Atenolol and Propanolol together? Or tips on switching? Help please, need advice!

[Chelle333]

My P.C. had me on Atenolol 75mg a day for tremor, anxiety, and high resting rate of 120bpm. I asked for Propanolol instead, as it seems more for my situation. The problem is he said to immediately stop Atenolol, and begin 10mg of Propanolol once a day. Atenolol works for 24hrs, where Propanolol is more of a 4 to 6. Therefore, the dose is not substantial enough to make a difference. Has anyone else been through this. I must say my doctor seems highly incompetent, spends 2 minutes with me, does not answer pharmacy calls, etc. Yes, I know I need a new one, but until my HMO figures it out any pointers will help. I am also on 10 mg diazepam daily which does nothing, but have to continue to avoid rebound effects.

[jeanjeannie50]

Hi Chelle

Welcome to the forum.

Could you perhaps split the 10mg of Propanolol and take 5mg morning and night. How about calling your pharmacist to ask for advice? They often know more about drugs than GP's.

Jean

[Chelle333 in reply to jeanjeannie50]

Thank you for your response. Unfortunately, the pharmacist out here (California) seem to be more like walking zombies. The refuse to give advice, unless it comes down to an interaction. Hence the "double" BB prescription. Nothing could be said but take one or the other and follow docs orders. If my doc office would answer EVER I would! This has been an issue since Obamacare. We pay for virtually nothing now, while other get the same treatment for free. So frustrating. 10mg is such a low "pediactric" dose, I dont feel like cutting them in half will do anything.....as 10mg of Propanolol doesnt do anything to begin with. Thanks again. ♡

[Gigi-gaga in reply to Chelle333]

Hope you will have a better and beautiful day today. Just one little piece of advice, if your physician has the “patient portal”, the internet site that is set up so that you can review your labs and other pertinent information about your healthcare, be sure to use this as a way of communicating with your physician! You can request appointment or just ask a question and in my experience that is the best way to get an answer. Offices are busy and only as effective as the front desk here in the South. You also have a permanent record of every time you attempted to contact your doctor and his response or even lack of. But I think they also realize this and will provide better communication.

[Bmwpaul1971]

Hi. This is just my opinion but for me 10mg of proprananol is very low. I was on 40mg and was told that was low. I don't know equivalent doses to antenalol but drs always start on low doses. But they are both beta blockers so I never understand why initial dose of the new drug is so low. It is not like you are starting afresh with beta blockers. The reason I am so opinionated by it was I was changed from proprananol to bisoprolol and back again and ended up in A and E twice because the change over tablet starting dose was way too low. A and E doubled it straight away and all was better. After 2 x 4 hours in A and E it annoys the hell out of me. It happened again recently when I am now changed over to calcium channel blockers and the stated starting dose is 40mg x 3 times a day. However, yet again, I was started on 2 times a day. Not enough, ticker was unhappy, racing pulse, headache etc. I rang the gp saying the meds were too low. Upped to 3 times a day and bobs your uncle miles better. I was on propranaol for 13 years and found it great. Good for anxiety, SVT, pulse rate etc. It's is an old drug but it worked for me. Good luck.

[Suzy1954 in reply to Bmwpaul1971]

Hi Bmwpaul. Do you find you are less breathless on the calcium channel blockers?

[Bmwpaul1971 in reply to Suzy1954]

Hi. I definitely feel more alive and not tired. My heart seems happier to exercise also. Early days for me but a promising start 👍

[Chelle333 in reply to Bmwpaul1971]

Hi BMW! Thank you so much for responding. Is A and E the emergency room? I apologize for such a dumb question, but am curious. What is the difference between Calcium Channel Blockers and Beta Blockers? I pushed for the Propanolol because I am an avid "googler" and it was rated #1 for tremors and anxiety.....the lower pulse and BP are just another benefit my body can use. I was always told both were high, but no doctor seemed to care and leaned toward "whitecoat" due to my crippling anxiety. Doctors kept saying my 24/7 tremors and pounding heart were "anxiety related. When I asked if essential tremor was a possibility he said yes...and nothing more. OK SO FIX ME DAM****! Sadly, I find Google to be more informative than my P.C., which is very sad at over $400 monthly. But I am one of those that don't like to confront ot bother people, so I just go with it....stupid me right? I shake from the time I wake, until bed...regardless of "anxious situations", but the shaking does increase when in public, if I get very mad, driving, etc.. My doc said go to counseling, counselor said my problem is physical NOT mental and was referred back to my P.C.. Soooooo annoying.

My main concern is withdrawal from Atenolol. I have gone from 75mg to 25mg now, with a half reduction per week. I actually do notice a higher pulse and an increase in "breathlessness heart pounding episodes" numerous times a day. I completely agree on the dosage, 10 mg of propranolol would be considered a pediatric dose. I almost feel as he just gave it to me to shut me up. After him cutting me off my Diazepam instantly (I never took more than prescribed, picked up early, etc, but I know that it should be tapered as well) I dont have much faith in him. I know people must be weaned off slowly....needless to say I am trying to wean myself as of now, sadly I have had to use other methods to obtain them. I guess when it comes to my "heart meds", that put an enormous damper on my doctor/patient trust. I have never been a shopper or seeker, but I feel he has pushed me towards that. He even once gave me Remeron for anxiety three times a day.....i was a zombie! Well that's because it is a SLEEPING PILL! I just dont see a relatively high dose of Atenolol (24 hour active) switched to the lowest dose of Propanolol( a few hours active) to be sufficient, helpful or worth it. 10mg 3 times per day would make more sense....but as I said my doc is far from trustworthy.

