Is it possible to get off Metoprolol?

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canon4me

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Jan 8, 2011
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Lately I have suffered from terrible bloatiness and gas due to Metoprolol. It has been so bad it woke me up in the middle of the night when I was belching in my sleep. I am on 50 mg twice daily. I haven't had any Afibs in about two weeks. I hope I am not condemned to take this stuff for the rest of my life:(

Any of you had any side effects from this drug?
 
My cardio kept encouraging me to stay on it ... It keeps the heart at ease and relaxed! I take 25 mg at night and I learned to manage with the side effects. To my benefit, my EF has just improved after four years of being on it! So, I peronally will gladly stay on it for some more months/years!
 
I was on 25mg for maybe 3 months after surgery and got the cough. Doc let me stop taking it and did not add anything else new. Cough went away after a few weeks. I never had AFIB.
 
Beta Blockers 101

You could ask your doctor to change to another type of beta blocker. one that does not interact with your central nervouse system as much as the Lopressor class of drugs, which includes Metroprolol.

I switched from Lopressor to Atenolol years ago. Here is some further information.

For simplicity sake (though nothing seems to be that way in medicine today), doctors, using their overall clinical experience, try to prescribe a beta blocker that is felt to be the most appropriate one that will effectively control a particular condition or conditions (dosage must be individualized) and do so hopefully with minimal (tolerable) side effects.
Contraindications, pre-existing medical conditions and drug interactions have to be taken into consideration when prescribing this particular drug as well.
Beta blockers can be cardioselective; decrease in systemic side effects and only affects beta-1 receptors located primarily in the cardiac muscle or non- cardioselective; increase in systemic side effects; and affects beta-1 and the beta-2 receptors (which are located primarily in the bronchial musculature and blood vessels).
Toprol-XL® (metoprolol succinate, extended release) is a beta-1 cardioselective drug. Metoprolol tartrate immediate release is availble as Lopressor® and is reported to be the most widely prescribed and competitive beta-blocker in the world.
In the U.S., Toprol-XL® is primarily indicated for high blood pressure (hypertension) and angina, but like other beta blockers, it can be prescribed for other conditions as determined by a qualified doctor.
Since everyone is unique, and therefore the metabolism responds differently to beta blockers, if a particular beta blocker works well for one individual that does not necessarily mean that it will work well for the next.
A problem with this class of drug is that some beta blockers are known to enter or cross the blood-brain-brain (BBB, actually there are two of them and is described as a protective network of blood vessels and cells that filters blood flowing to the brain) easier than others.
The ones that do this seem to cause more central nervous system (CNS) side effects, such as nightmares, hallucinations, and depression than others that exhibt low penetration characteristics (LPC).
If a beta blocker seems to be ineffective, doctors will either increase the dose or switch to another class of drug that is deemed appropriate.
When a beta blocker dosage is increased, one has to watch out for dose delivered side effects (DDSE) which can be an increase in the severity of present (if any) side effects or the onset of entirely new ones which may or may not cause an iatrogenic condition or disease.
Also, while on this class of drug, blood pressure and pulse/HR should be checked regularly and a doctor should be contacted immediately if/when pulse/HR falls below 50 BPM.
You'll obviously need to discuss your current medication and health status with your cardiologist next month.
 
I have been taking it since my valve replacement. I take metoprolol succinate ER, which is the timed-release version. I started out with 100mg/day. I had all the bloating, weight gain, gas, stomach distress that you mention, as well as the feeling that all day I was towing a sled full of rocks everywhere I went. Exercise was truly work. I hated it but with all the complications I had, my cardio insisted I stay on it. After about a year, I convinced him to cut my dosage in half, to 50mg/day. I noted improvements almost immediately. Less of all the side effects, but none went away. A few months later, with no afib noted on my pacer interrogation, I convinced cardio to again cut my dosage in half, now to 25mg/day. Huge difference. The bloating went down by about 90%, as did the gas and stomach problems. I also had less of the cough and runny nose. The best (for me) was that I have energy again! I feel like I did a few years before the valve surgery, and it is great.

My point? Why not try to convince your cardio to reduce your dosage, one step at a time? That way maybe you can arrive at a dosage that will satisfy him (and your heart) while still allowing you to have a more normal lifestyle. It worked for me.
 
My history with BP meds is long and difficult - I have never had anything approaching serious hypertension, but my docs have nonetheless insisted over the years that I take a number of different meds. The only one I have been able to tolerate is Norvasc - everything else has intolerable side effects for me (but maybe not so much for others). I experience everything from depression, dizziness and fatigue to relentless nausea, coughing, constant clearing of mucus - you name it. After my AVR my surgeon prescribed Amiodorone (for AFib, which I did not and do not have), Lisinopril, and Toprol in addition to my regular Norvasc. As a result, I have felt terrible ever since my surgery: I have so many side effects from the medications that I have no idea how I am "really" feeling. I will be meeting with my cardiologist next week and will be pleading to get off this poison.
 
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Give me a funny look, but why don't you just drop you dose to 25mg twice daily yourself and see? Who will know except us? Won't ring your doctor ;-)

Then you'll know if A) that makes any difference, as it did for Stevee or B) if you need to try another drug family as suggested by Rob
 
Give me a funny look, but why don't you just drop you dose to 25mg twice daily yourself and see? Who will know except us?

