Severe Weakness, S.O.B and Fatigue

[Josefio21]

Hey Guys,

I was diagnosed with IST last September, I was changed from Metropolol 100 mg to Ivabradine 5 mg twice a day, palpitations are under control but I'm experiencing Severe weakness and fatigue almost everyday now. When I have symptoms BP is 140/90 and shortness of breath. My cardiologist asked me to take half the dosis to see if I feel better, I did it and the second day I had an episode of tachycardia. at this point I don't know if the medication is causing the symptoms or there is something else. they wanted to try a different medication like Cardizem which didn't control the heart rate before on a higher dosis.

I was not feeling like this when I was taking metropolol with fewer symptoms, I don't know if the IST is getting worse or should I be back to the betablocker.

Any advice?

Thank you!

Jose Fiorentino

[Longqt]

Hi Josefio21, Obviously I can't say for you. But this may help when I tell you my story. Last May got diagnosed with IST SVT and transient long QT syndrome. For me I was feeling exactly like you and was on 5mg Ivabradine twice a day. What is working for me now is 2.5mg Ivabradine twice a day and 25mg atenlol at night and magnesium twice a day. When I have flare ups now it is because something is not right with me, e.g sick or get an occasional seconds of IST a few days before my period each month, which is fine. The last time I felt knackered it was my iron was low, just found by accident on a wellwoman yearly check with my gp of bloods. Usual bloods checked each year, e.g. cholesterol, glucose, liver etc. I had an iron transfusion a few months ago made a world of difference. My cardiologist thought may have gone low because of Ivabradine. He also gradually reduced my ivabradine so went from 5mg to 2.5mg at night then when that ok, morning one got reduced. I find my combination works for me, but when I get overtired and not iron issue now, I find caffeine helps e.g. chocolate. And when that happens I see the cardiologist and we start gradually reducing meds again. As what is the point in taking caffeine to make me feel better when med reducing was key. But, I know I have differences in my diagnosis but the combination of atenolol with Ivabradine for me works perfectly. On its own Ivabradine was not great, for me. Also this combination had meant I can exercise again, oh and I am 36years old.

[Kelly_lou19]

Hi Jose, again like the previous poster can’t say what to do but I have also experienced some of the same issues with Ivabradine and blood pressure. It’s being investigated as to what’s causing it because maybe it’s an underlying problem and not the medication but I have decided to stay on 5ml dose for now as it’s better than the symptoms of IST (hr would be around 180/190 just walking from bedroom to bathroom) I was experiencing so for me it’s been about weighing up pluses and negatives but I hope they find a combo That works well for you. All the best

[2k2d]

Sorry to hear you have been having trouble with your medication. I too was diagnosed with IST and possibly SNRT. My heart rate isn’t high all the time it just goes tachy for any stimulus so it’s been real hard finding the right balance of meds that don’t send my BP too low and leave me fatigued. What works for me is small doses of metoprolol tartrate throughout the day, like 12.5 when I wake, 12.5 at noon and sometimes little bits 6.25 in between or I’ll take 3, 12.5 doses on a really bad day or if my heart is “stuck” at a high rate. Depends on the day. Plus lots of lifestyle changes. I still don’t feel perfect everyday but I’m better. I guess, like previous posters said, no one can say what will work for you but tweaking meds does work, it just takes ages to find right combo. Why did they take you off the metoprolol if I was working? Just curious. And , I too tried ivibradine. It worked for the heart rate but made me feel weird like my heart was constricted plus it’s “off label” use here in the states so they couldn’t continue to give me free samples forever. Oh, and I too have a coffee regiment! It doesn’t effect my heart rate but helps keep my blood pressure higher I think?...keeping fatigue away. Anyway it helps me so I use it, morning and 2pm. Some people it doesn’t help. I also figured out alcohol makes everything much worse but I still drink, just cut back to 1 per day and have no effects, 2 or more and I get tachy in night & next day. So, good luck finding what works best for you - Hope you find your best balance soon!