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Discontinuing Metoprolol

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Kathy McCain

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Hi folks,

Well I have been on Metoprolol 12 1/2mg, since my AVR of Feb 2008. I have always had low blood pressure. The Dr kept me on the low dose to lower my heart rate after surgery. I stopped taking this med for 3 days last week, and did not notice much of a difference. Still had a lower heart rate and a normal BP. I called yesterday and explained what I had done. I asked the Dr. if I could discontinue the medicine permanately. I also told the nurse that I do not experience nearly as much "heart fluttering" as before. They called me back and gave the okay to discontinue.

Has anyone else been on this Medicine for a long period of time after AVR, for a faster heart rate, due to the surgery? It seems to me that 2 1/2 yrs is too long.

Thanks in advance for any feedback
 

nngbwh

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I am on Metoprolol 75mg daily for the last year. I will be discussing this with my Cardio on my next 1 year visit.
 

Cooker

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I've been on a low dose since before my AVR (a-fib) ... my cardiologist insist I stay on it although I don't think I need it ... I had an ablation at the time of AVR and no problem with a-fib since ... I have reduced the dose myself over the years but he still want me on the low dose ... I really don't think the dose I am on does much of anything ... I have never had a problem with heart rate or high blood pressure ... it is what it is:rolleyes2:
 

Mentu

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My surgery was performed at Oklahoma Heart Institu
Off but left with issues.

Off but left with issues.

Kathy, in May, my Cardio let me stop the Metoprolol after 7 months. At the end of that time, I was taking 12.5 mg twice a day. Initially things were good for a couple of weeks then my bp and pulse rate began to rise. By the end of one month I started having a headache once in awhile due to high BP so my family Doctor added Amlodipine to my list. Slowly, it has brought down my BP but I am still experiencing a much higher pulse rate and now some arrythmia. We will be discussing the issue in a few days but when we last spoke, she indicated that I may need to return to the beta-blocker but perhaps just 12.5 mg once a day.

My problem with the beta-blocker was the loss of energy it was causing. I really missed those first weeks following the AVR when I woke up feeling bright and energetic. I will look forward to reading of your experience now that you have discontinued it.

Larry
 

Bill B

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Kathy:

I've been on 50 twice a day since soon after surgery. It has dropped my heart rate a lot, even below my historic baseline, but I'm on it for high blood pressure and I don't mind the low resting heart rate (high 40s) at all. The drug is also quite beneficial for heart failure. I had quite a low ejection fraction post-op, and the metoprolol may have helped me in that regard as well.

You were on a tiny dose, but that doesn't mean you weren't getting a decent effect from it. Still, you've observed no change in the 3 days since you stopped it, and this drug is rather short-acting (on the order of 12 hours) unless you are on an extended release form, so I doubt you are going to experience any further change. Sounds like you are doing the right thing. One less drug you apparently don't need.

Continued good health!

Bill
 

Kathy McCain

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Bill.

I am on the extended release type.

I called my Cardios office back and asked them," how should I stop taking the medication. Just quit, seeing I'm on a low dose or get off gradually?" They told me to take every other day for one week, then every three days for one week, then stop. I'm sure glad I called back and asked that question. I don't know why they just didn't say that to begin with! I think I am going to wait until I actually CONSULT with the Dr. myself to discontinue. I have an appt Sep 1st. I also have had an irregular heart beat (fluttering which the Dr is aware of) that is of the benign variety. Sorry I forgot the medical term. What would you do?

Thanks again
 

Bill B

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Kathy:

Do what you feel most comfortable with. I think you're going to be fine either way, but it's never a bad idea to wait and confirm things directly with the doctor. Even with the long-acting form, which allows 24 hour dosing intervals, you're not seeing any real effect 3 days later. Tapering is rather standard but not much of a factor in most cases.

Bill
 

OldManEmu

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Kathy, I was on extended release Metoprolol for 12 months.
I was on 95 mg, after 6 months and my heart remodelling I was getting a lot of side effects so I halved the dosage to 47.5mg.
When I visited the cardio after 6 months on half dosage I requested to discontinue the beta blockers, I always felt lethargic when on them.
The cardio advised me to halve the dosage again and after 3 weeks discontinue them altogether.
Each time I reduced the dosage my heart rate would temporarily increase and pound for a few days.
 

hansong

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Kathy,

Perhaps the fact that eliminating the metoprolol for several days had no discernible effect on your heart is the key point. Not knowing how long the time-release version is effective in your system means the three day period may not yield a conclusive result, but there's no way your doctor can know what the effect of not taking it is until you stop taking it. He'd just be guessing otherwise.

One of my goals for taking care of my dilapidated aortic valve was getting back to normal, which means not taking medications after replacement. I reduced my metoprolol dosage over a period of a couple of months after surgery and then stopped taking it. My blood pressure is 120/70 when sitting with heart rate in the upper fifties which is what it's always been throughout my life except when really fit. I've occasionally had the pounding episodes, but when I've checked my blood pressure and pulse it's been normal despite the feeling of a stronger heartbeat, and the episodes have become much less frequent. I recently passed a stress test and echocardiogram and 24 hour Holter monitor for the FAA, so I'm pretty confident about the state of my heart and glad I'm not relying on medications for a sense of reassurance. Which is not to say I'm back to 100%; still working on that little chore. But at least I don't have to fight the drug-induced lethargy of the beta blocker.

