How did you wean off Metoprolol?

Anyone who wants to ween off beta blockers should read my story.
I had a heart attack July 2015 and was placed on beta blockers (metoprolol). I was on 25mg to start, half a pill in morning and evening. Over a few months my pulse was dropping to 43 bpm and my BP was very low. My doctor recommended cutting the dose to half to see how I did. It helped a bit. (12.5mg) once a day.

About 2 months later - out of the blue, my heart started racing 155 bpm and my blood pressure spiked to 180/100. I had chest pain, difficulty breathing, sweating, dizzy... was positive I was having another heart attack. Off to the ER. They did ecg and trope, X-ray... all was fine and my symptoms abated over a few hours.

The next attack happened about 3 weeks later. Same thing. They gave me a hotter monitor and nothing. This went on for a year. I had several stress tests that said all was good. They prescribed lorazepam and told me it was anxiety attacks.
Sometimes my heart rate was 170+ and bp 225/130.
I was in hell. Doing vagel exercises and holding my breath in a bowl of ice cold water. The attacks started to get worse and more frequent. Sometimes waking me up at 4am. The lorazepam did nothing to abate - but still 4 cardiologists, a heart specialist and maybe 25 different doctors wrote it off to anxiety attacks. Yet, after almost 3 years of this, I had strong suspicion it was a rebound effect from the beta blocker.

I tried to ween off it very slow for 2 years. Once I was off for 3 1/2 weeks and then BAM, massive attack that actually registered a tiny trope test. So I had to go back on.

Finally, my heart specialist said let’s switch beta blockers- that metoprolol is a twice a day drug and I was only taking a small amount once a day. So we switched to bisoprolol 2.5mg (half a pill) once a day. This was in August 2018.

The attacks stopped completely. What was happening, yet nobody will admit, was the metoprolol was wearing off every evening before I took my next dose, or shortly after... my body started to produce adrenaline again, and since I had developed billions more adrenal receptors (from being on beta blockers - bodies reaction to the drug), my body would flip out and I would have a hypertension/tachycardia attack.

2 weeks later on the bishoprolol and I felt like crap. Dizzy, no energy, insomnia... but no attacks. Bp and pulse were low so we cut dose to 1.25mg. Felt like crap for a month... then started to feel a little better.
This January, I had had enough of feeling dizzy and no energy. One night my pulse went down to 40bpm and my BP was 190/110. Off to emergency I went. They did all the tests and nothing. So we decided to cut my dose to ween off. I was told by several doctors to just go off cuz it was such a small amount. But having read so much, I thought I should ween. So .65mg tiny thing.

It has been 2 weeks now and I’ve been to ER with crazy high BP twice - but it always comes back down after a few hours on its own. I keep having these attacks again and I’m 100% sure it’s caused by the beta blocker.

This time I’m going to power through even if it kills me. This is a nightmare drug and after almost 4 years of pure hell - I have had enough.

My understanding is although I may be off the drug for months at some point- there is still the physical manifestations of the extra adrenal receptors that will eventually deteriorate as my chemistry normals.

Couldn’t imagine doing this without God. Good luck everyone who is fighting this battle.

thank you for your reply...I count carbs less than 30 at a meal and less than 100 a day. I have a mix of berries with small dab of cool whip for treat at night. Metoprolol keeps me from losing. Strange but true. I am an old Atkins diet user. I came across Atkins back in 1977 back then Atkins was considered very very bad for your health. Doctors poo pooed the idea of cutting carbs out of a diet. Well look at us now. Medicine you know why it is called a practice? Perhaps one day they might get it right. Thanks again nice chatting.

I would suggest if you can't lose weight and you walk 2 miles per day (bravo!), you eliminate carbs from your diet. For breakfast: a smoothie with added powdered protein and made only with berries and/or melon (other fruits are too sweet and create hunger). A big salad loaded with green lettuce (not iceberg) and other fresh veggies with egg/chicken protein for lunch. A dinner of meat, 3 veggie servings and no pasta, potato or bread. Not only will the weight melt off, but inflammation in your body will decrease and you will feel so much better. See a nutritionist if need be.

I thank you all for comments. I have slowly weaned myself off the 3 tabs daily of metoprolol down to one daily at 10PM so that I will not be such a zombie. Last evening I only took 1/2 of the tablet. My BP this am was 178 over 92 not good but lower. I have researched the side effects I know it is supposed to lower BP somehow my body is reacting differently. I do not smoke quit 48 years ago. I do not drink. I take nothing but clonidine, metroprolol, glipizide and metformen for diabetes small dose of aspirin that is all. I keep my diet at 1200 cal sodium less than 1000 gms and carbs less than 100 daily. I walk about 2 miles a day Still I cannot lose weight. EXCEPT the few days I stopped the metoprolol I lost 4 lbs. a first for me since I started taking the drug. We will see how it goes with me just taking .03 clonidine every 6 hrs I will keep posting. Again I truly appreciate all the advice given. Judy
PS I made an appointment with another medical provider today will be seeing him in April

Source #1
""Using metoprolol and clonidine together may lower your blood pressure and slow your heart rate. Using these medications together can cause a slow heartbeat, headaches, dizziness, or feeling like you might pass out. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or need your blood pressure checked more often to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.""

Source#2
""On the contrary, beta adrenergic blockers may also potentiate the hypertensive response to withdrawal of clonidine in patients receiving concomitant clonidine and beta-adrenergic blocker. If a patient is treated with clonidine and Metoprolol Tartrate concurrently, and clonidine treatment is to be discontinued, stop Metoprolol Tartrate several days before clonidine is withdrawn. Rebound hypertension that can follow withdrawal of clonidine may be increased in patients receiving concurrent beta-blocker treatment.""

