Whose advice to follow??? - Heart Disorders Message Board

missy101 · 12-01-2006, 11:54 AM

Yesterday I spoke with my GP’s office and my EP’s office. They both said to cut down to 25mg twice a day on the metoprolol. Now my cardiologist’s office just called and she said I should do 25mg in the am and 50mg in the pm because I may have palpitations more frequently with the dosage decrease. I asked her “Well, is that primarily a comfort thing or is it unhealthy to have more PVCs or palpitations?” And she kinda tip toed around it. I couldn’t get her to say that it wasn’t dangerous. I mean..if I can be absolutely certain that it will not hurt me..I can live with a couple extra palps (only a couple tho!!) if I can lose the weight and be less fatigued. Then she was telling me that I had to exercise more. Well, I am a SAHM and it isn’t that easy. I really do the best I can for the most part. Ugh. So…whose advice do I follow??

Some background...

I am 32. Non smoker. No caffeine or stimulants of any kind (except some chocolate). No alcohol. I was diagnosed by a cardiologist 3 years ago with SVT after a HR of 150 sustained for 5 hours landed me in the ER. Tho the EKGs in the ER showed only a very fast inappropriate sinus rhythm. I was prescribed the BB. I saw an EP a couple months later for a 2nd opinion. He said it was probably IST, no worries, nothing to ablate, just take the BB and I will live long and healthy. I have had several EKGs, an echo, a stress echo, much blood work, event monitor, and a 24 halter monitor all within the past 3 years...all normal except the one time in the er with the fast but normal sinus rytthm.

mnmnmnmn · 12-01-2006, 09:49 PM

Cheers.. i would always say to follow the advice of your cardiologist, they specialize in this. When i was on that I had to wean down but you can wean down in like a week. So take the 50 at night for a week or so and then take it down to the 25. You dont want to get rebound tachycardia that would just cause you more problems.

Lenin · 12-02-2006, 09:32 AM

I'd go with the 25-25 routine.

First reason is that 50 mg. just before bedtime might cause insomnia...it certainly would with me.
Second is that YES, PVC's and palps aren;t very dangerous, just annoying. You want to control them to a point that is copmfortable but if it takes elephantine amounts of drugs to eliminate them completely, maybe the benefit to risk ratio gets too small.

CAN you take 50 mg. metropolol at night and still sleep? (I know some sleep well with it...but not me.)

Thirdly,
I feel the LEAST amount of drug to accomplish a task is usually bet.