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.

@sue225

About a year after starting Metoprolol, my normally low blood pressure, (which initially went even lower on Metoprolol) started to climb. Cardiologist thought this was normal part of the aging process. Since it was sometimes high and sometimes not, I had the bp monitor test done and was told to monitor at home. Anyway, I thought it was weird that this was happening. Coincidentally, my appt with the specialist for osteoporosis was around this same time. Bloodwork showed my VitD levels were low. Started taking VitD religiously (1000iu to 2000iu daily). Within a few months, blood pressure back to my normal/low level and it has stayed that way.
I asked a bp specialist if there was a connection and he said there had been some small studies done showing a link.
So far no new meds needed!

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My email backed up. Sorry for taking longer to respond. I'll keep your discovery in mind. My neurologist tested the Vitamin D3 levels, and it's good, she was concerned I wasn't taking enough.

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@healthytoday

It's possible to take too much vit d, Do ur homework.

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The level quoted in this article on MayoClinic is 30 times higher than the 2000 IU that I take. I don't believe in Mega Vitamins myself, but 2000 IU has been beneficial for me. For those on Medications, or with illnesses, consulting a Doctor might be best before taking any supplement.
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-toxicity/faq-20058108

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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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Yes I've been taking Metoprolol succinate. Metoprolol succinate is an extended-release version of metoprolol, so it remains in your bloodstream for a longer time. Metoprolol tartrate is an immediate-release version of metoprolol.

I started 12.5 mg once daily for over a year now for a fast resting heart rate, and yes I am having growing problems with muscle cramps, spasms, stiffness and joint pain which makes no sense to me. It has caused a lot of anxiety and making it difficult to walk. I contacted my cardiologist and PCP and both stated definitely not to quit, reduce the dosage until something else could be prescribed.

Unfortunately, I lost my medical insurance and could not make an office apt to see the cardiologist or PCP for a different prescription naturally they would not prescribe another medication without seeing me.

The muscle spasms, cramps and stiffness are definitely a side effect. On some websites it's considered "less common" but it is listed (also on the Mayo Clinic website)

After significant research I found that metoprolol has an "anti-anxiety" agent which relaxes and lowers the heart rate. This can make it difficult for some people to quit cold turkey because after long term use the body can build a dependence on it so after consulting your doctor, reducing the dosage until another medication is prescribed makes sense for some.

Also, there are some people who are sensitive to Beta Blockers, I'm also one of them. I have searched and searched to understand what specifically in metoprolol causes this condition but can't find anything that explains it.There may possibly be vitamin or supplement that may help?

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@alwayshope1

Yes I've been taking Metoprolol succinate. Metoprolol succinate is an extended-release version of metoprolol, so it remains in your bloodstream for a longer time. Metoprolol tartrate is an immediate-release version of metoprolol.

I started 12.5 mg once daily for over a year now for a fast resting heart rate, and yes I am having growing problems with muscle cramps, spasms, stiffness and joint pain which makes no sense to me. It has caused a lot of anxiety and making it difficult to walk. I contacted my cardiologist and PCP and both stated definitely not to quit, reduce the dosage until something else could be prescribed.

Unfortunately, I lost my medical insurance and could not make an office apt to see the cardiologist or PCP for a different prescription naturally they would not prescribe another medication without seeing me.

The muscle spasms, cramps and stiffness are definitely a side effect. On some websites it's considered "less common" but it is listed (also on the Mayo Clinic website)

After significant research I found that metoprolol has an "anti-anxiety" agent which relaxes and lowers the heart rate. This can make it difficult for some people to quit cold turkey because after long term use the body can build a dependence on it so after consulting your doctor, reducing the dosage until another medication is prescribed makes sense for some.

Also, there are some people who are sensitive to Beta Blockers, I'm also one of them. I have searched and searched to understand what specifically in metoprolol causes this condition but can't find anything that explains it.There may possibly be vitamin or supplement that may help?

