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Old 05-27-2008, 06:05 PM   #1
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Anyone take metoprolol in a real low dose and split the pills?

I am wondering if anyone takes metoprolol in a real low dose. I was taking 12.5 mg twice a day. Now I take 6.25 mg twice a day. I have to cut the pill into 4ths which is not so easy. Does taking 6.25 mg lasts for 12 hours until next pill? I had seen my dr a few weeks ago and asked that and he seemed okay with it. I asked a pharmacist who said with that low dosage and if your bp is okay, one wouldn't need to take it at all. I was put on metoprolol after lisiniprol(on it for one month) made my bp too low and my heart rate was up so a PA changed it to metoprolol. I have been on it since January. I see dr next month and am hoping to get off it all together. Thanks, Pam

 
Old 05-28-2008, 07:59 AM   #2
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Re: Anyone take metoprolol in a real low dose and split the pills?

Pemmy,

what was your blood pressure before treatment? Is having an elevated blood pressure your only health problem? It would help to know why this particular drug was selected as your antihypertensive with so many others to choose from.

FG

 
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Old 05-28-2008, 10:52 AM   #3
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Re: Anyone take metoprolol in a real low dose and split the pills?

FG,
I don't know how to make this short. We moved to TN 7 yrs ago and I never got around to getting a physical exam until 2 yrs ago. Last July, I had my exam. BP was okay. Lady dr left practice soon after. I was dealing with a nurse practioner and 3 PA's before seeing the man dr. A few weeks ago, I talked to nurse and asked her to send me in office bp readings. July-2007 when I had my physical it was 120/88. Dr never said anything about that. My cholesterol was up so I saw the nurse practioner in Aug about diet. My bp was 134/96. My reasoning was I was nervous on seeing her as I knew what a cholesterol diet is and should have done it the year before. She said to monitor my bp. I did for a few weekends after that at Walmart and my bp was normal. I went back in Nov for cholesterol test to see her and my bp was 130/92. I told her that we were flying to NE for Thanksgiving and I have anxiety about flying. After we came back, I bought a homedics bp monitor. I did get some high readings. Then I got some error messages on it so I took it back. I went to see the nurse practioner in Dec and showed her the readings. She took my bp it was 108/76. She said something about spikes and of course, high blood pressure being a silent killer. She said keep monitoring it. I told her that I had to fly out any day back to NE as my brother was diagnosed with terminal cancer. She felt my thyroid was enlarged and thought she heard a heart murmur so wanted me to have ultrasounds. I had those on Dec 10(both turned out okay but thyroid is bit enlarged-no nodules). That afternoon I had to come back for a pap smear done by a Physician's assistant.IFor a couple of hours I worried about myself and my brother). My bp was 148/92. I did not know that at the time. She asked are you nervous. I had to explain about I might have to fly out any day and my brother had terminal cancer. She prescribed lisinipril. I was worried about being 30,000 feet up in the air and didn't want to have a heart attack or stroke. I had been on it for a week and had to fly out. I went into dr office to have my bp checked before leaving. Saw yet another PA and my bp on lisinipril was 110/80. She took blood to test it.(Later found out I had high calcium). The night before I had to fly, I felt dizzy. Thought it was my bp but checked it with a new Omron bp monitor and it was okay. I felt sick after that but still flew back. I felt sick for a month-thought it was due to anxiety, stress over my brother and thought I had caught a cold as I got a terrible cough. I went to walk in clinic and my bp was 98/60 but the nurse practioner asked when I had taken the bp med and I said about an hour before I came in. She didn't say anything about it. Gave me antibiotic prescrip because my throat was a little red. We flew home the next day and I went to dr after that. Saw yet another PA. My bp was low and my pulse was up. (I have to find out what it was). She changed it to metoprolol er(actually toprol xl but pharmacy gave me generic). I am guessing she gave that to me for the fast heart rate? I had to have a blood test for parathyroid hormone-turned out to be high. I was on metorpolol er 25 mg for 4 days and felt wierd and head sick. Called dr and talked to nurse. I was told stop taking it and come to see him on Monday. I did and he thought it was high calcium causing me to feel headsick. Changed it to reg metoprolol 25 mg but said take 1/2 a day. I still felt sick on it. I even came back into see him. I even thought my anxiety was getting to me. I got lexapro. Took it for 8 days and felt wired. Got heart palps at night. Called dr nurse to tell her. She didn't think it was the lexapro but high calcium/parathryoid causing heart palp. I asked don't I have to take metoprolol twice a day. She said you are on toprol xl. No, I am not. I even asked dr don't I have to take it twice a day as it is not time released. He said it was okay. Well, finally after calling nurse again, I was told to take it twice a day.
After awhile, the head sick feeling went away. I still kind of got heart palps at night. Then dr said it was anxiety causing those. I have had ekg's and fine. Even a holter monitor and it was okay-I was on metoprolol with that. I started taking magnesium at night to deal with heart palps. Seems to help. A few weeks ago, I had some low bp readings so I had asked if I could cut 1/2 pill in half and was told yes. I went to see dr to check my bp two weeks ago and it was 120/88. I had brought in my readings for the past two weeks(I alway says it's my home monitor and it might not be accurate. I have brought my monitor in twice before to have a nurse and the dr check it and they get high readings on it. I think it was because they weren't doing it right. Dr had me on his table and tube to my monitor was all twisted, etc.) I told him how hard it was to cut the pill into 4's. He said he had another patient that is on 1/4 dose. I even asked should I go back to taking a half and he said no. I asked if I could try getting off them. He was open to it but also asked if I wanted to try another med like Coreg. I had jury duty a week ago so didn't want to try getting off the metoprolol. I don't think I want to try Coreg. I am to go back to see him next month for bp check and get my cholesterol checked. I just don't feel comfortable with him. I know I should find another dr. I don't know too many people to find out who to go to as in a good dr.
I have had anxiety all my life and it's worse now. I did get some xanax to take. I feel weird in my chest-guess worry about taking a beta blocker or any other bp med. My mom is 83 and has taken a med for a fast heart beat for over 20 yrs and has been on lisinpril for the last two years. My older sister has been on metoprolol er for around 5 yrs for bp and fast heart rate. She was able to get off it for awhile but was put on half dose for fast heart rate. Then her bp recently want up so she is on a full dose now-I think 50 mg. I am 54 so bp can go up with age and being menopausal and hormones flucuating. Hyperparathyoid disease can affect bp. Anxiety and stress could be a factor. If I have to be on a bp med, I just want to be on the right one and correct dose. If I don't have to be on one, that would be great. I am wondering if the only way to find out is to wean off this and see what happens. I am trying to eat better, exercise, and do breathing exercises. Anxiety and worry are two of my biggest problems, too. I go back in July to endocrine surgeon to test blood for calcium and pth-have posted about that on thyroid message board. I might have to have surgery for that. So my worry now is cutting this small pill in accurate dose! Does anyone else take such a small dose? Sorry this is so long. Pam

