How did you wean 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.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

I only took the drug for a month & had some terrible side effects. I did like you cut the pill in half & weened off it.

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I have 20k heart pvcs. Will have a ablation March 12th. Hopefully no more medication after that

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@glr702

Hello,
I took propranolol 10mg 4 times a day for a week. Had horrible side effects, was switched to metoprolol succinate 25mg once a day for 2 weeks, felt a little better but still many side effects, so I was on them for about 3 weeks only. I tapered down and took the last dose 6 days ago. The first day was horrible, then a little better the second, same on the third. However, I’m still having palpitations, dizziness, head feeling weird, some tachycardia (somewhat less today), weakness. I’m much better than when I was on the medication, that’s for sure. I had almost all of the side effects I could get and even ended up dehydrated in Urgent Care, also got anxiety for the first time in my life which has been horrible. So, my main question is: am I any close to the end of this road? I don’t know if I’ll ever be able to feel like myself again. I was put on this for occasional hypertension and tachycardia, which I believe was caused by stress. I would appreciate it so much if someone could help me with their experience. Thank you so much

I’m listing all the side effects I had with these medications, sorry for the long post:
✔️Blurred vision
✔️chest pain or discomfort
✔️like electrical current in head
✔️tingling, chills like on arms, back and head
✔️confusion
✔️palpitations
✔️dizziness, or lightheadedness when getting up suddenly from a lying or sitting position
✔️hair loss
✔️dry mouth
✔️hot flashes/heat intolerance
✔️sweating
✔️unusual tiredness or weakness
✔️insomnia, nightmares
✔️soft stools
✔️difficult or labored breathing
✔️difficulty with speaking
✔️extreme tiredness or weakness
✔️fast, pounding, or racing heartbeat or pulse
halos around lights
✔️headache
✔️overbright appearance of lights
✔️lose weight
✔️seeing, hearing, or feeling things that are not there
✔️tightness in the chest
✔️tingling of the hands or feet
✔️troubled breathing
✔️continuing loss of appetite that got to the point when only could eat liquids
✔️continuing abdominal pain
✔️continuing nausea
dark urine
✔️difficulty with moving
fever
✔️general tiredness and weakness
✔️hoarseness
✔️increased frequency of urination
✔️muscle pain
✔️sore throat
✔️sores, ulcers, or white spots on the lips or in the mouth-white tongue
✔️unpleasant breath odor
✔️weakness
✔️anxiety

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How long did it take to feel better after discontinuing? Was your blood pressure still high after going off the metoprolol?

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@rezon8r

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.

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Hi,
How's its been since you've weaned off? I'm currently going through the process.

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@cturner01

I only took the drug for a month & had some terrible side effects. I did like you cut the pill in half & weened off it.

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How have you been since then?

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@atorgers

I was on metoprolol Er 25 mg for about 3 months. My ep then lowered it to 12.5 and now I split that. How long do the side effects last for? I’ve been weaning for about a month now and it is still kicking my butt. Get lightheaded, nausea, been to the ER with tachycardia and they do the normal tests and all come back normal. Scheduled for an ablation on March 5 th to take care of this and the PVCs I’m having. Any help is greatly appreciated!!! I’m also on flecainide and losartan. Just need to get off all of these horrible medications!

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Good luck with your surgery! How are you doing now?

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@silverkat

I took it too, but was suffering from rashes. My doc changed it to carvedelol. which seems to be okay.

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I've been getting terrible rashes too..

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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?

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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.

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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?

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