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I was told by my cardiologist that you cannot stop metoprolol cold turkey as doing so can cause serious heart problems.

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Hello Always Hope,
After a period of AFib where I did not have 3 steady beats in a row all day, every day..to the point where I felt faint all the time and the Holter monitor malfunctioned. I was put on the maximum dose of a beta blocker, Sotalol. I felt like an old lady but I was only 46 years of age. For almost 2 years I took that drug. The cardiologist told me that my heart could stop at such a high dose and to try to reduce it even by a bit. Try as I might, even cutting out 1/2 a tablet of the 4 I was taking daily, sent my heart into a tailspin.
I read that exercise can reduce arrhythmia and palpitations and I joined a gym. I went every day but Sunday for 35 minutes on the treadmill and then strength training for another half hour. I gradually reduced the dose of beta blocker and my heart remained steady. I was elated! At the end of a month, I was completely off the beta blocker.
My cardiologist said it wouldn't last. I kept going to the gym for 4 months. My heart remained strong and steady…and here I am 24 years later and my heart is fine. No issues whatsoever.
But I am sure half the secret is: since that dark period 24 years ago, I have cut out all stimulants; absolutely no coffee, tea, Coke, decongestants, any ephedrine drugs used in dental freezing or supplements that can be stimulating and alcohol. I have a friend with AFib who prefers to take the beta blocker so that he can enjoy his wine and morning coffee. For me…no thank you! I would rather be off those drugs and their horrible side effects.
Whenever you can, go the 'changes to one's lifestyle' route. Exercise and avoiding stimulants. It worked for me and my extreme AFib. So, it stands to reason that it CAN work for others.

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@sue225

I was told by my cardiologist that you cannot stop metoprolol cold turkey as doing so can cause serious heart problems.

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Exactly! That is just what my cardiologist told me. Over a month I gradually tapered off the beta blocker.

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@afrobin

Hello Always Hope,
After a period of AFib where I did not have 3 steady beats in a row all day, every day..to the point where I felt faint all the time and the Holter monitor malfunctioned. I was put on the maximum dose of a beta blocker, Sotalol. I felt like an old lady but I was only 46 years of age. For almost 2 years I took that drug. The cardiologist told me that my heart could stop at such a high dose and to try to reduce it even by a bit. Try as I might, even cutting out 1/2 a tablet of the 4 I was taking daily, sent my heart into a tailspin.
I read that exercise can reduce arrhythmia and palpitations and I joined a gym. I went every day but Sunday for 35 minutes on the treadmill and then strength training for another half hour. I gradually reduced the dose of beta blocker and my heart remained steady. I was elated! At the end of a month, I was completely off the beta blocker.
My cardiologist said it wouldn't last. I kept going to the gym for 4 months. My heart remained strong and steady…and here I am 24 years later and my heart is fine. No issues whatsoever.
But I am sure half the secret is: since that dark period 24 years ago, I have cut out all stimulants; absolutely no coffee, tea, Coke, decongestants, any ephedrine drugs used in dental freezing or supplements that can be stimulating and alcohol. I have a friend with AFib who prefers to take the beta blocker so that he can enjoy his wine and morning coffee. For me…no thank you! I would rather be off those drugs and their horrible side effects.
Whenever you can, go the 'changes to one's lifestyle' route. Exercise and avoiding stimulants. It worked for me and my extreme AFib. So, it stands to reason that it CAN work for others.

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Hi AF Robin, It's taken me a while and a lot of research to understand why I'm feeling this way, And by the grace of God in His wisdom He led me to the Mayo Clinic forum for more help and info. Unfortunately, now my mobility is diminished. I have still been taking the 12.5 mg in the morning. How did you gradually reduce your dosage? Thank you for the great advice and God Bless You.

