I have recently gone from PAF to the AF being semi-permanent. I have been prescribed metoprolol which is helping but every pharmacy I contact, and also my own prescribing surgery are finding it very hard to get hold of.
Anyone else have this problem? I am in UK.
My cardiologist put me on Metoprolol Succinate 25mg 1x daily in May 2022. Since November I have been unable to get that at pharmacies here and so have been on Metaprolol Tartrate which I have to take 2x daily. Not sure if it's psychological but I feel worse on it (more fatigued, mentally slower, vivid dreams). I am in Czech Republic.
I am sorry that you too have struggled to get the metoprolol - it is the succinate that I am seeking - 25mg twice a day. I have about a week's worth left and my surgery are trying to get them for me. I am seeing the cardiologist on 18th April and will discuss with him whether there is something else more available that I can take, as I am guessing this might be an ongoing problem, and it will be a pain to be having top chase round to find it every month.
I too am finding I am slowed down and having nightmares - but I can cope with that if it means I am not constantly in AF and out of breath.
I hope very much that you will be able to get hold of what you need and that life will become a bit easier for you.
Breathlessness, fatigue, and vivid dreams can be side effects of Metoprolol. Your system may adjust over time. Key is to control your heart rate. Cardiologist may recommend another beta blocker or calcium channel blocker.
May want to google Metoprolol, beta blockers, and calcium channel blockers for more info.
Have you tried to get it via the hospital pharmacy. My wife had terrible problems getting medication about 7 years ago when her consultant had said she had to keep on not just a particular medication but also a particular brand of medication due to allergies. In the end she had to get in touch with her consultant and have him prescribe it from the hopspital pharmacy which seemed to be able to get it.
Thank you for that suggestion - I will follow that up if the surgery draw a blank.
I wonder why you can’t be given the usual, which is bisoprolol? There are several beta blockers available but this shortage of drugs is a worrying situation.
Steve
I tried bisoprolol but became quite depressed, which was a bit scary ......
I suspect that all beta blockers have this potential, but I need to take something.
It is indeed worrying that some drugs seem to be in short supply. I did look into getting it online and it is possible at not too vast a cost - has anyone tried this?
That’s really unpleasant. I’ve read that although the drugs are mostly specific to the heart, that there are beta receptors in many organs, including the brain. That might explain what happened.
You likely know this but there are other options, depending upon your condition and doctor. There is a different kind of drug altogether called a calcium antagonist, such as diltiazem and two newer beta-blockers, cardevilol and nebivolol, which work rather differently.
Steve
Thank you for that information - that is very helpful.
It sounds as if you are not under the care of an electrophysiologist, but just a general practioner. You do not mention that you are taking any anti-arrhythmic drugs. You might want to read past posts about metoprolol and its interaction for AF patients. With the advancements in treatments for AF, patients will not hopefully get to the persistent stage.
I saw a cardiologist a couple of weeks ago - it was he who prescribed the metoprolol. I have always been on a beta-blocker and an anticoagulant. I have never been given an anti-arrhythmic.
Since taking the metoprolol, episodes have reduced to a few a week and lasting a shorter time - so it is doing something. It is also putting my pulse rate down to the high 40s, so I am out of breath a lot....... and cannot up the dose.
I had an echo earlier this week and will see the consultant on 18th for the result. I know I have a leaky mitral valve which is mild-moderate, and I think he wants to see if that has got worse and might be causing the AF increase.
A cardiologist is not an electrophysiologist. I had a cardiologist who was supposed to treat me for high blood pressure but put me into AF with his prescriptions. You are on a rate control program with metoprolol let alone that there are studies that show metroprolol is contraindicated with vagal AF. The latest guidelines are to place patients on a rhythm control program whether it be ablation or rhythm control pills. Cardiologists do not do ablations. If I were you, I would not leave myself in the hands of a cardiologist to treat the electrical problem of the heart -- the AF. Electrophysiologists are the specialists in that field, not cardiologists. An electrophysiologist is a cardiologist before he becomes an electrophysiologists. It seems you are on a path of persistent to permanent AF.
but put me into AF with his prescriptions.
Interesting. May I ask the prescriptions that caused the AF ? And was it confirmed in any manner ?
Not disagreeing with your post. I have reason to believe I may have encountered similar. But due to moderate aortic stenosis, I am not eligible for many antiarrythmic drugs. Others have similar issues that prevent antiaa drugs but it is the preferred method over rate control.
Also, cardiologists are not “dummies” some portray when it comes to AF. But the EP is certainly a specialist who seems to be mostly centered on ablations but can evaluate prescription intervention.
My situation involved a high blood pressure drug --Nifedipine. I have high blood pressure as well as AF. I had had three ablations with being in normal sinus rhythm most of the time. My blood pressure was not under control reaching over 200 systolic. I was sent immediately to the hospital by the clinic I attended. Fast forward to this cardiologist whose attitude was that he was not interested in my AF, and proceeded to overdose me on Nifedipine whose directions clearly state that a patient must be started on a lower dose. Taking this high dose, I immediately went into AF and stayed in AF whereby my electrophysiologist allowed me to go back on a previous calcium channel blocker rather than Nifedipine. This cardiologist also did other incompetent steps not necessary to relate.
I dropped the guy and navigated to an excellent internist who has diagnosed me correctly. I have primary aldosterone. I now take Spironolactone 50 mg daily which controls my high blood pressure beautifully.
Due to being allowed to go to persistent AF, I am still taking Propafenone 150mg twice daily .
My experience with two one visit cardiologists is that they have both been inadequate for my AF and high blood pressure.
It does sound as though you had a bad experience, and I am sorry to hear that cuore.
I am finding all this very hard as I no longer have my doctor husband here, as he died 4 years ago. It was always reassuring to know he would be on tap to make sure nothing serious happened. Being on your own with a heart rate at nearly 150 feels pretty scary - but maybe I am just a wimp!
I will carry on with the metoprolol for now and see how I get on, although having a pulse rate of 45 some of the time does not feel great. It has reduced the frequency and length of the AF bouts. I will see the consultant on 18th and get the results of the echocardiogram which should tell me how the leaky mitral valve is doing and we can think further from there.
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