Hi all. I was wondering if any of you have had similar experiences to mine in terms of propranolol (Inderal) withdrawal.
Today is my second day off propranolols (previously twice daily; 20 mg each dose). I am slightly hypertensive (untreated BP of 120/90s). I was started off on 20mg propranolols twice daily (with Xanax 0.5mg twice daily - for anxiety, and Valium 5mg once daily) about 10 months ago and 1.5 months ago voluntarily ceased taking the Xanax and Valium due to all the bad press both meds had in the press. I changed doctors at around that time as well (the previous doctor did not want to consider changing my meds although the medication combo above did not really stabilise my BP as on good days it could be 110/70, on bad ones it was around 120/90). The new doctor then recommended a calcium channel blocker felodipine (Plendil) starting at 2.5mg 2 weeks ago, and increased it to 5mg last week while stopping my propranolols by reducing the dosage from 20mg twice daily to 20mg once daily for four days, then cold turkey on the propranolols, and as mentioned above, the last of the propranolols was taken two days ago.
This morning, about an hour after taking just the Plendil, the following symptoms surfaced:
(1) palpitations with pulse rate in the high 90s, peaking at around 108 beats per minute. Felt at times the heart was "skipping a beat"
(2) felt slightly dizzy but this feeling did not persist
(3) pulse rate at rest was around 96. The slightest physical activity would raise this to the 100s, for example just getting up from the sofa to get a drink from the kitchen
(4) slight tremors in both hands
I haven't taken my BP for fear that it may be high, although it didn't feel that way (must be the Plendil doing its job). If the BP reading was high, it would probably freak me out even more and elevate the pulse even higher. http://www.healthboards.com/ubb/confused.gif
I was wondering if any of you have experienced the following withdrawal symptoms from propranolols cessation, and what you did to alleviate them.
I am an Oriental male, 35 years of age, non-smoker, do not drink alcohol and exercise regularly on the treadmill three times a week. I'm not overweight either according to the Body Mass Index calculator.
You sound like you have the same symptoms that Flamaest talked about
I am on my second day of non Toprol use and I anticipate symtoms to come. I think Propranol is also a beta blocker like Toprol. If so what you have is normal. Try searching for user under Flamest, he has been a big help to me in this withdrawal and even being on Toprol process.
You may want to call your Dr., but mine said there really should not be withdrawal symptoms, but I learned from this and another board, that some people do get them and they are the High heart rate and anxiety. Hang in there and if its worse, call your Doc to double check.
Thanks for your response! Yes, I do believe that Toprol is also a beta blocker like propranolol, but I'm not certain whether it is a selective beta blocker or not (propranolol is non selective - for more information on whether a beta blocker is selective or non selective, do a search on Google ).
If what has been described by flamest applies to me as well, then I don't have cause for concern. My problem is that stopping the propranolol while just starting the calcium channel blocker (Plendil) has a double whammy effect - because propranolol cessation may result in increased heart rates, and Plendil has also been known to increase heart rates for some patients! So, a double whammy for me to handle, something very unpleasant as you can imagine!
Anxiety also probably explains the tremors that I felt as well as the palpitations. After all, the worse the palpitations get, the faster the heart will beat due to the increased anxiety, right?
Anyway, I'm seeing the doctor tomorrow, and I'll ask her whether I'm coming off propranolols too quickly. Just keeping my fingers crossed that the Plendil will control the BP better than the propranolol...
A couple thoughts.
Plain vanilla proprolol (not extended release) is the fastest of the beta blockers wearing off in a couple hours. Add that to the fact that 2x20mg is an extrememely small dose and I'm willing to bet that any symptoms you feel is due to the calcium channel blocker (side effects are many and diverse).
I've gone on and off doses of 40, 80 and even 120 mg propranolol with no noticeable withdrawal.
I'll bet the Xanax and Valium withdrawals were no piece of cake though. THAT can be anxiety producing. Congratulations.
They are both very good drugs but OH so habit forming/addictive.
Today, to avoid what I felt yesterday, I decided not to take the calcium channel blocker (CCB). At the doctors, my BP reading was 130/95 which was worrying for me as I still can't believe that the diastolic number has gone so high for a person my age. The agreement I had with the doctor was that I'll continue taking the CCB (Plendil) but in smaller doses first, ie. 2.5 mg once daily. We will then increase this to 5 mg in a week's time if there are no noticeable adverse side effects.