 
Old 05-28-2008, 08:08 PM   #4
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Re: Anyone take metoprolol in a real low dose and split the pills?

Pemny,

You won't be able to get the dose just right because of the cutting issue. Just be sure & take your b/p before each dose so you can see if it is elevated excessively. Also look for other signs of withdrawal like chest pain, palpitations etc. Remember there is a drug reservoir in your body tissues after being on the drug for a month. So the body can call on those reserves. I had to go back & forth when I was withdrawing from some drugs. That is I would have to take a larger dose one time if my b/p was up too much. Then I would go back to the smaller amount.

Don't worry about your long post, those of us who have had similar things happen understand. I think you are doing great considering what you are going through. Your thyroid & parathyroid issues maybe fueling some of your anxiety. I have thyroid issues so I understand some of those problems. Just consider this a temporary thing that will eventually get settled. Fam

 
Old 05-28-2008, 10:03 PM   #5
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Re: Anyone take metoprolol in a real low dose and split the pills?

Hi Pam,

you seem to be right on top of things. No wonder anxiety has played a major role in your life, considering all that has been going on.

Your blood pressure is generally good. An increase in parathyroid hormone will cause hypertension with blood pressure fluctuations. Perhaps the elevations that have been noted on occassion are normal blood pressure fluctuatios.

Most people with parathyroid problems have symptoms, which, among others, include: kidney stones, headaches, depression, high bp which goes up and down a lot, inability to concentrate, bone pain, GERD and heart palpitations - often atrial arrhythmias.
Also, and this might apply here: heart rate of up to 200 beats per minute can accompany hot flashes during menopause. Your fast heart rate could be a result of hormonal changes, as you suspect. Episodes of an increased heart rate are also triggered by strong emotions, electrolyte imbalances and strenous exercise.
Palpitations happen when the stress hormone is released. Adrenalin makes the heart beat faster and with more force. This sometimes results in heart palpitations and arrhythmias. They appear as a reaction to psychological stress and do not signal heart disease. Other causes are coffee, tea and smoking, but usually palpitations are caused by anxiety, as your doctor believes to be the case.
You mention anxiety numerous times throughout your sizable post. It is probably responsible for at least some of your current issues.

