Metoprolol post CABG
I am 8 weeks out from 2x bypass and doing well.
Had my last visit with my cardiac surgeon…and got the 100% thumbs up.
Medications upon leaving the surgeon care were:
81g asprin 1/day
40mg Rosuvastatin 1/day
12.5 mg Metoprolol Tartrate 2/day
So, I was on a total of 25mg of Metoprolol Tartrate a day.
Now, the Metoprolol Tartrate was a 25 mg pill that I had to cut in half. Pill is very small and difficult to cut accurately in half.
I told this to my cardiac surgeon and he suggested when I went to see my cardiologist, ask him about a 1/day slow release Metoprolol.
So, a week and a half later I go see my cardiologist. Uneventful visit. All looks good. But I did ask him about the Metoprolol Tartrate situation. He said he could take care of that and called me in a prescription.
But….. when I go to pick up the prescription it is for Metoprolol Succinate. Well I researched it and Succinate is what the slow release Metoprolol is. OK.
Problem is it was for 50mg, not the 25mg I was expecting. So I called my cardiologist to ask if that was the right dosage. Never talked to him but to a nurse at the practice. She said she would ask the cardiologist and get back to me.
Whe she did she said because I was no longer taking Amiodarone, he put me on 50mg Metoprolol Succinate.
Well, the cardiac surgeon had me on Amiodarone post surgery. That perscription ran out about a week before I went to see the cardiac surgeon for the last time. I checked with him when it ran out, and he said yes, I was done taking Amiodarone. He DID NOT make any changes to the Metoprolol Tratrate perscription.
So, bototmline I am questioning my cardiologist substituting 50 mg of Metoprolol Succinate for 25 mg of Metoprolol Tartrate.
If I had never brought up the difficulty of using the Metoprolol Tartrate 25mg (small pill, difficult to halve, etc)….. I would have continued on taking that without any question and the subject would have never come up with my cariologist.
Not quite sure what to do now. I am continuing to take Metoprolol Tartrate 25mg, half, 2x a day (as if I never had the conversation about it being a pain to cut in half). I have about 30 days supply left……but I can get it refilled.
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So this is a confusing mess! So sorry! My husband and I both take Metoprolol since our surgeries- I take the tartrate and he takes the Succinate. I take twice a day- and he actually switched because like you he was on the 25mg dose but had to cut the pill in half. Anyway, I recommend you monitor your blood pressure and hr at least daily for about a week. If on your dose(12.5) it is running normal and not high, then you can call your cardiologist explain you were finishing this prescription and you have some concerns bc your blood pressure is already normal, switching to a higher dose. If you find that your hr and bp are running on the higher side on your dose (12.5) that maybe the reason he increased the dose? But whatever reason, even if it was misunderstanding on his part- this may give you a reason to question the dose again without sounding redundant. I would also monitor your bp and hr initially if you choose to increase your dose. Happy Holidays and Best Wishes for the New Year!!!
Thank you for the reply. Curiously enough, my HR on 12.5 mg 2x a day Tartrate is onthe low side. Resting is in the 50s……….even dipping into the 40s. THis causes me no issues…….but I feel that is about as low as it should go: another reason the switch to 50 mg Succinate seems like not the way to go.
Also, BP, meassured for 5 weeks daily at my cardio rehab, was usually in the 110/70 range.
Again, thanks for your reply.
Hi, I don’t have the answer but this is what one can do and it takes approx 15 minutes 4 times a year if helpful if sticking with the 12.5 dose via their doctor…. get a 90 day supply and split the pills, 4 times a year. Pill splitters are inexpensive (5$) on Amazon and some note “small pills” , that is what you have, and one that has lots of good recommendations. It should ideally have a small razor blade that cuts the pill. It is a one time 15 minute or so step/pain vs the other pills if you do a 90 day bottle. I wash/dry my hands first and use a clean paper plate then fill the bottle up with all split pills, the day you get them. It is pretty fast to do them all at once. My heart rate runs slow using just the 12.5. I have not tried metoprolol extended release but have had success with extended release versions of other medications. Most important to make sure your doctor is on same page with whatever you do.
Listed on Amazon as
2PCS Pill Cutter, Professional Pill Splitter for Cutting Small Pills or Large Pills in Half (Blue)
Also if you do ever get any extended release pills remember you do NOT want to split extended release pills typically unless doctor or pharmacist says it is ok as they are often made in a way not to be split regarding the extended release.
….spouse now on 20 different meds a day since triple bypass, diabetes, etc etc had to type up a schedule to follow and confusing too with different names for same meds etc. also water pill and trips to bathroom bowel damage from radiation…. but still trying to quit the devil nicotine,… not sure how he is coping with it all…. and as I have my issues this household is and never will bre the same… did we appreciate our good health years ago, well we didnt know any different did we; sure would like a taste of the "old days" …. J.