Metoprolol or not

[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.

[Leonxavier]

Metoprolol made me feel like I was under water. Switched to Bisoprolol and it was perfect. Did the trick but no side effects. I’ve ended up in the hospital with sex induced Af too 😀

[willec49 in reply to Leonxavier]

Thank you. Yes, Metoprolol had the same effect on me which is why I weaned off of it. I've messaged my doctor (covering for my regular Cardiologist) and asked why she didn't prescribe Bisoprolol instead. Will be interested to hear her answer.

[Malayabalaya]

Hiya I don’t have AFib but had ectopic beats at 22% of all beats. Started on Bisoprolol with an increasing dose but did nothing. Then Flecainide 50 mg twice a day like you which worked pretty well but with breakthrough ectopics towards the end of a dose. For a year now I take 100mg Flecainide twice a day plus my consultant said I should take 2.5mg Bisoprolol along with it for safety reasons ( maybe why your second cardiologist re-prescribed Metoprolol?) Anyway no real side effects with either drug. And ectopics very rare and only come with too much alcohol or stress! Heart rate 50ish but guess that’s OK. 50mg Flecainide is quite a low dose that they use and I’m wondering if it would be appropriate for you to go to a higher dose along with small dose of Bisoprolol? Perhaps worth running past your Cardiologist. All best wishes

[willec49 in reply to Malayabalaya]

Thanks for that. I appreciate it. I will run the Bisoprolol by her.

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.

[dmac4646]

hi my experience of Flec and Metroplolol was not good lower heart rate far too much - Bisop not great either but nothing like Metroplol

[BaileyC57]

I take ONE HALF of a 25mg in the morning and the other half in the evening , that seems to work out better when it is cut in half!

[willec49 in reply to BaileyC57]

Thanks, BaileyC57. Yes, that's exactly ( the half-and-half) was what I was taking for a couple of years before and directly after my Ablation. Then I weaned off of Metoprolol completely. The Flecainide alone was working for a year until last week. So now, like you, I am taking one half at night before bed but not the other half during the day. Will keep you guys posted.