So I have been planning on taking the Propanolol 10mg 3 times a day once I have weaned off of Atenolol. I am a little scared, as I am not following "instructions" with a heart medication.....but through reading and your advice, it is a tiny dose. I am tempted to just take one the next time I am real bad, even while still on the 25mg of Atenolol. Make sure the hubby is home and check my vitals, I cant see it as a problem, but you never know. These pills are like a pain pill where we can just take another if it gets bad, the "heart med" part of if gives me more anxiety about not following orders......but I am far from stupid.

Now you have me curious about Calcium Channel blockers! I can't find any info on them for tremor/anxiety, but it seems you have benefited greatly from it. Thank you so much for your response! This site is awesome and I am so glad I said something. I usually just read and scroll, but unfortunately I couldn't find a thing about my "issue".

[Bmwpaul1971 in reply to Chelle333]

Hi. Thanks for your indepth reply. A and E is accident and emergency in the uk. Just remember that what I said was just my experience not advice, I would not want you to do anything without your health providers advice as they are the professionals. I am not a dr but Calcium channel blockers act in a different way to beta blockers I believe they dilate the arteries to help improve blood flow and oxygen levels but again not sure. You sound like your symptoms are very anxiety based and maybe try to sort that. I seem to remember when reading the packaging for proprananol that it helps with a lot of your desribed symtoms but again ask your dr. Like I said last time, if it was me I would be questioning your drs starting dose of proprananol and chat with him. Good luck and take care

[Bmwpaul1971 in reply to Chelle333]

Forgot to say both are beta blockers and I believe should not be taken together so be careful and take advice

[Penny_08]

Hi Chelle,

Don't know if this helps, but I was on atenolol for HBP for 12 years, had an operation which triggered atrial fibrillation, then the cardiac doctors put me on Sotalol which they said is for HBP and AF. 40mg wasn't doing the trick, so the dose was doubled to 80mg twice a day and since then all has been stable. I find Sotalol agrees with me well and calms me enough to be able to speak and read in public, something which hardly happened before!

Best wishes to you.

[Chelle333 in reply to Penny_08]

I have never heard of Sotalol. Is it a beta blocker? What are the main uses? I pushed for the propanolol as I have read they are best for tremor/anxious situations. I have not been diagnosed with AF or a heart problem. My vitals are always elevated, which they say is anxiety or "whitecoat", but they have never ordered tests beyond a regular CBC, thyroid, and EKG. I am a tad underweight at 5'7 and 115 pounds. My main issue is round the clock tremor, which enhances my anxiety 10 fold. I start to freak out when I shake or my heart pounds, as if I have no control of my body. It has had me bedridden at times. I do know alcohol helps, but one can't live their life drunk! Atenolol seemed to do nothing for me, but now weaning off I do feel rebound affects. This is all so frustrating!

[Hidden]

Hi Chelle333

Yes Sotalol is a beta blocker. In the UK, it isn’t used much now and I believe only to prevent AF and other cardiac rhythm problems. And A&E in the UK = ER in the US.

Are your thyroid tests OK? Some of your symptoms are seen in overactive thyroid

[safaa]

For essential tremor starting dosage for Propranolol is 40 mg per day and titrated up from there. It is possible once you get things under control (HR, tremor, anxiety) that you can move downward, although 10 mg is as you say a very low dose. Frankly, it doesn't matter whether the symptoms are psychological or not, as the Propranolol will help you get them under control and provide a platform for other therapies. The problem is getting started when you are overwhelmed with anxiety about the symptoms themselves. I have similar problems and Propranolol helped immensely (conversely, antidepressant and sedatives were ineffective and even counterproductive). Of course you should be checked for the appropriate metabolic and neurological disorders, and have a rational schedule for changing from Atenolol to Propranolol. The latter is nonselective and is more effective for tremor and anxiety. I would redouble your efforts to find a good doctor. Good luck

[DawnTX]

don’t wait for your HMO to work on it you need to do something ASAP because I just went through this only it wasn’t just being lazy I can’t even say the words I want to about my previous doctor. He is too high and his ivory tower evidently and I have been suffering since the end of April when he did a procedure that he pioneered. Part of it obviously failed and I have been living in hell ever cents. I had a big fall out with his office because of the treatment I was receiving from them and the only person I could reach was a medical secretary as I was blown off by everyone else. I have a PPO now but I always had an HMO until I moved out of state. All you have to do is find a doctor and let the HMO know if this person is not your primary. Otherwise speak to the primary. I found that mine had wonderful professional connections And always got great doctors. I finally pushed myself and got a new doctor. I met him last Monday and last Friday he did a cardioversion on me. As of today my heart rate is 79 and as of waking up from my procedure it was 82. Earlier that morning it was 158. Had been like that since April