OT Can I quit Metprolol

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bwexler
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OT Can I quit Metprolol

Post by bwexler » Mon Jul 21, 2014 6:25 pm

For the group where someone always seems to know everything about a topic.

I have been taking Metoprolol ER 25 mg twice a day for about three and a half years.
I thought i was taking it to control atrial fibrillation.
Last week at my regular visit with my PCP I asked if I could ween off the drug.
His response was, sure just stop taking it, but monitor your blood pressure.

So I stopped cold turkey. First day my blood pressure was normal. Next day way up. It has been bouncing all over the place. The highest was about 185 over 110 but the day before it was 135 over 80.

Should I have titrated off the drug? Is there a chance I will normalize after a couple weeks?
Or am I hooked for life just like CPAP?

Google doesn't seem to understand the idea of quitting a drug, only the side affects and benefits and generic equivalent.

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Re: OT Can I quit Metprolol

Post by library lady » Mon Jul 21, 2014 6:34 pm

If your bp is bouncing all over the place, I suggest you talk to your doc about it. I take metoprolol too, not for a-fib, but for another heart issue. It would probably have been better to do what you had asked him about, tapering it off over a week or so.

Why did you want to stop taking it in the first place? My doc lowered my dose by half, but said if I feel funny or have other issues that concern me to let him know and he might want to up the dose. So far, so good.

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Re: OT Can I quit Metprolol

Post by bwexler » Mon Jul 21, 2014 7:30 pm

I started Metoprolol shortly after starting XPAP 4 years ago.
I am still tired and crave an afternoon nap.
I was reading the side effects of M and they include fatigue, dry mouth and others that I experience. Plus I hate taking any prescription medication and paing for it.
I don't remember having high blood pressure before and did not realizize until recently that was the main purpose of Metoprolol.
I am wondering if the docs real attitude was to let me quit and monitor my BP, knowing it would go nuts, so I would be convinced I need the Metoprolol.
He knows I am a data junkie and head strong when I "ask" him for something.

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Re: OT Can I quit Metprolol

Post by JCWarrior » Tue Jul 22, 2014 9:09 am

I can relate to your desire to stop taking Metoprolol. I started taking 12.5mg twice a day 2 years ago after experiencing a short V-Tach during a stress test. After having a heart cath which determined no blocakge or issues, an MRI that came back with no issues, genetic testing with no issues and wearing a holter monitor for 1 month with zero events, they determined I had idiopathic Vtach. Basically they could not find any reason why I would have had this single, short event.The EP doc kept me on a 120 BPM restriction which meant no more running for me.

My blood pressure has always been good (avg 110/60) and my resting heart rate is 56-60 BPM.

Feeling pretty dishearted with my situation I began seeking verbal, non-formal advice/opinions from other specialists. All of them told me I had no reason to be comcerned, based on the information I had provided them with.

After 2 follow up visits with my EP I was told I could increase my max HR to 145 BPM. They told me they were just being cautious and it's unlikely I am in any more danger than anyone else.

So now I am back to running and still leeping my HR at 145 or below, which is fine for me at this time. I am still considering seeking an official, 2nd opinion. Perhaps I could stop the medication altogether and take the limits off.

I'm curious to see what you decide to do.

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Re: OT Can I quit Metprolol

Post by old dude » Tue Jul 22, 2014 11:10 am

I'm taking 200 mg once daily for atrial flutter and BP as well.

From everything I've read you're not supposed to quit taking it abruptly at the risk of dire sounding consequences. If you google it up, these warnings pop right up.

In my case it's not a factor given that I'm unlikely to be coming off of it anytime soon anyway.

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Re: OT Can I quit Metprolol

Post by Krelvin » Tue Jul 22, 2014 11:50 am

Recently hospitalized for a bad reaction of one of my meds... When I came out, they took me off of Atenolol which I had been on for years and put me on Metprolol. For weeks after I got out of the hospital I was having real serious problems sleeping. Every time I lied down I would start to get chest soreness to the point I had to sit up within 30-45 mins later. This had nothing to do with sleep apnea.

One night I tool the Atenolol instead of the Metprolol and amazingly a few hours later, I lied down and got 4.5 hours sleep. The next night I did the same thing with the same results. I had an appointment with the Cardiologist a couple days later and I talked to him about it. He said the hospital changed the med and that if Atenolol was doing the same thing and not causing that side effect to switch. I am not 100% sure this was actually related, but I had the pain while lying down issue for 3 weeks and none afterwards. I have not had a sleeping issue like that since (now 3 weeks afterwards).