Quote:
bp can go up with age and being menopausal and hormones flucuating. Hyperparathyoid disease can affect bp. Anxiety and stress could be a factor. If I have to be on a bp med, I just want to be on the right one and correct dose. If I don't have to be on one, that would be great. I am wondering if the only way to find out is to wean off this and see what happens
.

Can a small dose of medicine be beneficial? It can. Can a tiny dose of an antihypertensive have any notable benefits? I am not sure. Would you be better off on another medication? Calcium channel blockers, verapamil and diltiazem, are also used to reduce heart rate. Since you've been told to use only such a small dose of your current medication, even your doctor might be questioning your need for it. Isn't that good to know?

I hope things work out for you. Please keep us posted.

flowergirl

 
Old 05-29-2008, 05:46 AM   #6
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Re: Anyone take metoprolol in a real low dose and split the pills?

Thanks famnd and flowergirl for replying. I am not sure if I can take diurectics or calcium channel blocker because of the high calcium in blood/parathyroid. I will see my dr next month.

 
Old 05-29-2008, 09:15 AM   #7
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Re: Anyone take metoprolol in a real low dose and split the pills?

I was about to post a similiar question myself. Here's my deal. 34 yr old male. I seemed to have anxiety issues about a year ago. I was getting the "lab coat" HBP of 150s/70s and even spiked at 170/70s at the doc's office. My at home readings always seemed fine.

The doc decided to put me on 25mg of Toprol. It was great. Very minimal side effects. I was calm,collected and my BPs remained in check 120/60s. Now almost a year later, I'm starting to feel really lethargic, and uninspired to do just about anything lately. I feel boring because I just don't feel anything! I'm not really happy nor am I ever really sad. Apathetic.

Just for shiza and giggles I took my HR and it was in the 40's. I've never seen it so low. Waited a day, and the same very thing.

Long story short, I'm going to split my pill in half and start taking 12.5 mg only per day because I think I'm actually being over medicated at this point.

Last edited by Sofa King; 05-29-2008 at 09:24 AM.

 
Old 05-29-2008, 03:16 PM   #8
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Re: Anyone take metoprolol in a real low dose and split the pills?

Sofa King, Are you taking the brand name Toprol or generic form metoprolol. Is it extended release as in Toprol XL or regular one. Let me know how it goes for you by cutting your dosage.
Pam

I tried to edit this once and it didn't post. So here goes again. Are you taking toprol xl, the extended release pill. I don't think you can split that because of the coating on it. Someone else might know more about that. I am taking regular metoprolol. Small pill with a line on it-kind of looks like a 1-where I can split it in half. You might want to check with your dr, too.

Last edited by pemmy; 05-30-2008 at 06:30 AM.

 
Old 05-30-2008, 06:41 AM   #9
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Re: Anyone take metoprolol in a real low dose and split the pills?

Quote:
Originally Posted by pemmy View Post
Sofa King, Are you taking the brand name Toprol or generic form metoprolol. Is it extended release as in Toprol XL or regular one. Let me know how it goes for you by cutting your dosage.
Pam
Originally, I was taking XL but now in the last 4 months I've been taking the metoprolol. I cut my dosage (25mg to 12.5) two days ago and now my HR has already risen into the 60s and I'm feeling better already. BPs are still normal.

Last edited by Sofa King; 05-30-2008 at 06:42 AM.

 
Old 05-30-2008, 08:51 AM   #10
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Re: Anyone take metoprolol in a real low dose and split the pills?

I think I am dealing with a similar situation. Several weeks ago I experienced a sudden drop in blood pressure from my then normal readings of about high 120's or low 130's over 85 or so diastolic.
My blood pressure has remained consistently low since - to the point of being symptomatic at times - dizziness, increased nausea or feeling disoriented. It is now in the low 100's or below. The diastolic is in low 60s to mid70's. There have been no changes that I know of to my lifestyle, medication, or a level of physical activity.
After a two month wait to see my new doctor, I've just learned she is and will remain unavailable. So, I find myself without a doctor and running out of my meds. I have cut back on my medication (I chose to lower the ACE inhibitor) and don't know where to go from there. I guess I'll have to start looking for a doctor. I have done some reading about hypotension and "seemingly" unexplained changes in blood pressure. One cause of hypotension I was not aware of is an electrolyte imbalance (excessive magnesium levels specifically). Of course, the antihypertensives often cause hypotension also.
I don't want to reduce the dose of the wrong medication - such as the beta blocker or the CCB and suffer the consequences (still fresh in my memory from last year). I've been thinking that perhaps I don't need ANY medication (or doctors) at all...