Good luck with your decision. Try to find what works best for you.

Gordon
 

jax

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i was taken off metoprolol a month after surgery and then last january was put back on the delayed release metoprolol for afib. Have been on it ever since.
 

JeffM

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Sounds like you're going about it the right way, Kathy. With Dr's approval and guidance, even though you had to initiate the process and ask the important questions. I weened off of it in similar fashion, but it was after about 5 months post op. My resting and exercise heart rate sped up a little, but I had no problems. I get occasional quick tachycardia runs, like maybe 5 - 10 at a time, but it's rare and I get a few PACs a day, but also rarely. Hopefully, you will not experience any difficulties getting off of it. Best of luck to you!

Hi folks,

Well I have been on Metoprolol 12 1/2mg, since my AVR of Feb 2008. I have always had low blood pressure. The Dr kept me on the low dose to lower my heart rate after surgery. I stopped taking this med for 3 days last week, and did not notice much of a difference. Still had a lower heart rate and a normal BP. I called yesterday and explained what I had done. I asked the Dr. if I could discontinue the medicine permanately. I also told the nurse that I do not experience nearly as much "heart fluttering" as before. They called me back and gave the okay to discontinue.

Has anyone else been on this Medicine for a long period of time after AVR, for a faster heart rate, due to the surgery? It seems to me that 2 1/2 yrs is too long.

Thanks in advance for any feedback
 

Mercia

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Kathy,

I started using Metoprolol - 2 weeks after my MVR surgery due to AF and fast heart rate - 150 and higher. Was able to exercise daily for min 90 minutes. Due to some other side effects requested to be taken off Metoprolol. My Cardiologist agreed after tests showed that my arrhythmia's were all harmless.

Also slowly decreased my dosage - similar to you. After about 3 weeks, of totally off Metoprolol, were unable to follow my exercise routine and ended up with AF and a fast heart rate (at rest) of 168bpm and higher.
Was hospitalized for 4 days, while they tried to get heart back into normal sinus rhythm. First tried high dosage of Flecianide to get me back into sinus rhythm, (which was the worse experience for me so far - had a terrible headache and chest pain for about 3 hours, and then slowly easing up to at least be more bearable) which was unsuccessful. They cardioverted me successfully the following day.
Now on 180mg Diltiazem ER, and 50mg Flecianide twice daily. Still adjusting to the new medicines etc.

Hope you have better success, and continued health without Metoprolol :).
 

Luckyguy17

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Kathy,

Am also trying to work off my two remaining meds including the beta blocker.

Post surgery and for 30 days I was on 25mg twice daily or 50mg daily of Metoprolol (much higher than your 12 1/2)
At 30 days post op, my cardiologist replaced metoprolol with the 24 hr bisoprolol and a single 10mg daily dose.
At stress test done last week, I could not get my heart rate above 105 and cardiologist thought it was likely caused by the beta blocker.
Cardiologist recommended a gradual reduction of beta blocker and have now been reduced to a 5 mg daily dose of 24 hour bisoprolol.

Am hoping to discontinue beta blocker and coumadin in about 30 days, to replace with an 80mg daily aspirin.

Gil
 

Philip B

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Mar 3, 2007
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Metoprolol

Metoprolol

They tried to put me on Metoprolol following AVR surgery, but I broke out in an extreme rash within minutes of taking the first pill. Needless to say, I was off it pretty quick. They did put me on something else (another beta blocker), but the name of the drug escapes me. With one pill, I didn't have to worry about coming off Metoprolol progressively.

-Philip
 

Shobu

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Mar 11, 2010
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Chicago
After my first heart surgery I was on 25mg of metoprolol for some time, at least 3-4 years, both to lower BP and to help regulate HR, as well as for the heart remodelling benefits that can take place with beta-blockers. Definitely had side-effects for me, especially around some exercise intolerance issues, as well as feeling tired, and some other issues. Talked to my doc (PCP), and they switched me to Coreg (10mg) and I felt much, much better, and most of my SE disappeared. Just had a second OHS with AVR; they put me on metoprolol again initially, but was having some significant side-effects, so my doc (new PCP) decided to switch me to Bystolic (5mg), and I have to say, so far it is the best beta-blocker I've been on, with absolutely zero side effects that I can tell so far. My cardiologist was fine with the changes; he is old school in many respects and likes metoprolol, but as long as I'm on a beta-blocker and my HR is fine, BP is fine, and the echo's show some reduction in size of my LV and increased EF, then he's happy, whatever I'm on.
Anyway, long story short, there are a bunch of different beta-blockers out there that seem to deliver the needed effects to many people without all the side-effects. Although it's a sample size of one, and I'm on betas forever, coreg and bystolic have worked nicely for me. Ask your doc if there might be some different ones they can try.
Good luck!

--Dan
 
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