Problems with Toprol XL, Vytorin, Plavix & Baby Aspirin

[woodbeck]

Hello, I had a heart attack in May of this year and had 2 stents put in and was put on a regimine of Toprol XL (now taking 12.5), Plavix 75mg, Vytorin 10/20 and one baby aspirin per day. Since taking them I have constant problems of heartburn/regurgitation, dizziness/lightheadeness, aches and pains, fatigue, headaches, and teeth and jaw pain. I have seen my doctor several times, been tested, and told that these pills are not the problem. Has anyone had bad experiences with them? Does anyone have any advice on what alternatives I could take? Any help is really appreciated

[Connie122516]

It's not unusual for people on beta blockers (like Toprol) to experience fatigue, dizziness, etc. I am on metoprolol (the generic, not time released version) of Toprol and have had no problems, but I know people who have had to switch to another beta blocker. I have no scientific evidence to back it up, but I tend to suspect timed release versions of any med are more prone to side effects, so you might do okay just switching to the metoprolol (which you'd have to take 2 x per day rather than once). It would also be cheaper (time release meds are a way for the drug manufacturers to continue to make $$ on the same old drug when their patent expires, though they may also have very useful benefits in some people).

Gastric side effects are relatively common with most of the meds you're on. I personally would never take Vytorin...it is a "combo" drug, i.e. it's two drugs in one. You likely need the Zocor that is part of it (a statin), but you need to be changing what you eat anyway, so why take the part of it that works on your intestines to remove the cholesterol you eat (and if I read the info about it right, also plant phytosterols which are usually good for you). And if it works to lower your cholesterol numbers, how does anyone know which of the 2 drugs is working?? It may have a place for some people, but my docs see no need for it, especially as the first drug that is tried. And given how Vytorin works on your intestinal tract, it only makes sense to me that it would have gastric side effects.

Muscle aches and weakness are a potential sign of the most serious side effect of the statins and should not be ignored (though it can be hard to figure out what's causing them as most of us tend to get them as we get older. This serious side effect is rare, however.

As you may have heard, the newest FDA recs this week are that people stay on both Plavix and aspirin for at least a year after stent placement so I don't think there's much you can or should do about that unless you begin to experience bleeding or excessive bruising. (You will likely get another opinion on that from a regular poster soon).

So, to summarize, I'd be asking my doctor: (1) why do I need Toprol XL; can we try metoprolol or another beta blocker and, (2) why do I need Vytorin; can we try just the Zocor, or Lipitor and I promise I'll eat less cholesterol and saturated fat and transfat.

Hope this helps and I'm sure others will come along soon with their take on some of this.

[woodbeck]

Thank you very much, you really took a lot of time and care in answering my question, especially since you do not know me. I really appreciate your help and thank you again. Sincerely, trying to get better.

[Lenin]

woodbeck,

Have you been taking the Toprol long?
Toprol is a beta blocker some people get reflux problems becasue the beta-blocker weakens the stimulation and strength of the esophageal sphincter and this can trigger reflux up the esophagus.
Fatigue and beta-blockers usually go hand in hand.

The Plavix (I'll skip my USUAL rant, Connie,) readily causes gastric bleeding and gastritis, esophagitis, and other abdominal discomfort. Have yourself checked out with an endoscope.


Side effeccts of the ezetimibe in the Vytorin are:

· tired feeling;
· stomach pain, diarrhea;
· runny or stuffy nose, cold symptoms;
· joint or muscle pain;
· headache, dizziness; or
· cough.

It will be trial and error to see what is causing you the most grief. Probably a good first elimination might be substitution of simvastatin (Zocor) 40 mg. for the Vytorin (simvastain and ezetimibe.) A couple weeks should tell if it was the ezetimibe casuing the problem. If not, you can go back on the Vytorin and stop the beta-blocker for a week or two.

IF you are seeing gastric erosion any esophageal bleeding in the endoscopic examination, then throw the Plavix onto the nearest dung heap.

[Connie122516]

Lenin,

Thanks for the info re: how a beta blocker affects the esophagus (makes sense; why didn't I think of that before?). I'd been blaming my increased problems with GERD since my stent was placed mostly on increasing age and the Plavix and aspirin (plus the Zoloft I was on for awhile, which I've ditched with much improvement not only in my gastrointestinal health but in my mental health...no more SSRIs for me...besides I think occasional anxiety and depression in someone with heart disease is normal).