled; often that can restore your control and balance without calling for help.

What about “hyperventilation syndrome,” a multifaceted condition that can be difficult to diagnose? Check out this article from the National Library of Medicine: https://medlineplus.gov/ency/article/003071.htm. It may give you a path to study.

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Forget that. Paper bag did no help. Matter of fact I googled the subject as soon as I pulled off I-85. I was totally out of control. I literally had to count the seconds between breaths, to stop me from passing out from hyperventilation while walking around in the parking lot of the gas station I was at waiting for my son to come get me.

Re-Read what I posted. I didn’t stop taking carvedilol on purpose (well yeah I did). It was merely a convenience issue with the RX. I am a cash payer. I don’t do insurance. So my rx’s aren’t always at the same time every month or whatever. If you re-read my post you will also notice my cardiologist said everything was normal, esp with blood chem’s. My BP was never an issue.

Third, your last paragraph, hyperventilation syndrome – No. This is where one is concerned about being in that condition. Not me. Hell we used to do this crazy hyperventilation stuff as kids just for fun.

Thanks for the response, but I highly recommend that if you ever stop taking this high level of Carvedilol (like we do), that it be done in stages. I am pretty sure this is what is causing my psychosis with these driving situations. It is not good. That said, Carvedilol has been a LIFE SAVER!
I’m back on it asap. I screwed up by not being smart.

Just my opinion.

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I must amend this: Hyperventilation Syndrome… this actually happens, when it is happening. And it is a really crude awakening if you’ve never experienced it. You’re afraid of it… but yet you think it…. and then you control your breathing like “On Purpose”. Even though you are not feeling any symptoms. And then it nails you to the wall – with THOSE SYMPTOMS. Yet, while you’re doing something complex like driving in heavy traffic. Seriously, It’s enough to say holy hell I’m done with this driving thing. That’s how bad it becomes so fast. It can happen in SECONDS. Nobody will EVER understand this unless they experience it first hand.
I really hope that getting my carvedilol back will fix this.
Take care all.

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@doug_58

Forget that. Paper bag did no help. Matter of fact I googled the subject as soon as I pulled off I-85. I was totally out of control. I literally had to count the seconds between breaths, to stop me from passing out from hyperventilation while walking around in the parking lot of the gas station I was at waiting for my son to come get me.

Re-Read what I posted. I didn’t stop taking carvedilol on purpose (well yeah I did). It was merely a convenience issue with the RX. I am a cash payer. I don’t do insurance. So my rx’s aren’t always at the same time every month or whatever. If you re-read my post you will also notice my cardiologist said everything was normal, esp with blood chem’s. My BP was never an issue.

Third, your last paragraph, hyperventilation syndrome – No. This is where one is concerned about being in that condition. Not me. Hell we used to do this crazy hyperventilation stuff as kids just for fun.

Thanks for the response, but I highly recommend that if you ever stop taking this high level of Carvedilol (like we do), that it be done in stages. I am pretty sure this is what is causing my psychosis with these driving situations. It is not good. That said, Carvedilol has been a LIFE SAVER!
I’m back on it asap. I screwed up by not being smart.

Just my opinion.

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@doug_58, I guess the only thing I’ll add is that I don’t just accept what a cardiologist tells me. I get a second opinion every time — from another cardiologist or another specialist, depending on what seems uncertain. In your case, it seems unusual that your BP was never an issue, especially since the paper bag wasn’t of any help. I have been advised that hyperventilation generally means hyperoxygenation and raising the level of CO2 in the blood is the antidote. Did your cardiologist address those issues? Or whether stopping Carvedilol might have caused your hyperventilation?

