Weaning off Metoprolol

Posted by kenny48 @kenny48, May 11, 2018

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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@afrobin

Hello Ellamster, I think I have written about my experience of getting off a beta blocker( for the worst case of Afib the cardiologist had ever seen) about 5 times so I won't go into it all again. Suffice it to say that I went from 320 mg of Sotacor per day (the cardiologist said it was a lethal dose and to lower it) to zero through exercise. I pushed my heart every day on a treadmill. It kept beating at 80 beats per minute but I guess it did my heart good because finally I was able to lower the dose as the cardiologist wanted and did so in increments. It remained steady. Like you, last year, I did have a stressful experience and was back on beta blockers for just a few days actually. LOL I just steer clear of ANY and ALL stimulants and that includes sugars and carbs to some degree. No alcohol, chocolate, coffee or tea. And all is kept nice and steady. I maintain that WE can do so much by tuning in to our bodies, doing our own research and altering our lifestyle.

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Sotacor mentioned is known by many as Sotalol, just a note for other readers. Strange how I've become more tolerant to physical exertion, but emotions seem to exacerbate my Afib. It all gets back to the AV node that controls the rate of signals passing from the top of the heart to the bottom. For those that can that are more physically fit have a naturally slower rate than those that aren't physically fit. And the AV Node is controlled by the Sympathetic and Parasympathetic Nervous System, so emotions can create the opportunity for a faster rate in people without Afib, governed by the SA Node, but in those of us with Afib, the Afib (fast Atrial Rate) makes it through the AV node more often and symptoms occur.

This still has me obsessed, a life time of periodic assaults by PVCs has made me hyper aware of my heart, I feel every variation (well, most at least) from normal. I had/have the chance to be converted, but reading the literature on Sotalol, something that was going to be used to prevent recurrence, it says only to be used in highly symptomatic patients and I'm not highly symptomatic. One Cardiologist that does ablation for Afib got to experience it for himself, and though he converted pharmacologically, he said some people have mild Afib and horrible symptoms and others have horrible afib and mild symptoms, he said it's an enigma, just unpredictable. Ugh.

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…and, Soliloquized, if you want to get your heart REALLY thumping and exacerbate Afib, you can watch the YouTube series, Nightmare Neighbour Next Door! Love the gardens, the accent…and the crazy (gunless) way neighbours settle their disputes! My daughter showed me how to watch the shows on the TV through our 'Google assistant'.

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@afrobin

…and, Soliloquized, if you want to get your heart REALLY thumping and exacerbate Afib, you can watch the YouTube series, Nightmare Neighbour Next Door! Love the gardens, the accent…and the crazy (gunless) way neighbours settle their disputes! My daughter showed me how to watch the shows on the TV through our 'Google assistant'.

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I'll have to give it a peek. We watch via the Roku, and for non-YouTube videos on other sites, often you can Video Cast them from the Tablet Computer through the Roku. It just sends the video address to the Roku, somehow, you can shut the tablet off once the video starts.

I get emotional about music. Not listening often, I could drive across the country and back and never turn on the radio. But when I listen, I listen to evocative stuff, some quite weird, some classical, a lot of Electronic music, but darn, my afib acts up then, too, short runs breaking through, not really runs per se, just faster than my resting heart rate at the time for several beats.

I went to get my PTINR taken for the Coumadin, and I got into an altercation with another driver, it took hours for my heart to settle down. But I'm talking resting Heart Rate in the 60s, and after the altercation, it was in the 80s, but before this all started, on medication, it was in the 50s.

Nightmare Neighbour Next Door, maybe tonight. If I remember, I'll take my heart rate before and during. LOL.

Thanks.

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To medicate or not to medicate: When Afib hit me out of the blue at age 46 (when my mother was dying), the cardiologist told me that out of ten patients he sees with arrhythmia, he only treats one. The cardiologist also said that he doesn't treat anyone who has arrhythmia who doesn't have serious symptoms like shortness of breath, weakness or feeling faint. He told me that many patients come in with PVCs and he does not medicate. My 38 year old daughter has skipped beats but no other symptoms so she is not medicated. The cardiologist put me on Sotalol/Sotacor and it required a massive dose just to keep my heart in rhythm…until I found that lifestyle changes CAN and DO treat and even cure cardiac arrhythmias as it did with me.
Could it be that because the US is such a litigious country unlike any other and is Big Pharma's biggest client, doctors are afraid NOT to medicate for fear of a patient having a cardiac event and blaming it on the doctor for not having medicated him or her? And you can be sure that Big Pharma, to set the example, would be there in court to back up the client who was 'denied' a drug. Doctors medicate often to protect themselves more than the patient…and can you blame them?
I live in Canada where you can sue for malpractice but you won't get much. My friend's, healthy and active 85 year old mother bled to death because a medical procedure was done on her without take her off blood thinners. It was clearly the fault of the doctor, hospital, nurse…anyone who looked at her medical records leading up to the procedure. The tearful and devastated, young doctor apologized profusely to the family. They let it go. This would not happen in the US.