Comments:
It appears that Metoprolol can cause hypertension if Metoprolol and Clonidine are taken together and Clonidine is discontinued. An interesting situation. Although this isn't your situation, it shows that an unexpected reaction can occur if both are taken together under specific circumstances. If I were you, I'd be sure to:

• See another doctor for a 2nd opinion.
• Carefully tell him or her of my research.
• The above potential interaction between Metoprolol and Clonidine as detailed under specific circumstances.
• The possibility of Idiosyncratic Reactions, where medications, or hypothetically combinations of medications, produce reactions opposite to the intended reaction.
• I would divulge all medications, supplements, herbs, vitamins, alcohol, tobacco, and other items used or consumed. There's a chance that something isn't being metabolized as intended, doctors need to know everything a person is exposed to.
• I'd consider looking for a good Endocrinologist.

I do not think my doctor is helping me. I have diabetes and high blood pressure. I am 73 i weigh 180 female. Gall bladder out at 18. Complete hysterectomy at 46 endometriosis stage 4 and fibroid turmors. They sliced the aorta I had 14 units of blood transfused. They also cut the ureter and forgot to take the stint out for 6 months until I complained of pain. Uncontrollable blood pressure started 6 years ago overnight it had always been 110 over 70 never over 125/80 overnight it went to 210/115 and continued to be high. In the doctors office at times 235/130. They just sent me home. Meds are clonidine .03 3 times a day. Metoprolol 100 gm 3 times daily. I am a zombie cannot keep my head up lost hair dry mouth. Brings my pressure down to 180/101 bounces around at that.
I did some research and found metoprolol can intefer with clonidine making them ineffective. My doctor hates when I try to ask her for changes she threatens to fire me. quit me as a patient. So I tried on my own. I weaned myself down to one Metoprolol at night. Continued the clonidine. My blood pressure dropped to 170/90 stayed low until time to take the Metoprolol I took one 100gm tablet and blood pressure spiked to 201/102 stayed that way for about 8 hrs then came down some. Next day I skipped metoprolol blood pressure came down to 120/80 stayed around there all day. I read about cold turkey of metroprolol said it could be dangerous so I am took it again blood pressure is back up 187/99. Doctor will not take me off Metoprolol I told her and she yelled at me said self medicating is going to kill me. I do not know the answer. Any one have any ideas This high blood pressure is bad. Oh on top of that the two days that I did not take metoprolol my blood sugar dropped from 250 to 126 whats with that?

All I take is metoprolol and vitamin d3.

Are you taking statins also? Statins can cause muscle pain and loss. If you are, there is a recommendation to take CoQ10 supplements as well.
I take both statins and metoprolol tartrate, also at 12.5 mg twice per day. I doubt my pains are due to the latter, but I've never tried eliminating them. I also cut mine to half dose because of the effect it had on my heartbeat.

I've been on metoprolol about 8 months for one bout of afib. I was prescribed 25mg twice daily. I took that for 2 days and my pulse was in the 40s so went down to once a day. It was still low 50s so I went to 12.5 and have been on that for most of the time. My resting pulse is mid 60s which is lower than it's been my whole life. I'm sensitive to most drugs and metoprolol I think is one of them. I'm having terrible back and hip pain to the point of it affecting how I walk. I've told my cardiologist and my pcp but they both say metoprolol isn't the cause especially at such a low dose. Tonight I started halving the 12.5 and will use that for a week and then stop. If after a few weeks if the pain goes away I'll know it was the drug and see what alternative drug is suggested by my cardiologist. Has anyone else had back and hip pain?

Oh heck no. I'm on nearly 400 mg of Metoprolol Succinate in divided doses, and 500 mg of Dilantin in divided doses, and taking Ranitidine (Zantac), Singulair, and Xyzal (all three of those for Chronic Urticaria) and Zocor for Cholesterol, according to literature, I should be a babbling sleepwalker, but honestly, I feel fine.

Results vary between individuals, in no way, shape, or form am I insinuating that certain people aren't experiencing brain fog even with lower doses, we all react differently to medications, I just wanted to assure you Brain Fog isn't necessarily a result.

One caveat. Dilantin can depress Vitamin D levels, and lack of sunlight in the winter the same, and at one time I'd get Seasonal Affective Disorder (SAD) so on my own, I started taking 2000 IU of Vitamin D3 once a day, 365 days of the year, and it made a HUGE difference in my Seasonal Depression, I'm not sure if it helps with cognition too. Always consult with your doctor or pharmacist before adding supplements, either vitamin or minerals.

Here's just one of the interactions possible between Vitamin D3 and one of the prescriptions I take, but my doctors are aware that I take it and the Neurologist tested me to be sure I was taking enough, which I am. Plus I'm not taking a High Dose of vitamin D3:

""MONITOR: Coadministration of thiazide diuretics with high dosages of calcium and/or vitamin D has been associated with reports of hypercalcemia in some patients. Thiazide diuretics inhibit the renal excretion of calcium and may also enhance responsiveness of bone and renal tubule to parathyroid hormone, thus concurrent use of large amounts of calcium or vitamin D can lead to excessively high plasma levels of calcium. Patients who are particularly susceptible include those with hyperparathyroidism, those being treated for osteoporosis, and those receiving high dosages of vitamin D for hypoparathyroidism. Metabolic alkalosis and the milk-alkali syndrome have been reported during prolonged therapy with thiazide diuretics and calcium.""