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How did you wean off Metoprolol?
Hi,
I've been taking both flecainide and metoprolol now for eight years, as a prophylactic for Afib. I recently moved to North Carolina and have a new Cardiologist. Have had a lot of PVC's this past two months, and had to wear a heart monitor for an entire month. He said that although I had a lot of PVC's I didn't have even one PAC! He also noted that my BPM was low in the low fifties most of the time. He asked why I was taking metropolol. I told him that the only thing my previous doctor had said was " it makes the flecainide, work better". He suggested I stop taking the metoprolol to see how I do without it. Unfortunately I read a lot of information on the internet. I read that it can be very dangerous to stop taking it. I take 25 mg metoprolol succinate, split in half. Once in the morning with my flecainide, and then again in the evening for a second dose. He wants me to take half in the morning and skip the evening dose for two days, then stop entirely. Has anyone else stopped taking this drug in a similar manner? I'm worried that the cut off is too soon.
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I think Amanda asks the key question, why would you arbitrarily change any dosages of your medications?
You are on what seems to me, high dosages at this time; I would surmise that there is a good reason.
You have PVCs and no AFIB.
Your doctor appears to want to lower the effort on your heart, why would you take a chance on a heart event?
You best step is to fully discuss this with you doctor to achieve a better understanding of your situation/options.
Certainly you should be your own advocate, but there is a difference between that and taking a "shot in the dark."
SO far so good, I hope you solve the PVCs.
Hello @ejh4 and welcome to Mayo Clinic Connect. You will notice that I have moved your post into an existing discussion on Metoprolol so you can more easily connect with other members who have been decreasing/weaning as well.
You've shared quite a good history and explanation as to why you are considering decreasing Metoprolol. I'm wondering, is this something you've discussed with your doctor yet? If so, what was the recommendation?
Hello there, it's an absolute joy to find this forum online! I enjoyed reading about everyone's story, and I'm writing with my own story and some questions relating to my own heart situation. Let me start with some brief background:
I'm Eugene, 47 y.o. male, 244lbs (yes, working on the weight! Lol), I had a "mild" heart attack in the summer of 2018. 3 stents, plus two more blockages at 60 to 65% that they couldn't stent must be 70+% for insurance to cover them). According to echocardiogram (and confirmed by another this past fall), I was lucky that it showed no heartb muscle damage! During the angioplasty, I clearly remember the doctor looking down at me and said, "you have small arteries," so mainly it was coronary artery disease that occurred earlier because of personal anatomy and poor eating. Prior to the cardiac event, my BP usually was 130-ish/78to82-ish with a pulse of about 80 to 82.
At discharge, I was prescribed the following:
Metoprolol Succinate 50mg
Lipitor 80mg
Small aspirin
Recommended multivitamin and CoQ10 to mitigate statin effects, and I take them too
...and that's exactly what I've been taking up until today. (No other meds of any kind, too) The cardiologist in a local clinic recommended continuing everything since I was tolerating them well, so they've never changed. My blood pressure also had been quite stable at approx 112to115-ish/75, resting pulse about 65 to 70, which was comfortable for me.
Anyway, fast forward to Feb 11 of this year. I woke up and discovered I was having a lot of chest "spasms" -- that's what I called them, at least.
I had a spasm or two occasionally every couple of days since my heart attack, and I didn't really know what they were.
I thought they might be muscle spasms from Lipitor or something, especially since I am on the highest dose. Come to find out, they are very likely to be PVCs and maybe an occasional PAC. The increased spasms were present most hours of a few days that week, and they were so troubling that I went to the ER because I thought I was having a heart attack again. Of course, when I get there, they disappeared, and all bloodwork and tests were normal. So I go home, cardiologist orders a stress test. During the first resting phase, they spot at least one PVC, but I was able to make it thru 3 treadmill phases completely, and I didn't have any PVCs during exercise, which they said was very good. Since then, I'm noticing that my PVCs occur almost always when the parasympathetic system is dominant -- at rest, sitting/slouching, laying down (mostly left side), eating larger portions/drinking water until very full, and stuff like that. In fact, I also was having some abdominal pain, possibly related to a hiatal hernia or the gallbladder, which might have contributed to their frequency too. I do not have them when I'm active, such as walking briskly for exercise.
So...I also had ringing in the ears that worsened since last summer, and that's when some symptoms started to worsen, including the frequency of PVCs. I Googled palpitations and tinnitus, and the first few results were about cervical instability, which is the upper back and lower neck, and also the topic of the vagus nerve. That led me down a whole different rabbit hole of information, and I began to think I was having an issue with this thing called the vagus nerve. Anyway, that led me to a chiropractor 4 weeks ago. I told him my symptoms, and he agreed that it could be a hernia or spine/nerves that contributed to the PVCs. So he adjusted my middle and upper spine, the Atlas joint in the neck, and also some maneuvers in my abdomen. When I checked my blood pressure the next day, it had fallen by 8 to 12 points -- both numbers!! Since my adjustments, my BP when I wake up has been around 96-ish/62, pulse in mid 50s! The adjustments have helped my PVCs in frequency, but I still have them the most when I'm doing restful things, which reinforces their relation to the parasympathetic system and, thus, the vagus nerve.
Here's where I'd like to ask all of you some questions, especially people that get PVCs at rest instead of exercise. Have any of you thought about decreasing your BP medication a bit to see if your PVCs would decrease? I've read a lot of research about the vagus nerve connection to vital organs in the abdomen, and, yes, palpitations can be caused by too low of a blood pressure and pulse. I think I'm falling into that category. I don't want to stop taking my medications altogether, but I'm definitely interested in reducing the dosage of Metoprolol to see if the heart strength would increase a bit and pump better, perhaps reducing or eliminating PVCs in my case. Has anyone tried that, and what was the result? I'm definitely interested in hearing your story.
Sorry for the long message, but I wanted to give as many details as possible. This has been a very stressful, sleepless 5 weeks, and I'm trying to figure out what to do next.
Hi @wes13, welcome to Mayo Clinic Connect. I am sorry to hear that you are having trouble with rashes in addition to trying to taper of the medication. Can you share a little more about what you are experiencing while getting off the medication and what brought you to Connect?
I've been getting terrible rashes too..
Good luck with your surgery! How are you doing now?
How have you been since then?
Hi,
How's its been since you've weaned off? I'm currently going through the process.
How long did it take to feel better after discontinuing? Was your blood pressure still high after going off the metoprolol?
I have 20k heart pvcs. Will have a ablation March 12th. Hopefully no more medication after that