How did you wean off Metoprolol?

I have Tachycardia and AFIB. My Cardiologist successfully weaned me off Amiodarone and switched me to Metoprolol about a year ago. It's worked fine so far ... I now am comfortable hiking/jogging/walking about an hour at a time instead of 30 minutes max. before. My resting heartbeat with Metoprolol went from the 60's to the 50's, but no noticeable symptoms developed.. Taking 25 mgs a day. Any noticeable palpitations or arrhymths during the day are short-lived and stop on their own w/o any additional pills. Doc wants me to get Internal Loop Recorder next. Should I?

P.S. I was on Metoprolol for sinus tachycardia

I was on Metoprolol Succinate 25mg twice a day for 15 months. I slowly developed all the symptoms you could imagine. I was also on Paxil at the time. I thought that the symptoms were from the Paxil so I weaned off them. The symptoms continued to slowly worsen over time. The light headedness/dizziness got to the point were I was barely able to drive a car and function. The doctor finally agreed that it "may" be the Metoprolol and to wean down to half a tablet once a day for a week. After researching I extended the wean to three weeks ending with 6.25mg once a day. Day one off of Metoprolol was great ... then the withdrawals hit, terrible first week... felt like I was going to faint all the time and ended up in the ER. Everything was fine after all the tests were run, and sent home. On day 16 now and feeling better, some lingering symptoms like head tightness/tingling, and a bit of dizziness (nowhere near as bad), a few palpitations, and some temporary spikes in BP and HR ... oh, and on day two my teeth hurt ... haven't seen that one on the forums before.

I've been taking 50mg a day metoprolol for the last four years. It slowed my heart rate to about 45-50/min. Didn't help at all with my AFIB. So about three month ago I changed my cardiologists and now I'm under care of an EP. He added Flecainide to my medications list. About the same time I started keeping track and really analyzing my heart rate. Some days it was down to 40!
So I decided that I will now take only enough metoprolol to maintain my heart rate around 50.
Metoprolol also lowers blood pressure, so that needs to be monitored too and now I use the same approach with my blood pressure medications. So the end result is that on average I take one 25 mg metoprolol a day and some days I skip it all. Same goes for my blood pressure medications.

Some people have a genetic issue that makes them poor metabolizers of metoprolol. This is usually found out when a person faints, or has very low BP and heart rate after two or three doses of metoprolol over a single day. The problem is that you're not clearing it...metabolizing it, and when you take the next dose, it adds to what is still circulating in your system. Then, you take the third dose....you get the picture.

I couldn't possibly in good conscience say you ARE a poor metabolizer of metoprolol, but a trained technician can sample your blood and look for the genetic markers. It's a thought...something to keep in the back of your mind for the next consultation. Or, you're simply taking too much or too often.
https://www.aafp.org/pubs/afp/issues/2008/0601/p1553.html#:~:text=Genotyping%20for%20CYP2C19%20%2A2%20and,CYP2C19%2A3%20identifies%20most%20CYP2C19%20poor%20metabolizers.

Is anyone else taking Metropolol for heart rate? I have low normal BP, which makes it hard to take. I switched to evening but now I wake up five hours later and cannot sleep. Also I am losing my hair. I thought the Pacemaker would manage the heart rate better. It was implanted after an almost deadly prescription for Flecainide, which never should have been prescribed for someone with chronic AFib. It is contraindicated for us.

Is anyone else taking Metropolol for heart rate? I have low normal BP, which makes it hard to take. I switched to evening but now I wake up five hours later and cannot sleep. Also I am losing my hair.

Hello Everyone,
My recently fired cardiologist and GP told me to stop “(cold turkey)” taking my daily (prescribed for heart failure in November, 2019) metoprolol 37.5 mg. 08:00 hrs. and 37.5 mg 20:00 hrs. in May,20:2023. Then in June, 2023, he sent a fax to my pharmacist with instructions for me to stop taking (cold turkey also) my ramipril 2.5 mg. Three different internists, six or more general practitioners and at least six cardiologists, over the past 10 years, have OK’d prescriptions for zopiclone 7.5 mg, quetiapine XR 50 mg., AMITRIPTYLINE 25 mg, trazodone 100 mg, cipralex 25mg ,Escitalopram 20 mg, for my chronic insomnia. In addition, I also take Synthroid 88 mcg. for hypothyroidism. I repeatedly complained to every doctor of these aforementioned medical symptoms as well as their misdiagnosis and their treatments for insomnia. I have never been diagnosed for depression or any psychiatric disease in my life, but one would never know that after looking at the number of antidepressants that all these physicians and surgeons prescribe for insomnia.
The moral of this story is , if your physician or surgeon doesn’t listen to your description of symptoms and prescribes unrelated medication, do not hesitate to FIRE every one of them after getting second and third opinions from different doctors and then talk to your attorneys. I would love to hear your comments. Thank you.

Yes, I took metoprolol 25 mg in morning and lisinopril in the evening for about 15 years. They also gave me 80 mg furosemide in the morning. My bp was always below 100/60.
I moved, a new kidney doc changed the furosemide to morning and night. Along with restricted salt diet, I’ve lost 40-50 lbs. Bp dropped more, often 90/50 and I was woozy and short of breath. Heart was happy, it didn’t have to work very hard!
New cardiologist stopped the lisinopril completely. I cut metoprolol to 12.5 mg. PCP and cardiologist neither liked that. Now, they changed the metoprolol to 25 mg 2x a week. My weight kept dropping! Low potassium, also.
Now, I Use daily weighing to be the controlling factor for the furosemide dosage.he has me Limit more salt, too!
I feel better, but have chronic low potassium & palpitations at night when I lay down. Shift my body position and they settle down.
I’m Moving again in 6 weeks across country to east Coast to be near my son & family. Now, bp is around 115/75 most of the time. I’m struggling with my salt and fluid retention, but doing well. I’m 81 yrs old so just trying to maintain. Have dealt with some of this for 60 years! I’m still here, must be a reason.

I don't mean to sound contrary, but how do you know your 'standing' or average BP was 160/92, and that it then dropped to the last number you cited? Were these averaged over several readings each day? A single reading taken during the day is NOT an indication of a high pressure or a low one, and it does not constitute an accurate assessment. So, if you ran a cuff several times throughout several days, and then came up with that high systolic/diastolic, then you had something to worry about. The last pressure, even off metoprolol, suggests that it was probably closer to the real average value for you, but if it's a single measurement, no, it's not.

You probably reduced your dosage correctly, over time, and now your system is finding its equilibrium. To get a more reliable indication of your true BP, do what trained athletes know to do: take your resting HR first thing before you get out of bed, and use a calibrated device to get a BP at the same time. Then, ignore that first day's reading, but record it. Record a day each week for the next three weeks, and then take an average of the three records. That, more than anything will tell you what your BP really is, and that will be quite low. The rest of the day should be, if you're normal, all over the place. Chop cordwood and see what happens to your BP. A measurement taken during that effort will no more be an indicator of your real average BP than would a single measure of your heart rate.