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@soliloquized

I'll have to give it a peek. We watch via the Roku, and for non-YouTube videos on other sites, often you can Video Cast them from the Tablet Computer through the Roku. It just sends the video address to the Roku, somehow, you can shut the tablet off once the video starts.

I get emotional about music. Not listening often, I could drive across the country and back and never turn on the radio. But when I listen, I listen to evocative stuff, some quite weird, some classical, a lot of Electronic music, but darn, my afib acts up then, too, short runs breaking through, not really runs per se, just faster than my resting heart rate at the time for several beats.

I went to get my PTINR taken for the Coumadin, and I got into an altercation with another driver, it took hours for my heart to settle down. But I'm talking resting Heart Rate in the 60s, and after the altercation, it was in the 80s, but before this all started, on medication, it was in the 50s.

Nightmare Neighbour Next Door, maybe tonight. If I remember, I'll take my heart rate before and during. LOL.

Thanks.

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You are on Coumadin and a beta blocker? When unmedicated, do you only have occasional skipped beats and an increased heart rate (into the 80s)? If so, you would fall into the unmedicated category with my cardiologist. Years ago, once on the beta blockers, I didn't need a blood thinner because my Afib was well controlled. Currently, my heart rate at total rest (watching TV) can be 110….after eating a sugary food. Otherwise it's a normal 80 beats per minute. My cardiologist told me not to be concerned about the 110 beats. He says that I should only be concerned if my heart rate is up above 160.

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@afrobin

You are on Coumadin and a beta blocker? When unmedicated, do you only have occasional skipped beats and an increased heart rate (into the 80s)? If so, you would fall into the unmedicated category with my cardiologist. Years ago, once on the beta blockers, I didn't need a blood thinner because my Afib was well controlled. Currently, my heart rate at total rest (watching TV) can be 110….after eating a sugary food. Otherwise it's a normal 80 beats per minute. My cardiologist told me not to be concerned about the 110 beats. He says that I should only be concerned if my heart rate is up above 160.

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Life time of PVCs. On and off. One doctor offered anti arrhythmic drug, I declined because my situation technically wasn't dangerous. He switched me from Atenolol to Acebulolol, the PVC occurrence plummeted. All was well.

Incidentally, it was too much quality chocolate at Easter that started my worse episode of PVCs that lasted months, that was the cause of the PVCs above.

Years went by. The usual stuff, periodic tests, everything's OK. Last November, the afib started. They were going to do a Adenosine Stress Test, that would have been followed by a Heart Cath. My wife worked for a cardiologist that was not infrequently angry at these extra tests, he believed there is a group of doctors that get a cut of the insurance by doing needless tests. I told them no stress test, get rate controlled, anticoagulation in place, and I'll see my own doctors.

My cardiologist is very well known, he saw no reason for the stress test, neither did my family doctor, and, in a way, I had one. They withheld the Metoprolol, most of it, on the day of the stress test I refused. Having been told that I'd have an Echo Cardiogram the following morning after admission, here it is, three days later and still no test. So they sent me for one, prior to discharge, or so I thought. During my echo cardiogram, my heart rate was 160, I didn't even know that, but they refused to discharge. They finally gave me the full Metoprolol, I was discharged the following day, and they bumped it up more. My cardiologist bumped it up more still.

The Echo Cardiogram was normal, the same as one I had last year, except afib was now present. The same doctor, also very well known, interpreted both. But think, it was done with my heart at 160, I'd think I'd have chest pain if there was restriction, and there should have been additional changes in the EKG.

I'd rather have a normal rhythm, but converting, and maintaining it isn't without risk too. The literature on Sotalol says Highly Symptomatic patients should only use it, I'm not, at that point. Younger patient's are similarly given Sotalol, it's a quality of life thing.

I just read an article the other day, urging doctors not to over medicate Afib patients, the article cited 110 as a target heart rate, interesting yours said the same. I was used to mine in the 50s, I'm in the upper 60s at rest now. (Summer will probably be higher).

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Wheezing on. Metoprolol for afib

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@afrobin

Are you sure that your Afib did not return? Apparently some people are not aware that their hearts are out of rhythm. I don't get how that can be because it's like a huge thumping in the chest and needing to take extra breaths to get enough O2 in the system etc.. In any case, be careful. How are you going to keep your Afib at bay? You can't just expect it not to return. Something has to change. You need to be proactive. The cardiologist advised me to avoid ALL stimulants; alcohol, chocolate, Coke, any drugs or supplement with ephedrine in them, too many carbs especially sugar, being around cigarette smoke and avoiding very stressful situations. But what cured me of my serious case of Afib was exercise; pushing my heart. A walk didn't work. It had to be where I was working up a sweat. I suggest you really research and learn about your condition. My aim is to know as much as my doctor, if not more. I also cured myself of bladder infections..no thanks to my urologist. I had 28 in a row inside a 2 year period. Now gone! Become ultra informed about how your body works, reacts to meds and food and exercise etc… Good luck to you. Keep well!

