Metaprolol and orthostatis

[pem]

Hi. I'm taking 50mg of Toprol (Metaprolol XL) daily post surgery. At first I took 25mg, then started having lots of PVCs, so they boosted my dosage to 50mg. The PVCs went away, but I think they were situational and would likely be mostly gone anyway.

Following surgery, I had some orthostatic hypotension that caused me to feel like I was going to faint moments after I stood up. That has slowly passed. I stopped the post-surgical amiodarone a day early in case that was the cause. My question today is, is it possible that my continued mild orthostatic hypotension could be caused by the metaprolol? I'd be happy to reduce or come off of it.

Also, I took it in part to lower my blood pressure, which seems to remain stubbornly around 130/90, but the metaprolol doesn't seem to help. Are the folks for whom metaprolol doesn't affect their average blood pressure?

I realize I should discuss this with my cardio, but my appt isn't for another month or so.

Thanks,
pem

 

[Lynlw]

Can't you call or email them? Thats what I would do if i had med questions.

 

[LouLou]

I am taking 150 mg of Metaprolol along with 600 mg of Multaq for AFIB. Although I have occasional dizzy spells with the AFIB, I do not seem to have issues with my BP.
The Metaprolol does not seem to effect my BP too much although it is not resolving the AFIB issue either but at least it makes it tolerable.
If you feel uncomfortable, you should definately contact your Doctor for peace of mind. Good Luck.

 

[rvrkumar]

I take 100 mg metoprolol. Occasionally, I feel dizzy (few seconds) when I stood up or get up from bed. I don't know if it is caused by metoprolol, but my doc did mention that I may feel bit tired because of metoprolol. My cardio talked about moving me off metoprolol to some other drug around 3 month post-op check.

-Kumar

 

[Kiwimac]

I take a whole pile of dugs (5) to control my BP and 130/90 would be a really good reading for me!

 

[Bina]

Metoprolol does have a known side effect such as you described and many doctors will advise to get up slowly and
report back to them if the dizzy or faint spells are causing problems. If you need a med adjustment your doctor is the
one to discuss this with and maybe he will choose another med for your situation.
Also, if you have recently stopped the Amiodarone drug you will need to keep an eye on your INR !!

 

[ElectLive]

Pem - One thing to keep in mind is that the Toprol might impact you differently depending on timeframe relative to surgery. I was on 25mg daily both before and after surgery, still ongoing, with no other related medicines. Prior to Toprol, I was usually around 120/80 and a resting heart rate of 8o or so. After Toprol, which started 4 weeks prior to surgery upon diagnosis of my 5.0 aneurysm, I was usually around 110/70 and rate of 65 or so. Occasionally, when getting up quickly, I did feel dizzy, but was able to gather myself pretty quickly. After surgery, at least up to 3 months, and maybe longer, I was usually around 130/90 with a rate of around 90 or so. Same Toprol dose...heart was just still adjusting. By 6 months, I was back to the new medically adjusted "normal" of 110/70 with a rate of 65 or so, and has stayed the same since.

I don't have any dizziness now at all. I'm not sure why. Maybe I'm just used to being on the drug, or perhaps subconsciously adjust my behavior (get up more slowly), who knows. Anyway, just wanted to mention a little of my experience, because at your stage of recovery, the Toprol did not appear to have any impact on my blood pressure, but based on my pre-surgery and 6-month and later post-surgery experiences, it clearly does.

I'm certainly glad that I've had pretty smooth sailing with Toprol, and able to keep a low dose. Others I know aren't so lucky. Low blood pressure and heart rate are particularly important for aneurysm patients so I'm more than willing to continue my cardio's orders to stay on indefinitely.

 

[joanie]

I never took Metropolol until my surgery. Post-surgery I was prescribed 25mg twice a day. I found I was light-headed/dizzy from it (it took a bit to isolate the cause of the light-headedness) and after playing with dosages (directed by my doctor) I've settled on 12.5mg in the morning and 25mg at night. I haven't had any dizzyness for more than a year.

Best advice - talk to your doctor.
Good luck!

 

[pem]

Pem - One thing to keep in mind is that the Toprol might impact you differently depending on timeframe relative to surgery. I was on 25mg daily both before and after surgery, still ongoing, with no other related medicines. Prior to Toprol, I was usually around 120/80 and a resting heart rate of 8o or so. After Toprol, which started 4 weeks prior to surgery upon diagnosis of my 5.0 aneurysm, I was usually around 110/70 and rate of 65 or so. Occasionally, when getting up quickly, I did feel dizzy, but was able to gather myself pretty quickly. After surgery, at least up to 3 months, and maybe longer, I was usually around 130/90 with a rate of around 90 or so. Same Toprol dose...heart was just still adjusting. By 6 months, I was back to the new medically adjusted "normal" of 110/70 with a rate of 65 or so, and has stayed the same since.

I don't have any dizziness now at all. I'm not sure why. Maybe I'm just used to being on the drug, or perhaps subconsciously adjust my behavior (get up more slowly), who knows. Anyway, just wanted to mention a little of my experience, because at your stage of recovery, the Toprol did not appear to have any impact on my blood pressure, but based on my pre-surgery and 6-month and later post-surgery experiences, it clearly does.

Thanks - it is helpful to hear about your experience as well as the others on this thread. It's certainly hard to tease apart what is caused by medicine, what is caused by surgery, what is caused by both, and what is caused by neither (I had quite a dizzy spell today, but I think it was vertigo - unrelated to heart stuff) But I will be interested to see what happens to my BP if I am able to reduce or stop the Toprol, and also what happens over time as I get further away from the surgery.

Best,
pem