I didn't have any major incidents today (ie. no repeat of yesterday) apart from the normal symptoms associated with hypertension, ie. some pressure in the eyes and a mild headache, which went away with some sleep. I do feel slightly more energetic though having come off the propranolols. I hope the side effects will wear off soon.
Your comments about the "extremely" small dosage of propranolols may not apply to me, I think. I am an extremely "medicine sensitive" person, and even with 2X20mg of propranolol, my heart rate went from the mid 70s to the low 60s, with no substantial change in blood pressure. If this is not the case, then my mind must be playing some nasty tricks on me!
And I'm also very glad to have come off the Xanax and the Valium - they were really playing havoc with my mood and desire for life!
Will try to keep the board posted on any progress I make...
Pls check ur reading for errors..if your diastolic is consistently high while your HR has been lowered by beta blockers then it just means you have more fluid retention..ACE inhibitors that dilate blood vessels to accomodate more volume or diuretics that flush out fluid to reduce volume may work well for you than ur current medications..
I have also notices that on ACE inhibitors I had 100-115/65-75 BP & HR 60-70 without a lot of variations but on beta blockers it varies from 110-135/65-85 HR 50-60.Beta blockers dont seem to be as effective as ACE inhibitors in controling the spikes of BP within a day.
Talk to ur drs about different clas of medications try them one by one..you will find the magic pill and dosage that works like a charm stick to it..Drs are sometimes like mechanics..some drs "think" and are comfortable prescribing a certain type of medication because that is in their "top of mind" or they have read that it is good.But you may be able to achive less side effects and control your BP more smoothly using a diff class od medication and even at lower dosages..
Hi there sunkarthik, thanks for your reply and thoughts.
Yes, while I agree that the systolic seems to be under control, and the diastolic is a tad high, your theory on excess fluid retention may not hold true. I don't detect any edemas on either my face or legs, especially the ankle. I was examined by two doctors today (my normal GP as well as a cardiologist) and they have ruled out excess fluid retention.
This morning I woke up with palpitations with pulse in the region of 100-120 even while resting, which seemed to get worse even with the slightest physical activity such as getting up from bed/the sofa! I must admit I was rather anxious during the entire day, and I first paid a visit to my GP after making an appointment (overdue, in my opinion!) with a cardiologist. The GP didn't prescribe anything, and my pulse at the doctors was 90.
This afternoon I saw a cardio who did a "normal" ECG/EKG on me and found nothing unusual. She attributed my symptoms above to three possibilities:
(1) beta-blocker withdrawal will cause "rebound tachycardia", ie. fast heart rates in some individuals
(2) Plendil may cause a fast heart rate although in her opinion she considered that 2.5mg was much too small a dose to cause the symptoms
(3) anxiety plays a big part in how fast the heart beats. The more you panic, the faster the heart beats
It could be a combination of the factors above which is causing my tachycardia.
She recommended the following:
(1) no more additional drugs - going cold turkey and grinning and bearing it is the way to go. When asked how long it would take for the recovery, she said (predictably) it depends on the individual. Some take weeks, others as long as 6 months!
(2) if the ECG/EKG is normal, a slightly fast heart rate does not cause damage to the heart
(3) exercise whenever I have the symptoms above, and exercise even more if I do not! Exercise, while increasing the heart rate, triggers off the release of some chemicals in the brain affecting the heart which could help the heart recover faster to its "normal" rate
(4) changing medications won't help much since she doesn't think Plendil is causing the symptoms
(5) watch my borderline cholestorol level (not caused by high LDL or low HDL, but in my case, by high tryglicerides which raised the overall ratio ) - kind of obvious, because who doesn't need to watch their cholestorol levels, right?
Finally, she mentioned that my anxiety/panic attacks is most probably caused by the withdrawal of Xanax, a very powerful drug which acts on the brain's ability to function correctly by suppressing certain chemicals which trigger panic attacks. Boy, am I glad I took the decision to wean myself off the Xanax and Valium (and propranolol!). I'm beginning to feel some energy returning already! Oh, she also mentioned that a visit to the psychiatrist may not help - they may actually prescribe the same drugs that I am trying to get off!
Anyway, will follow the cardio's recommendations and hopefully my "recovery" process will be faster
Will keep anyone who is interested updated on my progress...
[This message has been edited by wr6969 (edited 10-22-2003).]
