Visit to cardiologist/beta blockers

[Pr0jection]

I recently visited my GP in order to get a medical examination for the renewal of my driving licence here in Cyprus. She thought she found an arrhythmia and referred me to a cardiologist who I've just seen this afternoon. Thankfully he says my heart is strong. I have a slight murmur, nothing to worry about but he could put me on beta blockers. I told him I was on 7.5mg prednisolone and really didn't want to take any other medication unless absolutely necessary. He said OK, no problem. However, I thought I'd ask the question here. Does prednisolone react well with beta blockers. I don't really know what they are or what they do to be honest. I could ask Mr Google but I'd rather get some input from you, if I may......

[DorsetLady PMRGCAuk volunteer]

I was already on one for hypertension (Atenolol) when I started Pred (high doses for GCA) no issues…

The drug interaction site does say Pred may cause the BB to be slightly less effective but it’s classed as a mild interaction.

Not on it any longer, as have been changed to Candasarten (an ARB)..and no longer on Pred.

[PMRpro Ambassador]

I'm on bisoprolol, a beta blocker, for atrial fibrillation, The a/f started about the same time as the PMR symptoms and the cardiologist was quite sure it is due to the autoimmune part of the PMR damaging the electrical cells in the heart. I had PMR for 5 years before pred, and it was another 3 or 4 years before i was out on a beta-blocker, at the time together with Losartan, and angiotensin II blocker (an ARB) and an antiarrythmic.In the meantime the losartan has been stopped and the very low beta blocker dose upped a bit. I have never had any problems with any of them and have been on a fairly high dose of pred for PMR all the time.

Why did he want to use it? He doesn't sound as if he feels it is essential.

[Pr0jection in reply to PMRpro]

He said it's very mild. I believe it's the mitral valve. I have occasional flutterings but not really any palpitations. The cardiologist speaks very good English but with a strong accent which I find difficult to understand but my OH picked it up. At the moment I have a heart monitor on for 24 hours. Will return it today and someone should call me within a week. Unfortunately one of the leads got caught on a cupboard door handle and came off but I managed to reconnect it and will tell him. I don't suppose it will make a lot of difference to the outcome. Thanks for your reply PMRpro

[PMRpro Ambassador in reply to Pr0jection]

I always make sure I have a top on that covers all those dratted leads! Even wear it overnight ...

[Pr0jection in reply to PMRpro]

Me too. The worse part of the examination, for me, was lying there with no bra on in front of 3 men and a very young trainee who lifted and moved all my wobbly bits to attach the pads. Hey ho.

[PMRpro Ambassador in reply to Pr0jection]

My cardiologist is a female! Not that bothered about it being men but 3 of them is a bit OTT!

[Pr0jection in reply to PMRpro]

Thought I'd let you know that the cardiologist rang me today to say that he's studied the results of the heart monitor I wore for 24 hours and says that everything is fine and he can give me a prescription (Beta blocker) for the palpitations. When I said that I would like to wait a month before making a decision he said he would put a prescription onto the Cyprus equivalent of the NHS system and leave it up to me to decide. To be honest I can hardly feel the palpitations and they've only really started since I've been slowly slowly tapering for the last 10 days. They seem to come when I have a bit of anxiety (real or imagined).

[DorsetLady PMRGCAuk volunteer in reply to Pr0jection]

Good news - and what a sensible consultant… Might be with having them to hand, especially if you are likely to get anxious when tapering.

Fully understand you don’t want to take more meds than necessary….but

[PMRpro Ambassador in reply to Pr0jection]

As long as they are not too bad. I have to say it is my anticoags I value most!!!

[Kendrew]

I'm on the beta blocker Propranolol for ectopic beats. ( extra beats.... feels like palpitations and uncomfortable but harmless) The Propranolol calm my heartbeat down and stabilise it. Basically, they slow it down. I've had no issues with taking them alongside my steroids so far.

[Chris_1236]

I take a light dose of Atenolol to offset elevated heart rate from Prednisone.

[cycli]

Like Kendrew I'm on betablocker same as PMR as heart rate was over 100 due to slightly weakened valve caused they think by pred. \No adverse reaction and heart rate steady and normal level now.

[Pr0jection in reply to cycli]

Thanks cycli, good to know. My heart rate rarely goes above 70-74, very occasionally up to 80 when I've been too active especially in this hot weather here. I'll await the results after wearing this heart monitor for 24 hours.

[Broseley]

I've been on bisoprolol for 10 years now. Due to suspected a/f which has never been confirmed even after 3 goes at wearing a heart monitor for a week. The initial dose made me feel like a zombie, so GP agreed to reduce it to 2.5mg which is fine. I've had no issues with pred, as far as I know!

[Exflex]

Really interesting to read the replies. Six months into PMR and on 12.5mg of Pred at the time I was picked up with a left bundle branch block. Having read PMRPro’s response I ask myself whether the inflammation of PMR caused it (up to the age of about 50 I was flying and had cardiograms as part of my fit to fly and there was no indication). Thie investigation into the LBBB led to diagnosis of stenosis in the LDA leading to a stent being inserted. I’m on 2.5mg bisoprolol (beta blocker) to protect the heart and stent and have no known interaction with Pred. (I’m half way through a 3mg to 2.5mg taper, so quite a low dose).