Experiences with Metoprolol

[willec49]

I was dx with Parosyximal Afib in 2019 and, after the customary course of starting with a beta blocker - Metoprolol, which didn't work - and then adding flecainide which did help but not prevent breakthrough episodes, had an ablation on March 16 of 2022. After the ablation, I weaned off of the metoprolol in April because it sapped my energy, but was continued on Flecainide, 50 mg. twice daily, morning and evening which seemed to be working. In June, my doctor stopped the Flecainide after which I had two Afib episodes, one on June 23 (4 hours) and another on July July 8 (6 hours.) After those episodes, I re-started the Flecainide at 50 mg. x2 daily. Except for a few ectopics, I was free of afib until just this past Sunday, 8/14 when I had a 2-hour episode. So it had been over a year. This happened during the night after having sex which was one of my original Afib triggers.

When I reported this to my cardiologist, asking if I should be concerned, he was out of town but the doctor covering for him prescribed metoprolol (again) 25 mg. daily with instructions to stop taking it if lowers my heart rate - which is already low-in the 50's - or makes me dizzy. I filled the prescription but am reluctant to take it as I am already light-headed and dizzy much of the time. Anyone have a similar experience with this drug regimen? Thanks.

[mav7]

bing.com/search?q=can+metop...

Check the above links and google for other info. Other articles state it can have additive effects like dizziness.

What is the range of your heart rate and blood pressure ? Heart rate should be above 50 and below 100 and blood pressure below 130/120. High blood pressure may be causing your symptoms.

If your symptoms persist and you can't see your doctor, consider going to the ER or A&E.

[willec49 in reply to mav7]

Thanks for your reply.

My heart ranges between 50 and 60. My blood pressure is in the 120-130 /116 range. I don't have high blood pressure.

I haven't felt the need for emergent care, etc. as a 2-hour Afib episode wasn't out of the ordinary for me and I know many people have much longer episodes. My concern and question for my Cardiologist was, "Should I be concerned? Does this mean the Ablation is starting to fail and will I possibly need a second one. Also, I wondered about others' experiences with the Flecainide/Metoprolol combination at this stage of recovery.

[mav7 in reply to willec49]

Sounds like you are in good shape. Good questions for your cardiologist upon his return.

[fairgo45]

I sympathise after ablations it's always horrible when you get a break through episode.After 12 years I still get awakened by afib episodes at night now and then though I'm in permanent AF these days i dont feel it usually.

I keep a metoprolol on my bedside table as it seems to calm it down and I go back to sleep again.

My episodes come after doing something extra exerting like doing a lot of gardening and making a bonfire a lot of bending down raking etc not from having sex but if thats your trigger at least you know what to stop!

[willec49 in reply to fairgo45]

Thanks for your reply. My former Cardiologist told me to just take an extra half (50mg) of Flecainide if I know I'm going to have sex which I have done many time and it worked. My new Cardiologist told me to never take Flecainide when in ectopics (not afib) because it can be an arrhythmic agent and even lead to severe arrhythmia and even death. Rather confusing but I think I get the picture. OK to prevent afib and restore sinus rhythm when IN afib but not OK for etopics.

[Ppiman]

I think a beta blocker is, at least, safe to take if not always well tolerated (although mostly so). If I were you. I'd give it a try. If sexual activity is a trigger for AF, then a beta-blocker taken beforehand might help.

Steve

[willec49 in reply to Ppiman]

Thank you. Now that's something to think about.

[OzJames]

Metopropol at 25mg made me really sapped with resting heart rate as low as 42. Cardiologist reduced to 12.5 twice a day made a difference felt better and resting HR went back to around 55. Normally I would be mid 60’s without drugs. I’ve now reduced with his permission to 8.5mg twice a day and will look to reduce again to 6mg. even at 8.5mg my resting HR is between 52-62. Eventually hope to carry on without drugs again

[bayonnejoe1 in reply to OzJames]

I had a very similar experience with Atenolol. 12.5 mg is my effective dose these days. 25 mg was too much, after over 20 years at that higher dosage. Bodies change and the impact of a drug can too.

[OzJames in reply to bayonnejoe1]

Yes I believe the body does adapt and doses should allow for that. I’ve got PAF and atm no AF so doctor said stay on aspirin and metoprolol. I noticed you had a stroke on aspirin but it seems you had AF a percentage of every day. I’ve invested in an Apple Watch and monitor HR during exercise to make sure I don’t flip into AF and not realise it

[willec49 in reply to OzJames]

Thank you. Following Ppiman's post above, I went ahead and took 12.5 mg of Metropolol Tartrate last night before bed along with the Flecainide which seemed to work! The doctor had prescribed Metropolol Succinate - the long lasting- once daily version but I happened to have a prescription of the Tartrate which has a shorter half life. I think I will present this to my doctor.

[Hallju]

I hate to say it, but my cardiologist put in a pacemaker in 2012 and set it at 60 bpm since my rate would drop into the 30s. At least it is comforting to know that I’ll never bottom out again. Also, I had an ablation in 2016, and take Metoprolol 25 mg twice daily, and Flecainide 50 mg twice daily—with a PIP 100 mg Flecainide for my occasional AF breakthroughs. I still would love to know what triggers those breakthroughs, though.

[willec49 in reply to Hallju]

Thank you. For me, this time and in the past, it was sex to ejaculation (as I mention above) Following Ppiman's post above, I went ahead and took 12.5 mg of Metropolol Tartrate last night before bed along with the Flecainide which seemed to work! The doctor had prescribed Metropolol Succinate - the long lasting- once daily version but I happened to have a prescription of the Tartrate which has a shorter half life. I think I will present this to my doctor. I hope you figure out a pattern for what triggers your episodes.

[JOY2THEWORLD49]

Hi

Metoprolol is not good for me.

It makes me breathless, with no energy, fatigued and pauses of 2 second during the night.

AFers should change to Bisoprolol I was told.

I also uppered my B12 to 700.

cheers JOY. 74. (NZ)

[PRM54]

I’ve been on Metropolol since February and it makes me lightheaded and tired.

Will ask about Bisoprolol next visit to cardiologist.

[willec49 in reply to PRM54]

Yes, same here. That's why I quit taking it in the past and I was on the Tartrate which is shorter acting than the Succinate version of Metoprolol. Thank you. Following Ppiman's post above, I went ahead and took 12.5 mg of Metropolol Tartrate last night before bed along with the Flecainide which seemed to work! The doctor had prescribed Metropolol Succinate - the long lasting- once daily version but I happened to have a prescription of the Tartrate which has a shorter half life. I think I will present this to my doctor.