Change in my Metoprolol dose.

[Dodgerguy]

I was taking 50 mg XL Metoprolol twice a day to once daily. I’ve been taking this for about seven months now. My Electro Cardiologist ( EP) changed this. With such a large decrease ( or maybe not) Will I feel any negative effects with this new change? I asked if I should taper this dose and he said there was no need to taper. My heart rate definitely is higher than it was on twice daily but nothing too high. I’d like any options/ past experiences on this . Thank you!

[mav7]

Would trust your EP’s advice. He knows your system the best.

Suggest to monitor your HR and BP to note any effect.

(I have reduced metoprolol by .25mg with no issues)

[OzJames]

i was on the Tartrate version 50mg twice a day but only for 2 months then reduced to 25mg for another month then one a day for a month then stopped. I felt odd for a few days then ok after that. I got an episode of AF about 10 months later and he now has me on 12mg twice a day and 25mg Flecanide

I thought the XL version is only for once a day? Maybe ask if he prefers to put you on the tartrate version which is for twice a day and take 25mg each time. They may have different applications so check with them

[Dodgerguy in reply to OzJames]

Thanks for your reply!

Yes XL should be once daily in most cases. My Primary care had the same thing to say!

I was on 50 mg XL twice a day for about 7 months and was told yesterday to take it to once a day. I felt awful yesterday. I wasn’t sure if I was getting a cold or if it was the change in Metoprolol. This morning I definitely don’t feel like I am catching a cold but do feel a bit better. Maybe my body needs to adjust to the change in Metoprolol 50 mg XL twice daily to 50 mg XL once a day. My Heart rate is up but nothing crazy high. Resting rate is under 100. My job is very active so heart rate does rise above 100 most of the day ( my watch said highest was 118). These U.S. doctors have their hands on the door knob while talking to you ready to rush out!

[mav7 in reply to Dodgerguy]

If you have not, suggest you ask the EP to prescribe a heart monitor (preferably Zio Patch) to get an average heart rate and evaluate your heart to insure proper medication and dosage.

Though 60-100 bpm is considered normal, it is best to reduce that to average 80 and below per advice of many doctors.

[Dodgerguy in reply to mav7]

Thank you for the response. Question, when you say an average of 80 or below , is that resting heart rate?

[mav7 in reply to Dodgerguy]

Yes. I read that is the preferred goal if you have afib and are taking medication.

Do ask to wear a heart monitor. Would give true eval.

[Dodgerguy in reply to mav7]

Thank you again for your reply!

I wore a holter monitor six weeks ago before the medication change. My average heart rate was in the 60’s. Do you suggest wearing another?

My heart rate has been in the 70’s when at rest ( according to Apple Watch ) but during the day it gets into the 100’s because my job requires a lot of moving and running around.

I appreciate your feedback! I just saw the EP on Wednesday and he said there was no need to follow up with him unless there was a need. True American Medicine, lol! 😊

[mav7 in reply to Dodgerguy]

Not a doctor, but as a long time afibber (4 years) I don’t think another monitor would be necessary.

Seems your overall heart rate is excellent. My average is 82bpm with .75mg of Metoprolol. Cardiologist is satisfied considering all and my age (78).

[OzJames in reply to Dodgerguy]

it does take a few days to adjust to change in dosage. The stress of it all could also bring up HR. Try some mindful breathing through your nose for 5 minutes 3 or 4 times a day and that should help. I feel taking the Tartrate version twice a day is liking keeping it topped up and in your case it would eventually go to 25mg twice a day. If you adjust to the once a day at 50mg and your HR settles then great otherwise maybe talk to them about the other version of Metoprolol and see what they think.

Have a look at a book called Breath by James Nestor it’s an easy read and highlights the importance of breathing properly