Toprol XL to be taken 2x daily?

[Hdev]

I’ve been taking the beta blocker metoprolol 12.5 mg 2x daily for my afib these last few years,,,my afib is starting to occur more,,,,2x in the last 3 weeks,,,I normally have 2-3 events yearly,,,the nurse practioner just switched me to Toprol XL 25 mg 2x daily but the paperwork with the drug says it is to be taken once daily due to its coverage being about 16 hours,,,I see an overlap here where the side effects might really be an issue,,,I already had bradycardia and had to get a pacemaker and my normal BP,is about 125/67,and pulse about 65,,,,,I fear this new drug will lower my BP,Pulse and the concentration will be too much,,,,anyone have experience with Toprol XL taking it 2x daily? I have contacted the EP office and await a response,,,,Thank you!

[mjames1]

Not knowledgeable on beta blocker dosage with a pacemaker, but you seem to be on the right track reaching out to your ep directly. I would also ask what they are trying to accomplish, because in at least a non-pacemaker situation, beta blockers are weak anti arrhythmic drugs and really don't do much to change the frequency of afib episodes.

Jim

[BobD Volunteer]

Beta blockers do nothing to control AF. What they do is reduce heart rate when it occurs. If you are trying to reduce the number of events then you need an anti-arhythmic drug but that may not be approproriate for you so please discuss with your EP.

Regarding the PM, if the lower limit is set correctly you should not be able to suffer bradycardia as the PM will kick in and control at base level. Mine for example is set at 60bpm to prevent the pre-syncope I suffered on a few occasions previously.

[Hdev in reply to BobD]

Thank you for your input! I was given a PM due to the bradycardia caused by the original metoprolol prescription when diagnosed with afib 6 years ago,,,so increasing the drug seems counterproductive in some ways,,,I got a nurse to respond to my call this morn and she totally supported the practioner’s decision to switch to Toprol,,,I gather my EP doctor has been too busy to be involved yet,,,I am due to see him in 4 weeks so I plan to hold off switching until I can actually talk to him! In The USA also it’s getting harder and harder to get md appts or speak to an md,,,,their support staff is left to make decisions and deal with patients,,,unfortunately,,,they may never have met you before nor are they familiar with what you said to your EP at the last appt,,,I’ll be 76 in 3 days and remember a time when it certainly wasn’t like this,,,the last 10 years have seen many negative changes in health care here despite the many new treatments, clinical trials and advancements in medicine.Be well!

[Quilter43]

I'd a pacemaker for slow beats only? Told needed one for pauses..Can a dr.dismiss you for not following orders?

[Quilter43]

I think maybe contributes to slow beats.pauses.chicken or the egg?

[Quilter43]

I take 100 in am..recently 50 at night.been told I need a pacemaker.keep wondering if meds make it worse interms of slow heartbeat..wondering..