Your heart rate is too low. No wonder you've been feeling lethargic and have no energy. You need to go on a different medication. Inform your doctor - don't wait too long.

flowergirl

 
Old 05-30-2008, 09:04 AM   #11
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Re: Anyone take metoprolol in a real low dose and split the pills?

Quote:
Originally Posted by flowergirl2day View Post
Your heart rate is too low. No wonder you've been feeling lethargic and have no energy. You need to go on a different medication. Inform your doctor - don't wait too long.

flowergirl
It was pretty strange how quickly the onset of the lowering HR was too. The only thing I can attribute it to (other than the meds) was an increase in exercise. I stepped it up a few notches for a Vegas trip (poolside) but other than that, I don't know.

I'm going to ride out my meds at a lowered 12.5 mg one time a day to see if I continue to improve HR while maitaining BP. If I see anything unusual, I'll get on the horn to the doc.

 
Old 05-30-2008, 06:26 PM   #12
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Re: Anyone take metoprolol in a real low dose and split the pills?

FG,

Are you getting enough fluid? You need to see a Dr. especially since you are getting symptoms. Lack of potassium will decrease one's b/p but I know at least one of your meds can cause an increase in potassium.

I was busy working on the house this weekend & didn't eat much. I know my potassium got low so now I'm playing catch up.

Remember the the recipe for low b/p that you can always use. I've had to do it several times in the past 5 yrs. Drink 16 oz of fluid (water or some kind of easily absorbed fluid). Drink the fluid within 15 min. This always raises my b/p 20 points systolic for 2 hrs. Fam

 
Old 05-30-2008, 08:17 PM   #13
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Re: Anyone take metoprolol in a real low dose and split the pills?

Quote:
I'm going to ride out my meds at a lowered 12.5 mg one time a day to see if I continue to improve HR while maitaining BP. If I see anything unusual, I'll get on the horn to the doc

Sounds good! Would you please let us know what happens? Perphaps your blood pressure will return to its normal levels - thanks to your increased physical activity - and you won't need any medication. That drop in blood pressure could be a result of your healthy lifestyle (sounds like you don't live up to your screen name... ) and is a goal a lot of us on this board have been trying to achieve.

flowergirl

 
Old 05-30-2008, 09:09 PM   #14
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Re: Anyone take metoprolol in a real low dose and split the pills?

Hi Fam,

Quote:
Are you getting enough fluid?
I am not sure but it's been hot here and I get thirsty a lot. I only drink water when on my breaks - just one small glass, which is probably not enough.
I would go see a doctor but don't have one right now. I don't know what my labs are. None have been done since very early January. I am supposed to have everything checked every 3 months at least. I resent finding myself in this position through no fault of my own.
You are right, maybe my potassium is out of balance again. Perhaps I should say more out of balance than usual. I experienced hypotensive symptoms for several days last year when being treated for severe edema. My dose of Hctz had been doubled. This increased dose, combined with my other medications, resulted in a drug-induced hypotension. The doctor told me I'd have to put up with the hypotensive symptoms until the edema resolved itself. This meant staying in the house since I was too dizzy and sick to stand or walk.

I still eat a lot of fruit and veggies. No problem there. Thank you for reminding me about the importance of adequate fluid consumption and your recipe. I'll up my fluid intake - and do as you suggest.

flowergirl

 
Old 05-30-2008, 11:47 PM   #15
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Re: Anyone take metoprolol in a real low dose and split the pills?

FG,

Are you getting enough fluid? You need to see a Dr. especially since you are getting symptoms. Lack of potassium will decrease one's b/p but I know at least one of your meds can cause an increase in potassium.

I was busy working on the house this weekend & didn't eat much. I know my potassium got low so now I'm playing catch up.

Remember the the recipe for low b/p that you can always use. I've had to do it several times in the past 5 yrs. Drink 16 oz of fluid (water or some kind of easily absorbed fluid). Drink the fluid within 15 min. This always raises my b/p 20 points systolic for 2 hrs. Fam

 
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