Pellicle, a former military veteran was lamenting about the high cost of medicine with the radio program personality, Bruce Williams, on the radio one night. He went on to say that with the little bit in survival techniques he had learned in the military he could be responsible for a lot of his own healthcare thereby reducing his health costs. Mr. Williams' reply to him was, "Listen Tiger....as far as doing your own doctoring......anybody can knock somebody out, BUT it takes a real pro to wake you up!"

A kid came into my office one day with a tshirt on that had inscribed on the front in big letters, "Amateur Gynecologist".

I am not prepared to experiment with my own health, but your suggestions were noted.

I did, however, place a call to my Dr.'s nurse who said she would address my request to lower my dosage as soon as the Dr. returns in two weeks from his vacation.
 
A kid came into my office one day with a tshirt on that had inscribed on the front in big letters, "Amateur Gynecologist".
Ahh the claassic. "...don't know much about it but I'll look at it for you"

I am not prepared to experiment with my own health, but your suggestions were noted.
Understand. It was just a suggestion. As always it is you who must do and see what happens. Your reaction seems to have been strong, that part I don't understand. The commentator on the radio could also bee an idiot and the veteran may well have been just as able to look after himself as he stated.

Our society is becoming much more dependent than independent. But then I'm just a wild colonial boy at heart.

I did, however, place a call to my Dr.'s nurse who said she would address my request to lower my dosage as soon as the Dr. returns in two weeks from his vacation.

Hope you get a good result.
 
Mine too. He also told me that Cardiologists take Metoporolol all the time, "like candy" he said. I assume he's exhaggerating somewhat...

True! This is exactly what I heard...new and experienced doctors, CEOs, executives take it before their presentations ... It keeps their hearts calm when their pulse tends to rise. Thus, they stay calm!
 
Hi cannon4me, I was one who sore up and down that this drug was goofing me up. I did have some side effects that allowed my doctor to remove it from my daily diet. He did how ever increase my Lisinopril by another 20mgs a day. So I now take it twice daily instead of once.
I thought one of my side effects was muscle/tendon ache and pain is why I really wanted off. Well after several visits to Doctors , one of them finally had me go in for a neck MRI and finds out I have a swollen disc in my neck. This is more then likely pinching a nerve and sending the pain down my shoulders and fore arms.

So getting off did not take care of all the issues I was after, but I fiind it is one less med I have to remember to take.
 
As jmstallard and eva mentioned, metoprolol is often used "off label" as a calming drug. My daughter works in the mental health profession and has said that sometimes they prescribe metoprolol for patients who need to be calmed down but do not need the full effect of meds specifically targeted to anxiety. Small doses of metoprolol keep your heart rate from elevating (this I know, as I still cannot get my heart rate above the 140's in the gym), thus suppressing the "fight or flight" reaction.
 
Yeah, the biggest complaint has been the terrible bloat and burping it has caused. I belched in my sleep the other night and it woke me, my wife and both dogs up. The only thing worse is if I DIDN'T belch and it got past my stomach. There would be suffering to go around for everybody:). Drugs like Metoprolol always scare me a little because of their ability to alter/control heart rhythm which can be scary. On a related subject, prior to surgery, my RPR was about 55-60 with being in fair shape from running about 1/2 hour 5x per week. NOW, my RPR is between 43-48. I have no explanation.
 
This is all very interesting -- I was not put on any of this stuff except for amiodorone, which my surgeon just took me off at my two week post-op appointment the other day. I did have one short episode of AFib in the hospital, but none since. Are you finding that metoprolol and other beta-blockers post-AVR are the standard of care where you are? Or do certain conditions or complications prompt cardiologists to prescribe them?
 
This is all very interesting -- I was not put on any of this stuff except for amiodorone, which my surgeon just took me off at my two week post-op appointment the other day. I did have one short episode of AFib in the hospital, but none since. Are you finding that metoprolol and other beta-blockers post-AVR are the standard of care where you are? Or do certain conditions or complications prompt cardiologists to prescribe them?
My surgeon (Ammar Bafi, Washington Hospital Center in DC) puts all of his patients on Amiodorone, Lisinopril and Metoprolol, in addition to whatever meds they were taking pre-surgery, for 30 days (actually the Amiodorone dosage is heavy for two weeks and then tapers off and stops 10 days later). This is apparently the standard used at WHC. I was a little concerned about the Metoprolol and my (pre-existing) Norvasc, because the Medscape interactions tool puts up a big red flag about using them together - I'm seeing my cardo next week and we'll get it sorted out.
 
I was on it for 2 weeks post surgery and coughed so much they had to take me off. When they took me off I had afib and went to the emergency room and they gave me a calcium channel blocker. It worked and my heart resting was around 106 which was ok with me. It took 2 3 weeks for the coughing to go away. After 2 1/2 months my cardio doctor took me off of the calcium channel blocker and a ok. I am now on the same medicines I was prior to surgery and none left over from surgery except warfarin! Yipee. My resting heart rate was 72 at the drs yesterday. Warfarin is the only new medicine I am taking and I almost have it regulated. Trail and error.

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AVR May 23, 2013.
 
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