I’m on Metoprolol 25mg for 4 weeks for Afib and need to go off it as I have been prescribed Multaq (see post link below). After 3.5 hours after my normal dosage time (so after 28.5h since last dose) my BP spiked suddenly to 155/95.

Before metoprolol my BP has been picture perfect (120/80 typically). Never had BP issues my entire life.

Called the doctor’s office and for now on 1/2 per day until I can fully go off it. After taking half dose it’s back to normal.

Is this caused by stopping Metoprolol?

Is this just a temporary effect of weaning off it?

I'm getting pretty scared of all these side effects... Thanks to the wonderful community here can keep my sanity. Thanks for helping.

(Note, the last time I delayed taking Metoprolol for about the same amount of time, BP shot up even higher, landing me in the ER)


Posted earlier question about Multaq:
[www.afibbers.org]



Edited 1 time(s). Last edit at 04/12/2023 01:53AM by hds.

"7. Beta-blocker withdrawal. Abrupt discontinuation of beta-blockers can lead to a “rebound” effect characterized by tachycardia and hypertension. Patients with ischemic heart disease may have exacerbation of angina or acute ischemic events.

In general, the risk of this rebound phenomenon decreases with increasing half-life of the beta-blocker. Carvedilol, sustained release metoprolol, and bisoprolol all have relatively long half-lives, minimizing the risk of beta-blocker withdrawal rebound. However, if beta-blocker discontinuation is necessary, it is preferable to do so in gradual fashion if possible." Source

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GeorgeN
if beta-blocker discontinuation is necessary, it is preferable to do so in gradual fashion if possible.

Thank you, George, you're an amazing ally in the Afib community. ❤

Doctor's office told me to take 1/2 for now (12.5mg). Any thoughts how to more gradually wean off it?

Quote
hds

if beta-blocker discontinuation is necessary, it is preferable to do so in gradual fashion if possible.


Thank you, George, you're an amazing ally in the Afib community. ❤

Doctor's office told me to take 1/2 for now (12.5mg). Any thoughts how to more gradually wean off it?

If you are stable at that, then (I'm making this up), I'd try to wean over 14 days. I'd use a single edge razor blade and cut a little bit more off each day. Probably doesn't have to be perfect, but this should be a safe approach. You could also search on Metoprolol weaning and see what other ideas come up.

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GeorgeN
I'd use a single edge razor blade and cut a little bit more off each day.

That's a very good suggestion. I will follow that.

Thanks again...

I was on Tenormin (atenolol) for 16 years for micro vascular disease (small vessel disease) and an attending ER doctor, after my first Afib, had me stop the BB cold turkey against the advice of my pharmacist husband. I got the worst rebound for 6 months. I failed the tilt table test and it also affected my BP. I ended going back on it. Even now I on a small dose of time released Cardizem just for the rebound after my AV ablation when technically I didn’t need it for my hr but my BP became once again super high. I feel better on it.

George is right-use a razor blade and slowly wean off.

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susan.d

George is right-use a razor blade and slowly wean off.

Thanks for sharing your story and sorry to hear you had to go through that.

I’m on day 3 of weaning off it, following George’s advice. Having been on 25mg and now on 12.5mg and slowly decreasing.

Somehow I already feel much better than before on 1/2 a dose (minus 2/14). Hard to qualify it, but feel more ‘normal’.

12 more days to go … fingers crossed.

It’s less than a month I’ve been on it.

My EP told me to reduce every 7 days. So I suggest continue on 12.5mg for a week and then take a razor to the half and cut again.

Instead of slicing with a blade, I used this expensive cutter. It quarters a pill quite well with practice.
[www.amazon.com]

A quick update. I am on day 6 of weaning off, currently at 1/3 of a 25 mg pill (started on 1/2 a pill).

Actually, feel much better since the dose reduction to 1/2 as instructed by EP (he stated I could go off it since am on Multaq now).

Have occasional dizziness in the mornings. Some mornings more than others (like today).

The trend of having an episode each other day has been broken as well. EP told me it will take a while before Multaq will take action. I had an episode last night and HR averaged 80 with the occasional spike to ~100. Once it converted it went back to normal rate of mid-50's (prior to Afib sleeping HR was 51).

My blood pressure has been 120/75 (approx) during the weaning so far.

So far so good. I have learned to take things one day at a time...

Thanks