Hang in there!! Its probably the beta blocker mostly. Let us know in a few days if its better and how you're doing.
I have a little more energy and am a little more hungry since I am off the Toprol. I am watching my pulse and BP closely. Trying not to panic either, having less anxiety symptoms also, but some at night for some reason more than day. Saturday was my last day of 1/2 dose, so I am off only since sunday, not that long.
I wish I had paid more attention when my Gp put me on Toprol. I was just concerned with the BP. I should have gotten a second opinion and maybe tried a diuretic or something else. Oh well too late....
Today was generally fine. Small episodes of palpitations (hovering around 100+) without anxiety - kept telling myself that it's due to the withdrawal, stay focused and it'll be over soon
Went to see an acupuncturist about my gastrointestinal problems (hyperacidity which requires me to eat once every few hours, otherwise the stomach churns due to excessive acid causing wind which then causes general discomfort ) and he said that I definitely had problems with my stomach as well as my metabolism. He then administered some treatment (told me I required three "courses" - each course needed 6 half-hourly sessions). He was also interested to find out why I was suffering from hypertension since I did not have any family history. Before the treatment, he took my BP - 125/90 with a pulse of 86. Immediately after the treatment he took another reading (with one of those very expensive Omron machines) and it was 115/84 with a pulse of 76. I was surprised to say the least since I never was much of a believer in traditional medication...but there you go...I believe that acupuncture is rather widely practised nowadays, so any of you who are suffering from this, and who are at your wits end may want to try this...
Keeping my fingers crossed that the course will produce the desired benefits
Sounds good with the accupuncture. How long did the low BP and pulse last? Was it because you were laying down and relaxed? If I lay down and relax my BP goes down also. I have a friend who raves over accupuncutre. I may try it someday
[This message has been edited by Sillyme03 (edited 10-23-2003).]
I've been off the propranolol for about 6 days now. Although the palpitations are not as bad now as they were when I first went off, they're still there, although I didn't take propranolol for that long, and that heavy a dosage (took it for about 8 months, 20mg twice daily).
The lower BP and pulse that I mentioned lasted for about a couple of hours, at least for the pulse (I didn't do a follow up measurement of the BP).
Today I went to the acupuncturist again, and measurement of BP in the morning at about 9+am was about 122/84 with no BP medication. I didn't sleep well at all last night, stomach gastric hyperacidity kept me awake and my pulse rate up higher than "normal"...after another session to treat the gastric hyperacidity, I felt more relaxed and managed to catch some forty winks upon coming home. I didn't manage to measure the BP after this acupuncture session though...pulse as I write this is still a little high, mainly due to worry, anxiety and the resulting stress of thinking about it, I think!
I know its hard, but try to relax, and your anxiety could still be from the Propranol. It takes a while to get out of your system. I get palpitations here and there and try to relax. Sometimes if I do a simple task it starts beating fast, but I know it will calm down and its a side effect of withdrawl. I have only been off Since Sunday, no even a week yet.
Just came back from GP this morning that originally put me on Toprol. Told her how much better I felt being off, appetite better, not as anxious, not dizzy, etc. She pretty much did not believe me that it was the Toprol. Said she never heard of it causing anxiety!. I told her I had talked to people on this board and had found several here and on another board who had same symptoms. was not open to possibility it was toprol at all.
My BP was 127/74 at the Dr's.!! Don't know how long that will last!
I am so glad that I took myself off Toprol and found this board. I am not back 100%, but better every day and hope to keep it that way. I am still tired more, but hope to start exercising soon.
Hope you get well also and try to relax.
[This message has been edited by Sillyme03 (edited 10-24-2003).]
Hi there, sorry to hear you're still experiencing these symptoms! I've generally been OK, nights have been rather undisturbed in terms of sleep. High pulse is still there, unfortunately, around 90-110 depending on whether I think about it or not! I'm continuing with my acupuncture treatment daily for my gastric hyperacidity (seems to be getting better, or at least I think it is ). BP reading today at the acupuncture centre was 105/81, with a pulse of 91.
Hopefully my body will wash itself off the propranolol soon!
One thing I noticed is that when I take the calcium channel blocker (Plendil), I start feeling a little edgy about an hour after I take it. It's really strange...considering I only take a 2.5mg dose, once daily...perhaps I'll start another thread for Plendil side effects...just joking...
[This message has been edited by wr6969 (edited 10-26-2003).]