The use of Atenolol however is to keep my heart rate limited as I have a heart condition which leads to Angina, so it is not for BP for me.
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Re: OT Can I quit Metprolol

Post by bwexler » Thu Jul 24, 2014 12:16 pm

I have decided, after talking with my doctor yesterday, to start taking the Metoprolol 25 mg once a day instead of the previous twice a day.
I will continue to monitor my BP and see how it goes.

I simply hate prescription drugs and want to minimize there use.

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Re: OT Can I quit Metprolol

Post by 49er » Fri Jul 25, 2014 12:47 am

bwexler wrote:I have decided, after talking with my doctor yesterday, to start taking the Metoprolol 25 mg once a day instead of the previous twice a day.
I will continue to monitor my BP and see how it goes.

I simply hate prescription drugs and want to minimize there use.
That sounds like a good plan as I was concerned that you might suffer adverse effects due to cold turkeying the med. Obviously, you and your doctor have to do what you think is best but if your BP seems to be stabilizing after a week or two, I would ask him about making another cut of the med to see how you do.

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Re: OT Can I quit Metprolol

Post by purple » Fri Jul 25, 2014 7:22 am

Perhaps the doc felt that in your case, if you take am minimal dose, that it would be safe. Usually, one should never quit a Beta Blocker, which I see Metprolol or Atenolol both are, cold turkey. As that can cause "rebound."

The drug blocks a thing called a beta -something or the other, the body will produce more beta particles. Eventually the drug will overcome the bodies production of beta particles, and you will have the benefits of the drug. Notice that in the first few days, some people feel very weak until their body starts increasing its beta particle production as it tries to over come the drug. After awhile the patients body will balance, and they can feel pretty good as these drugs help the heart to beat more slowly, but more powerfully.

When one quits cold turkey, "Rebound" describes the blood pressure (and other effects) which occurs from that surplus of beta particles and no beta blocker to stop them. "Rebound" can cause heart attacks and strokes.

I have been lobbying my doc to change the Atenolol to something else for two reasons. One is that someday I will miss a dose, and it might severely damage my health with a stroke or heart attack. It is what I call a disaster drug for we older people, someday we will miss a dose. Nearly as bad is taking the pill twice, which might only louse up a day with no energy, but for some, if they try to drive, or fall.

The second reason I want off of Atenolol is it reduces my getting adrenaline. I feel some of my difficulty in exercising is that my muscles heal very slowly and grow slowly is because of that lack of adrenaline.

I had a stroke from "Rebound" when I was 27, which kept me from using my left arm for weeks, and I could not feel my left leg, although I could control it.

Beta Blocker drugs are amongst the oldest drugs for heart problems with decades of data which suggests that when take properly, are among the most useful for helping patients. They are the first group of drugs reached for by a medical doc, because they make the heart beat more slowly and powerfully are among the drugs used by those with severe heart disease.

I have read that they are screened for in athletes as they can be used to enhance performance. Also suggested that they can be used as part (plus some therapy) of treating PTSD, as they inhibit the adrenaline surges which cause a PTSD to wake up with night sweats, and pounding heart from a dream.

I also strongly suspect, that my essential hypertension which I have had since I was young, is more related to sleep apnea than anything else.

My primary doc said if I lose enough weight, then he would consider reducing blood pressure med. Diabetics do not much lose weight, particularly with the handicap of muscles which do not heal. and taking drugs which help to drive diabetes.

I have gotten more life quality improvement with a sleep apnea machine than all those other docs.

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Re: OT Can I quit Metprolol

Post by englandsf » Fri Jul 25, 2014 8:05 am

Metoprolol has many known lethargy inducing side effects. It is actually used in lower doses as a phychotrophic drug. I had the same trouble and switched to Bystolic, much better but way more expensive (I have my own company so HSA and insurance covers it all).

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Re: OT Can I quit Metprolol

Post by JBW@SJC » Fri Jul 25, 2014 4:12 pm

I'm a cardiologist, so maybe I can provide some insights... although I don't know about anyone of you specifically.

Metropolol is in a class of drugs known as Beta Blockers. As someone eluded to in one of the posts, a beta blocker works to offset the effects of a hormone in your body that raises blood pressure through constricting blood vessels, it elevates your heart rate, and it makes your heart pump more vigorously (there are a few other things this hormone does as well, but we will focus on these three).

A question was asked can it be stopped abruptly. This would not be the best thing to do, but the effects of stopping suddenly will be most profound if someone is on a high dose of the drug, and less so if on a low dose.

Someone mentioned some side effects from this drug. There can be many. Some may be reduced exercise tolerance, tiredness, dizziness, to name a few.

That said, all medications, including something as simple as aspirin, have side effects.

The most important question to ask is one of what is called "competing risk". This is how a physician thinks. He asks himself the question; "what are the risks of this medication compared to the risk of not treating the problem".

