Recent visit with my EP - Prescribes Metoprolol

HI, hope everyone is doing fine!

So I had my annual visit with my EP (Dr. David Mok – Burbank CA.) last week, actually it was 1/11 when I last seen him.
Anyways, I still have permanent AFIB, no surprise! Lol
My EP said that my blood pressure is too high (160/100) so he prescribed me Metoprolol Succinate Er Tabs (25mg) once a day in the evening.

Note: He said if I was to lose 40lbs or so that it would significantly lower my BP and I wouldn't need to take the medication.

I currently take Diltiazem 360mg once daily and a 325mg aspirin.

I have not started taking the Metoprolol just yet and wanted to get your guys’ opinion on this new medication.
Have any of you been on this medication?

If so, is there anything you care to share with me (good or bad) before I start taking it?

Thanks in advance for any and all replies.

-James

Hello James, nice to hear from you again.

About metroprolol, i can only tell you about my own experience with it. It was prescribed to me the last time i was hospitalized with a real bad cold, the kind that is supposedly untreatable because it is only a virus, and everybody knows antibiotics do not work on viruses. That is what was told to me when i saw my doctor because i had already had this thing for 2 weeks. I went home still sneezing and coughing and miserable, and in another week or so i got an afib episode out of it. I went to a local hospital and was duly admitted, and once i was established in a room the doctors on that floor wanted to listen to my heart and lungs. They were unable to do so because of the rattle in my chest caused by the aforementioned "virus" cold. That same rattle had been present a week previously when i was in the doctor's office being "diagnosed" with the "virus". I had not drawn a breath without it in weeks. These hospital doctors did not seem impressed with the virus theory and prescribed some azithromycin, an antibiotic. It worked just fine and within 24 hours they were able to listen to my chest sounds quite well. They called this cold bronchitis and treated it sucessfully with an antibiotic., which sounds to me like my trouble was not caused by a virus at all.
Meanwhile, as i was lying there afibbing away in a poorly concealed state of panic, i suggested to one of these doctors that his job might be easier if he gave me some kind of trank. He suggested ativan and had it injected into my IV line. Amazing thing, the afib stopped immediately. In a few days i was discharged and went home feeling much better. This same smart young doctor gave me 2 prescriptions, one for ativan and one for metroprolol. The ativan proved to be very useful. I got one or 2 more afib episodes while getting my magnesium and potassium and taurine levels back to what they had been before my adventures in the world of medicine, and one tiny ativan pill converted them all within an hour.
This doctor did not know me at all, of course, and i guess he must have thought i got afib episodes every other thing like most afibbers he had seen do. He wanted me to take those 50 mg metropolol pills twice a day, and i did so for several months. Then i began to notice that if i forgot that pill, i was reminded of it by a very unpleasant tachycardia, the kind that usually flips into afib unless i can get it slowed down again pretty quick. My regular dose of metroprolol abolished it, of course.

It began to seem to me that if some emergency were to separate me from my regular routine and particularly from my drawer full of pills,i was going to have to deal with an afib episode on top of whatever else was happening. I did not like this prospect much so i decided to taper off this medication. I cut those pills in half and took only 25 mg twice a day instead of the 50. I kept this up a couple weeks, then tried skipping a dose. Wrong move, here came that same scary, uncomfortable fast pounding heartbeat again. Took my half dose and it went away. So i went to cutting those half pills in half again, so as to take only about 12 mg each dose. A couple weeks later i tried again to omit this very small dose and was sucessful this time. I still have the bottle of metroprolol and on the rare occasions when i get that very rapid heartbeat, i take one of those 50 mg tablets along with my ativan that i use when it actually does turn into afib, and all has been well so far.

Tthe next time i saw my regular doctor i explained that i had discontinued this medication on the grounds that it is addictive, and he had a hissy fit about that. Said that without it my heartbeat would revert to the speed it had been in the hospital, and that i was mistaken about it being addictive. I ignored his point A because i already knew better - at that time i had already gone several weeks without any such thing happening - and gave him an argument about metroprolol's addictiveness. He is an earnest young fellow, and when i explained my difficulty with discontinuation and called that fast heartbeat a withdrawal symptom he seemed to have run out of arguments, and that is how things stand today, about a year later. I came to no harm from the metroprolol, neither from taking it nor from stopping it, except if you count the difficulty i had discontinuing it. I think the only reason it was prescribed to me was that hospital doctor thought i was having episodes every little bit, and doubtless if i was it might have been helpful to be on something that slows down the heartbeat. But actually i do not get more than a few episodes a year if that many, so most of the time i am enjoying sweet NSR, and i do not need my heartbeat slowed down. My regular doctor, the nice boy who thought i ought not to discontinue any prescribed medication, did not much understand my situation either, i would guess. I think i qualify as a difficult patient because of thinking i know more than he does about what is good for me. So be it.

PeggyM

Hi Peggy,

Good on you for sticking to your guns!!!

George

James, I noticed you saw Natale a couple years ago. Are you still thinking not worth going the ablation route?

Hi James - You know what you need to do about the weight loss. Only you can commit to doing that. You can also do a lot to control your hypertension through diet and making sure that you are optimized in magnesium and potassium and avoid packaged, processed foods that are devoid of nutrients but loaded with sodium which helps contribute to hypertension. Have you read Conference Room 72? If not, you should visit there.

As for the amount of diltiazem you are taking... I can't imagine using that dosage. I felt bad on as little as 30 mg daily. The metoprolol has the tendency to cause insulin resistance. Do I recall that you are also diabetic or am I thinking of another afibber?

Jackie

James - I concur with Jackie's comments. I was on metoprolol from 3-5-12 until 12-12. I was prescribed 25mg of metoprolol two days before my stroke to calm my A-Fib. Its the most benign of the heart medicines but hard to kick due to causing A-Fib type palpatations unless you wean yourself from it slowly. Get yourself a pill cutter because metoprolol is issued in 50mg & 100gm tablets that must be cut to get smaller doses. As soon as you start taking taurine 1000mg /day & magnesium glycinate your A-Fib should moderate or disappear as mine did. Make sure you hydrate with spring water having magnesium.