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I am wondering about how to wean off Metoprolol also. I had panic attacks as a teenager, and they disappeared once I was older. Once I was placed on Metoprolol XL 25mg, I began having more anxiety attacks which seen to be getting worse. I tried getting off of this with my University of Michigan physician but I felt terrible the entire time. I want to wake up late on the weekend. I want to go out of the country without thinking about having to take my pill on time. If not taken without 15 to 20min of the normal time, I begin having palpitations and panic. I want my life back.

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@dr010196

I am wondering about how to wean off Metoprolol also. I had panic attacks as a teenager, and they disappeared once I was older. Once I was placed on Metoprolol XL 25mg, I began having more anxiety attacks which seen to be getting worse. I tried getting off of this with my University of Michigan physician but I felt terrible the entire time. I want to wake up late on the weekend. I want to go out of the country without thinking about having to take my pill on time. If not taken without 15 to 20min of the normal time, I begin having palpitations and panic. I want my life back.

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"I want my life back." Yes, me too. Before I developed afib and heart failure two and a half years ago, I was a very active person on a ranch. But this illness took me down. I am lot's better, heart failure corrected etc. and also am on Metoprolol which is taken to slow the heart rate. This is working fairly well but I have little physical energy. Part of Metoprolol's job as I understand it, is to keep the heart rate lower and when I start exercising I am fighting this med not allowing the rate to move much higher. It's a confusing thing for my need for movement and my heart's need to not beat too fast. Yes, I'd also like a normal heart function but at 71 I am where I am. Trying to be at peace with this process, not able to make plans that can't be changed because I might be having a difficult heart day etc. On the other hand, I am grateful I function as well as I do and the illness is being managed.

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My experience was that being physically active allowed me to lower my beta blocker dose. When I kept up the exercising month after month, I was able to get off the beta blocker completely. Of course, I NEVER drank coffee, tea, alcohol, went near smokers, or took any stimulant like decongestants etc.. I know I keep writing the same story but I can't tell who has read about my AFib cure. This happened when I was 46 over a 2 year period. Now I am 70 years old and have had the odd blip and skip but it is usually because I had some chocolate (stimulant) or a sugary meal. That scares me into total compliance with the 'NO stimulating foods or drugs regime'. I wish the same experience for everyone.

Liked by Soliloquized

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@healthytoday

"I want my life back." Yes, me too. Before I developed afib and heart failure two and a half years ago, I was a very active person on a ranch. But this illness took me down. I am lot's better, heart failure corrected etc. and also am on Metoprolol which is taken to slow the heart rate. This is working fairly well but I have little physical energy. Part of Metoprolol's job as I understand it, is to keep the heart rate lower and when I start exercising I am fighting this med not allowing the rate to move much higher. It's a confusing thing for my need for movement and my heart's need to not beat too fast. Yes, I'd also like a normal heart function but at 71 I am where I am. Trying to be at peace with this process, not able to make plans that can't be changed because I might be having a difficult heart day etc. On the other hand, I am grateful I function as well as I do and the illness is being managed.

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We all respond differently to medications, to some degree. But I'm taking, for various ailments:

Phenytoin 500mg as 200mg AM and 300mg PM

Metoprolol Succinate 350mg as 200mg AM and 150mg PM
Metoprolol Tartrate 25mg mid afternoon.

The Metoprolol, my pharmacy had to clear the extra little bit of Metoprolol Tartrate with my doctor. The Max dose of succinate is 400mg, of the tartrate is 450mg. I'm under the Max in both cases, but that little bit, mid afternoon, makes the day smoother heart rate wise for me. And the Max dose can be exceeded under a doctor's instruction for many medications.

Singulair
Xyzal
Zocor
Levothyroxine
Coumadin

If you read the drug monographs individually, you'd think it was impossible I'm still awake, but not uncommonly I'm up by 4:30 AM through 10:00 PM, so they're certainly not having the negative effects that one would think. I'm almost 62, retired, I'm not as active as I used to be.