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I was recently put on Carvedilol for high blood pressure by my primary doctor. She started me out on a low dose and kept increasing it because my bp was not going down. At a check-up at the ER, it was increased also to 25mg in am and 12.5 in pm. I was actually found to have a really bad bladder infection going on for 2 weeks before it was found which is what I believe drove my bp up drastically and had a really bad case of gerd. Even though I had a heart attach in 2005, (a minor one) I have never had an issue with blood pressure. After I was on the carvedilol for a couple weeks, I started feeling very anxious and having tremors. It got to the point where I thought I was having a nervous breakdown. I went back to the dr. and she prescribed Zoloft and Ativan to help until the Zoloft kicked in. She also said to continue the Carvedilol 12.5 in am and 6.25 in pm. About 4 days into the Zoloft, I really thought I was going to have to be hospitalized. I stopped taking it but I continued with the anxiousness and tremors and continued to take the lorazepam .25 a couple times a day. Occasionally I would take 12.5 mg of benadryl to also help. I would then feel somewhat normal again and tell myself that it’s just the medications making me feel this way. I don’t believe I needed to be on a psych med but thought I’d try to see if it would help since it’s used for anxiety also. It only made it worse. I am currently weaning myself off the carvedilol. I am going to make an appointment with a cardiologist to see what they would recommend. This has been an extremely difficult 2 months. I am 62 and never in my life have I had anxiety issues or panic attacks like I have since being on this medication.

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@lola63

I was recently put on Carvedilol for high blood pressure by my primary doctor. She started me out on a low dose and kept increasing it because my bp was not going down. At a check-up at the ER, it was increased also to 25mg in am and 12.5 in pm. I was actually found to have a really bad bladder infection going on for 2 weeks before it was found which is what I believe drove my bp up drastically and had a really bad case of gerd. Even though I had a heart attach in 2005, (a minor one) I have never had an issue with blood pressure. After I was on the carvedilol for a couple weeks, I started feeling very anxious and having tremors. It got to the point where I thought I was having a nervous breakdown. I went back to the dr. and she prescribed Zoloft and Ativan to help until the Zoloft kicked in. She also said to continue the Carvedilol 12.5 in am and 6.25 in pm. About 4 days into the Zoloft, I really thought I was going to have to be hospitalized. I stopped taking it but I continued with the anxiousness and tremors and continued to take the lorazepam .25 a couple times a day. Occasionally I would take 12.5 mg of benadryl to also help. I would then feel somewhat normal again and tell myself that it’s just the medications making me feel this way. I don’t believe I needed to be on a psych med but thought I’d try to see if it would help since it’s used for anxiety also. It only made it worse. I am currently weaning myself off the carvedilol. I am going to make an appointment with a cardiologist to see what they would recommend. This has been an extremely difficult 2 months. I am 62 and never in my life have I had anxiety issues or panic attacks like I have since being on this medication.

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@lola63, it is regrettable that you have had to move through a bramble-patch of medications to deal with your hypertension over two months. Do I understand that your experience with Carvedilol came from prescriptions by two doctors — one your primary care physician and the other an ER physician — but not from specialists with more advanced knowledge of your symptoms?

I have been on Carvedilol for over a year and am now taking 25 mg tablets twice daily without apparent side effects. This is the latest in a string of 15 different medications for hypertension — almost all of which were prescribed by a nephrologist. My HMO’s standard treatment of hypertension is assigned to nephrologists because the kidneys are organically central to the problem. I also had the good fortune to find a nephrologist who is devoted to finding essential causes rather than managing symptoms with a fusillade of medications (which I had endured in years past). My initial treatment 20 years ago by cardiologists, as well as their return two years ago to my medical team, had no apparent effect on my blood pressure; their focus now is on atrial fibrillation which developed in 2015.

I know it’s reassuring when you can identify a single cause of medical symptoms. Your primary physician seems to feel that you are beset by a complex of symptoms that a complex of medications could address. Would you feel even better if your condition were described by a specialist and confirmed in a second opinion by a team of specialists, such as you can engage at the Mayo Clinic? Let us know how we can help you think through finding a map to diagnosing and treating your condition.

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