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How did you cure yourself of bladder infections? Please share!

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@geckotee84

How did you cure yourself of bladder infections? Please share!

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Hi Don't get me started (lol) I had 32 UTIs pretty much back to back…except when I started vaginal estrogen (which is a standard therapy). I had a 4 month break but my doctor urged me to get a cystoscopy and I got an infection from it and from then on in it was UTI after UTI…which meant 32 rounds of antibiotics. I think we all know how they destroy the good bacteria in the gut. And since the gut is where 80% of the immune system resides, I was very concerned about my ability to fight infection; little and big..like cancer for example. Long story short, my urogynecologist, Dr Walter in Montreal, suggested I try a new and promising, well researched, over the counter supplement called UTIVA. I fully expected it NOT to work because I had tried everything up to that point including d-mannose, cranberry supplements, vaginal and oral probiotics, drinking lots of water, the vaginal estrogen etc..Dr Walter explained that Utiva is not a cure. It must be taken daily preventatively. So, I ordered the Utiva on line from Utiva Health and started taking it AFTER I just finished antibiotics (for infection #32 in 3 years). I waited for the next UTI…it never came! And here I am about 2 1/2 months later, UTI free! I wish I could share this with others like me who basically live on antibiotics, never feel 100%, with the threat of a kidney infection hanging over their heads. This thread should probably be moved to the kidney/UTI section…where I have written about my experience with Utica.

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Cystitis is gross. Fortunately I haven't had outbreaks since I stopped being sexually active. Can you tell us what UTIVA is? Sulfa always used to work for me, but it's not allowed with Dofetilide (Tikosin) which many of us use.

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@soph

Cystitis is gross. Fortunately I haven't had outbreaks since I stopped being sexually active. Can you tell us what UTIVA is? Sulfa always used to work for me, but it's not allowed with Dofetilide (Tikosin) which many of us use.

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It is derived from cranberries BUT it is not d-mannose.The owner of Utiva told me that in their clinical trials done in the US, d-mannose combined with Utiva actually diminished the effect of Utiva. I was also told that if I felt a UTI coming on, to just double up on the Utiva…which I did for 2 days at one point.The day before the onset of UTI symptoms, I had eaten a lot of carbs at a party and as always that is a UTI trigger. I still continue to shower morning and night to be sure I am 'clean' and I take the vaginal estrogen which is absorbed almost totally locally I am told and the Utiva. The most important thing to understand is that Utiva is to be used preventatively; in other words right after antibiotics when one has NO infection in the bladder. That is key.

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Thanks, and for those of us who use Warfarin as a blood thinner, we might have to check out if using Utiva is like using cranberries. Cranberries intensify the blood thinning of Warfarin, so you have to check it out and perhaps use less Warfarin with the Utiva in order to get the right INR. It's easy to make this adjustment if you are careful to do the same doses of both every day.

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@soph

Thanks, and for those of us who use Warfarin as a blood thinner, we might have to check out if using Utiva is like using cranberries. Cranberries intensify the blood thinning of Warfarin, so you have to check it out and perhaps use less Warfarin with the Utiva in order to get the right INR. It's easy to make this adjustment if you are careful to do the same doses of both every day.

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Excellent point on cranberries / warfarin. I drink cranberry juice if INR is way too low.. too many greens. It doesn’t affect INR much I discovered. But best to check any cranberry based product.

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@kenny48

Ok, took my half dose for two days, today I'm supposed to stop entirely. I am feeling like a zombie. No get up and go, lightheaded. My BP is higher than it usually is but not thru the roof. 133/84 after doing some deep breathing exercises. Was 140/92 before. Doc said to go to emergency if it goes over 180. But that was the only thing they said to me. They said nothing about feeling like this. Mentioned some people get tachycardia. My heart rate is better than it was before 60,61 BPM but I feel so weak. They said nothing about this. Is this normal? When I asked about the tape off time, they said it's because I was only taking 25mg a day. Said it's a low dose, and I don't have to worry.

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Three years of heart disease and have improved alot. 80%. But, I think it can make you depressed. You might need to see a therapist or a group. My cardiology dept does not have a support group, but some do. I'm also into animal therapy, pet the neighbors cats and dogs whenever I see them. Also visit neighborhood horse ranch and commune with horses. Move beyond the physical realm and feed the heart the nourishment of love.

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@jlbyrd975

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?

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Hi..i too have been on metropolol for 7 months .
I bounce between 50mg a day and 25…i think ive never gotten used to this and want to weane off it..i too have been sufferin lately from back and hip pain…
I too was put on it for 1 bout of afib. I also think every 2 months it makes me dizzy and naeuseas…were u able to come off it successfully…thanks colin

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