Inderal LA

Hi,

I just had my Natale ablation 8/2/19. I looked forward to getting off of sotalol & Xarelto (the latter drug will have to stay a while longer I am told).

Since my ablation I have had a kind of cough reflex in that when I take in a little more air (a slightly deeper inspiration sometimes), it causes me to sort of gag/cough. Totally non-productive cough and non-relieving, but kind of the same way one has to gag before throwing up - just an involuntary thing.

Possible reasons why posed to me: anesthesia effects, intubation irritation, caught a bug?, & I think sotalol effects have gotten stronger. I felt a bit of this dry cough since starting sotalol last February, but after the ablation it is way magnified. I am now 13 days post ablation & have gotten off of sotalol bec the St. David's nurse said I could try it. It has only been 3 days & the cough might be abating, but it is not totally gone yet. Yesterday when I saw my local cardiologist, he firmly said sotalol does not cause cough. So, I said I did see where sotalol causes about 4 things that could fall in my category like chest discomfort, difficult or labored breathing, tightness in the chest, & it actually does say COUGH or hoarseness. Anyway, I told the cardiologist like I had told Dr. Natale that I did end up realizing that I was enjoying the calming effect & almost complete eradication of my hand tremor, so after getting off sotalol I wanted to try a bit of beta blocker & they recommended Inderal, of which effects (re before public speaking or acting) I knew of for years. Only after being on sotalol did I realize the tiredness did lessen over time.

What I want to hear now is if Inderal LA 60 mg once a day will also make me have the cough or any other bad effects. I should mention I was on sotalol 80 mg q.12 hr (twice a day evenly spaced). I have not picked up my prescription that is ready yet, bec first I want to see if the cough goes away with a few more days' time before I add in another variable. And, I want to hear any feedback on this from you.

Thanks very much.

Inderal LA. The LA is the long acting and dosing is once per day. I have been on it for over 20 years and have not developed cough.

Nobody can predict that for you. Beta blockers are known to cause a cough in some people. You might be one of them, and if so the Inderal might not be any better, but all you can do is try it.

Quote
Madeline
Yesterday when I saw my local cardiologist, he firmly said sotalol does not cause cough.

So I guess the FDA, Mayo, Cleveland Clinic, the NHS, and a few dozen other authoritative sources are all wrong.

Quote
Carey
Nobody can predict that for you. Beta blockers are known to cause a cough in some people. You might be one of them, and if so the Inderal might not be any better, but all you can do is try it.


Yesterday when I saw my local cardiologist, he firmly said sotalol does not cause cough.

So I guess the FDA, Mayo, Cleveland Clinic, the NHS, and a few dozen other authoritative sources are all wrong.

Hi Carey,

Well, you know, I gently persist & recategorized how I defined cough & said it felt more like a tightness in the chest & lungs that just made the gag/cough reflex happen when I took in deeper breaths & he did admit the beta blockers caused - i think he said bronchospasm & maybe something else lung related, but not cough. So, we left it there. He is a pleasant guy, but he is firm in his opinions, and he does not seem to accept much outside of that, though as long as I am polite, he lets me do what I want. He wrote the new script for Inderal LA & was okay with me getting off sotalol. You know what he told me though - sotalol was a full beta blocker, where I had thought it was mainly an antiarrhythmic with some beta blocker in it. I of course researched this on Internet & did find an equivalency calculator that deemed the #mg equaled the same thing in sotalol as it did in Inderal & that indeed sotalol is a full beta blocker too, even if it does help control rhythm some as well.

My cardiologist is still also remaining firm on me being on blood thinner for 1 year as he does not accept that new finding of not counting female as added to the ChadsVasc score, but if Natale tells me I can quit it at 3 months, I will.

I definitely wouldn't allow your local guy to overrule any of Natale' recommendations. I hope the Inderal works better for you. And if you can get by without any antiarrhythmics 13 days post-procedure, that's a really good sign.

I found an answer to someone’s question re a post-surgical cough on the Internet last night and this is what was said:

Dear Dr. Roach: A year ago, I had cardiac bypass surgery. Everything went great: I had no pain.

About a day or two after getting home, I started coughing. I would cough and cough and cough. It started when I would lie down, and sitting up initially helped. Later, I was coughing all the time. Cough drops or syrup didn’t help. The doctors could not find any fluid around my heart, or anything out of the ordinary.

To make a long story short, my doctor prescribed a short course of steroids and then benzonatate, which was the only thing that would stop my cough. What would have caused a post-surgical cough?


Dear K.C.: There are many possible causes for cough after surgery. During surgery, a plastic tube is inserted into your airway so the machine can breathe for you: This can cause irritation, and is a frequent cause for cough. (That usually lasts only a few days.) Fluid overload can also do it. Infection in the lung is probably the biggest concern. Often, medications that are started after surgery, especially ACE inhibitors (their generic name ends in “-pril,” like “lisinopril”), cause cough after being on them a short while. The nerve to the diaphragm, the phrenic nerve, can be damaged or irritated during surgery, causing a cough that might last for months.

The doctor answering her questions said more than what I put here, but I just wanted you to see the part about the phrenic nerve in the diaphragm irritation possibly causing cough.

Your cough started in February when you started the sotalol. Very unlikely it's phrenic nerve injury. That's not a mistake Natale makes. A sore throat and/or cough from the ET tube usually goes away in a day or two. I think it's really unlikely it was a consequence of the ablation.