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    Old 07-08-2008, 10:55 AM   #1
    Lourage
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    50 mg lopressor twice daily?!?!

    Long story short, went to hospital yesterday morning with trouble breathing/pain by heart. Had the heart pain for months, doctors never ordered me to get it checked out. So comes yesterday i woke up in a state of panic not being able to catch my breathe. MY BP rose as i felt my face and ears i knew it was high. At the hospital it rose to around 158/112. I was given 3 intravenous shots of lopressor and one oral, and it still stayed around the 90-100 area. At one point when i was close off i was ablt to relax and it hit about 147/77. I tried telling the hospital people it was due to stress and anxiety and it just spikes like that during anxiety filled situations. STILL they said it shouldn't be that high especially after given the beta-blocker. So they ran tests, ruled out a bunch of things. ( i always thought i had an enlarged heart from how fats my heart beat over the years and years and years of working out) But nothing wrong with it except rapid heart beat.

    I got the report ( a few pages) and been told to follow up with my doc. Now all my past docs refused to put me on any beta-blockers, as i'm 27 healthy, and said they will cause me more problems. but i always disagreed thinking a small dose would be fine and HELL, it would help out with my anxiety symptoms also, such as racing heart, red face.

    So when getting discharged from hospital and not being able to find a reason for my high BP i was prescribed 60 pills of 50 mg lopressor twice daily. Now my question is should i wait to see my doc in a few hours or already start this dose?!?! I mean, i took my BP this morning and it was 135/64 with a pulse of 68... why would i take this medicine and lower it even more? especially a dose like that!??! Maybe i only need something for anxiety situations? should i maybe take half of a 50 mg tablet before the doctors visit today and see if it lowers my BP when it's actually high? Or is 50 actually a low dose of this beta-blocker? and does it take a while for a beta-blocker to get into your system anyway to actually lower your BP and it's not like for example say a benzo that you take and it works right away.

    Last edited by Lourage; 07-08-2008 at 11:02 AM.

     
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    Old 07-08-2008, 07:00 PM   #2
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    Re: 50 mg lopressor twice daily?!?!

    Lourage,

    Whether or not to take your medication is a tough call IF your blood pressure hasn't changed. Your reading of 135mmHg could have been a NORMAL blood pressure variation. You should check your blood pressure again, this time in both arms. Wait a couple of minutes between the readings. You might find that your blood pressure is near normal.
    How soon is your doctor's appointment - in a few hours? Has your heart rate changed? It was fine earlier. Are you having any chest pain? Be careful about lowering your diastolic too much with the beta blocker.

    I was on Lopressor SR 100mg 1x a day briefly last year before being switched to Labetalol. I don't think it's a very good drug because of its many side effects. Read about the side effects (ED, sexual dysfunction, depression and many others) before you see your doctor. Perhaps you should try another medication if you truly need it. Metoprolol has a short half-life, therefore it is fast-acting. That's why you are supposed to take it twice a day.

    Don't think about what might have happened in the ER regarding your blood pressure. You might never get an explanation for your blood pressure spike. BP spikes are worrisome if they increase in frequency. In those circumstances, their cause should be actively sought. I was sent to ER on Friday while picking something up at the hospital lab. I was kept there for several hours while they ran additional tests and labwork, before letting me go to work (4 hours too late!!!) Sometimes the medical personnel don't communicate very well. Mistakes are made and some things overlooked. Keep in mind that these guys do not know your medical history, other than a few facts you tell them on admission. They only have the vitals to work with and not too much of a medical background.

    Good luck - keep us posted.
    flowergirl

     
    Old 07-08-2008, 08:47 PM   #3
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    Re: 50 mg lopressor twice daily?!?!

    FG,

    What happened? Can't believe you were in the ER. You are right re: the ER especially Urgent care places. Our bodies are designed to pull the "flight or fight thing" when we get in tight places at times even though it is only the med staff not a bear to be contended with. Sustained HBP is the key unless you are having symptoms or at risk. Fam

     
    Old 07-08-2008, 08:57 PM   #4
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    Re: 50 mg lopressor twice daily?!?!

    Lourage,

    I question whether that was an accurate b/p since the diastolic was out of proportion to the systolic. I've given up on trying to get a accurate b/p in the medical setting.

    I think you should have been given clonidine or labetalol in the ER after first letting you lie down quietly in room with pleasant music. Apparently, that used to be the policy for army recruits getting their first miltary physical. Just lying down will reduce b/p about 20 points & if you factor that with a supportive, calm atmosphere I bet no med would be needed.

    Labetalol & Clonidine will start decreasing b/p in about 20 min in my experience. One important fact is that one's b/p shouldn't be lowered too fast as it could cause a stroke by dislodging a clot.