Let me be incredibly clear here... not treating high blood pressure is a HORRIBLE MISTAKE. Untreated, you risk stroke, heart attack, atrial fibrillation, becoming a cardiac cripple just to name a few. And high blood pressure can be treated in almost everyone very effectively with minimal side effects. Beta blockers are only one of many classes of drugs that can effectively treat high blood pressure. There are many others. And sometimes changing to a different drug within the same class of drugs will also have good results (someone mentioned Atenolol which is also a Beta Blocker). Be assertive with your physician and find a solution that controls your pressure with minimal side effects. BUT TREAT IT!!!!

As I mentioned early on, it is difficult to weigh-in on the appropriateness of a particular pharmaceutical for anyone in this thread having not seen them. But I will reiterate; preventing the terrible cascade of events that will (not might, will) occur from high blood pressure is preventable.

JBW

P.S. someone in the blog was using Metropolol to treat Atrial Fibrillation. It sometimes be effective for AF, but often times not. There are other drugs that can be used (with their profile of side effects) and there are procedures that are also performed to treat AF.

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Re: OT Can I quit Metprolol

Post by zoocrewphoto » Sat Jul 26, 2014 5:42 am

JBW@SJC wrote:I'm a cardiologist, so maybe I can provide some insights... although I don't know about anyone of you specifically.

The most important question to ask is one of what is called "competing risk". This is how a physician thinks. He asks himself the question; "what are the risks of this medication compared to the risk of not treating the problem".

This is a really good point. Back when my last doctor started me on medication for high blood pressure, she started with one, increased the dosage, added another, and then another. There were improvements with each, but not enough. It never occurred to her to ask me how I slept. Once I learned that my undiagnosed sleep apnea was most likely the cause of my high blood pressure, I confessed, had a sleep study, and started cpap. As long as I sleep with my cpap *and* take my medication, my blood pressure is in the normal range. If I miss my medication or have a bad cpap night, it starts climbing again, but not as bad as before medication and cpap.

When I switched doctors, I went to my first appointment with a complete list of my medications, both prescription and over the counter. I also had a short list of my issues that I wanted to concentrate on - high blood pressure (my medications had run out, and I didn't want to go back to that doctor), asthma (had been worse in the past few years), coughing (easily triggered and going for weeks at a time, seemed to be asthma related), and gerd (I had it for a long time, but never told my previous doctor).

My doctor started with the medication list. First item was the metprolol. Her reaction was why. It can cause problems in some people with asthma. Hmm. No wonder my asthma was acting up more. She changed me to amlodapine. She kept the losartan. And she she kept the hydrchlorothiazide (water pill). Seemed okay, but I was having problems being consistent with the water pill. It sends me to the bathroom every 45 minutes or so for 5 hours. I can deal with that on work days by taking it during my last break and only have one or two extra bathroom trips before going home and having the rest of the bathroom trips at home. But if I forget to take it then, I have to choose between skipping the dose or waking up frequently as it is too late. If I take it in the morning, I will be in the bathroom all day. And then I travel a lot. 3-5 hour drives are not great if you have to pee every 45 minutes. I also go hiking, and there aren't any bathrooms along the route, and some of the places have lots of people, and not so many trees. I asked my doctor if there was one that wouldn't last so long, as in maybe only a couple hours of bathroom trips. She decided to change my medication so that I take losartan and cardizem. She said it has a wider range of dosage possibilities, and I went back in a month. It wasn't down as far as she wanted, but it was down from the previous appointment, so at least I didn't have to go back on the water pill. She increased the dosage, and I go back after 6 weeks to see how that is going. I really like that she has worked with me to find something that works for me, doesn't cause other problems, and I feel much better.

She also pointed out that several other medications have a side effect of raising blood pressure, something my other doctor never mentioned. Aleve. My cough pill (prescription). My allergy pill. I still have problems avoiding Aleve as it seems to be the only thing to eliminate certain types of pain, but I limit it to when I am really having a lot of pain. My cough has not returned as my doctor has been treating the causes of the cough, so no need for that pill anymore. And my allergies have been pretty much eliminated with nasacort. (I never found any relief from zyrtec, clariton, or allergra, which is why I was taking chlotrimeton).

I think it is really good to have a doctor who considers what you need from a medication as well as what you need to avoid. There are alternative medications, just as there are different masks for cpap. Sometimes, it takes some trial and error to find the right one.

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Re: OT Can I quit Metprolol

Post by Country4ever » Sat Jul 26, 2014 2:34 pm

I can't believe your doc said to just stop it. What kind of a doctor is he??
You must never just quit a beta blocker. It can lead to tachycardia and other problems.
I'm just shaking my head.

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