I'm in afib, I had the opportunity to be electrically cardioverted, but I was to be put on Sotalol. Reading the literature on Sotalol, it says it should only be used in "Highly Symptomatic" patients. I'm not highly symptomatic, no dizziness, no shortness of breath, just those darn flops in my chest and irregular rhythm. Today is bad, I suspect too much salt in Easter Food, or just too much food. On the days when it's calm, I feel I made the right decision in not getting Cardioverted, but days like today, I wish I had.

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I am curious; do you drink coffee, tea, alcohol etc.? Do you get out every day for exercise? These can make a huge impact on your conditions as I said above.

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@afrobin

My experience was that being physically active allowed me to lower my beta blocker dose. When I kept up the exercising month after month, I was able to get off the beta blocker completely. Of course, I NEVER drank coffee, tea, alcohol, went near smokers, or took any stimulant like decongestants etc.. I know I keep writing the same story but I can't tell who has read about my AFib cure. This happened when I was 46 over a 2 year period. Now I am 70 years old and have had the odd blip and skip but it is usually because I had some chocolate (stimulant) or a sugary meal. That scares me into total compliance with the 'NO stimulating foods or drugs regime'. I wish the same experience for everyone.

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The Parasympathetic Nervous System acts as a Brake for heart rate. I never realized how much until the afib started. Metoprolol does a great job controlling rate, but I had an altercation with another driver recently, OMG, what was I thinking. Although the rate probably didn't go above 100, it hasn't been near that at rest in awhile, more like the 70s at rest, 90s after climbing the stairs. It took hours for my heart rate to return to normal. Adrenaline causes a higher rate, the parasympathetic nervous system brings the rate down, but something that upsets it lets the rate go, or remain, high.

Reading a medical article recently, the doctor said when they see heart rates above X amount, it means Parasympathetic Response has been withdrawn entirely.

So, in those approved to exercise, and in those cases exercising commensurate with their doctor's oversight and in ways approved by the doctor, increased conditioning brings increased parasympathetic tone and a naturally lower heart rate.

Liked by sue225

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@soliloquized

The Parasympathetic Nervous System acts as a Brake for heart rate. I never realized how much until the afib started. Metoprolol does a great job controlling rate, but I had an altercation with another driver recently, OMG, what was I thinking. Although the rate probably didn't go above 100, it hasn't been near that at rest in awhile, more like the 70s at rest, 90s after climbing the stairs. It took hours for my heart rate to return to normal. Adrenaline causes a higher rate, the parasympathetic nervous system brings the rate down, but something that upsets it lets the rate go, or remain, high.

Reading a medical article recently, the doctor said when they see heart rates above X amount, it means Parasympathetic Response has been withdrawn entirely.

So, in those approved to exercise, and in those cases exercising commensurate with their doctor's oversight and in ways approved by the doctor, increased conditioning brings increased parasympathetic tone and a naturally lower heart rate.

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So, that's why my cardiologist keeps stressing exercise.

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@soliloquized

The Parasympathetic Nervous System acts as a Brake for heart rate. I never realized how much until the afib started. Metoprolol does a great job controlling rate, but I had an altercation with another driver recently, OMG, what was I thinking. Although the rate probably didn't go above 100, it hasn't been near that at rest in awhile, more like the 70s at rest, 90s after climbing the stairs. It took hours for my heart rate to return to normal. Adrenaline causes a higher rate, the parasympathetic nervous system brings the rate down, but something that upsets it lets the rate go, or remain, high.

Reading a medical article recently, the doctor said when they see heart rates above X amount, it means Parasympathetic Response has been withdrawn entirely.

So, in those approved to exercise, and in those cases exercising commensurate with their doctor's oversight and in ways approved by the doctor, increased conditioning brings increased parasympathetic tone and a naturally lower heart rate.

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What if you can't exercise due shortness of breath due to afi b and metropolol

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