    You needed some serious counseling for the anxiety. I agree with your Dr's about not going on drugs which can cause serious drug reactions in the future. Get on an exercise program (moderate nothing heavy duty), try the DASH diet for HBP. Turn your life around-you can do it. Fam

     
    Old 07-08-2008, 09:42 PM   #5
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    Re: 50 mg lopressor twice daily?!?!

    Quote:
    What happened?
    Nothing much, really. As soon as I got to the lab for the test results (on my way to work), I was asked to report to the ER and escorted there by the tech. The reason for this was my ECG from two days before. A new ECG was done, a neurological exam, new labwork and some other stuff. Previous cardio test results were requested from the records. Some phone calls were made. I started to get a bit nervous, since no one knew where I was. In the end, they told me I could leave. Everything is a OK. I have a doctors' appointment tomorrow. From what I could see (the original labwork) it's not too bad (with exceptions). The electrolytes are good. I'll see how the doctor interprets the results tomorrow.

    FG

     
    Old 07-09-2008, 01:49 AM   #6
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    Re: 50 mg lopressor twice daily?!?!

    But what is bothering me is that i suffer from severe panic disorder, so it's always elevated in any type of social situations. Like right now it's fine, does it spike high? YES when I'm taking it or thinking about taking it. High BP runs in my family, but even my dad who is in his late 50's doesn't take a beta- blocker for his high BP. They ran tests on my heart AT the hospital/blood tests, you name it, everything was fine. Wouldn't that let them know that it's just random spikes and not constant BP i have? My face turns red and i got hot when my anxiety sets in, i know it increases my BP. I followed up with my doc today and NOW even though my reports were fine she wants me to go see a cardiologist ( called for an appointment, next one they have is August 5th..great) So now until then she agrees with the hospital doctor and wants me to start taking this med, btw when they took my bp at the doctors it was 150/90. After i told them it would be high and i could feel myself tensing up when they took it.

    But why start this ? why not have me get a holter monitor so it records my BP throughout the day when i'm in more relaxed settings? starting right away on a beta-blocker seems harsh, and now i have to take this beta-blocker for a month? and get it into my body, and who knows what the cardio will even tell me? probably to get off it, then i get to withdraw from it and i hear thats fun on these types of meds *sigh*

    what i really think i need is to make an appointment with a psych and get my anxiety in check before anything else. cause i bet that would decrease my anxiety ten-fold. But who knows. To top it all off i was told i can't exercise or anything until then, yet i have worked out for over 15 years with anxiety and must have been high BP also, yest everything is fine in my tests. LOL i want to cry right now from frustration and stress just from hearing this today! THIS really will give me constant high BP.

    Last edited by Lourage; 07-09-2008 at 01:51 AM.

     
    Old 07-09-2008, 01:58 AM   #7
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    Re: 50 mg lopressor twice daily?!?!

    Also, i'm probably off on the top to bottom numbers of the BP, i just always remember the bottom as thats the one i'm worried about when it's high. But here is what my ekg and chest x-ray report said:


    here is the report from the ER in brief.

    History:abdominal pain:

    chest x-ray

    The heart is magnified in this projection. The trachea is midline. The visualized hilar and mediastinal structures are un remarkable. Impression: NO acute disease.

    I guess this one is from my ekg, but it's a graph with what looks like heart rythms, it says on the top

    Rate: 123. sinus trachycardia
    RSR' in VI OR V2, Probably normal variant

    PR 180. Borderline T abnormalities, inferior leads
    QRSD 78
    QT292
    QTC 418

     
    Old 07-09-2008, 06:51 AM   #8
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    Re: 50 mg lopressor twice daily?!?!

    I think your anxiety is to blame for your increased heart rate. Anxiety causes increased heart rate (which rises even more during acute anxiety attacks), and elevated blood pressure. Anxiety causes the heart to move through the PQRST faster, resulting in shorter Twave. It can also cause the chest pain and many other symptoms.

    Sinus tachycardia is a rhythm faster than 100 beats per minute. It happens due to increased sympathetic stimulation of the heart (for whatever reason), fever or cardiac toxicity. Your doctor will run another ECG and request additional tests, if he considers them necessary. ECGs are not a diagnostic tool. Your anxiety and medications (if you take any for it) could play a major role in your increased heart rate. I forgot where my ECG book is, so can't help any further. Don't worry too much, it does not sound bad at all.

    As for the blood pressure, it takes more than one reading to diagnose high blood pressure. The elevation noted could have been due to anxiety and/or white coat hypertension. No one should be started on blood pressure medications based on a single reading of high blood pressure. Beta blockers are prescribed off-label for anxiety. This could be one of the reasons you were told to take it. It will also help keep your heart rate where it should be.

    Good luck! Please keep us informed about any feedback you get. Most importantly, try to relax and put this out of your mind for now.

    flowergirl

    Last edited by flowergirl2day; 07-09-2008 at 06:54 AM.

     
    Old 07-09-2008, 09:55 AM   #9
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    Re: 50 mg lopressor twice daily?!?!

    Well, the doctor at the hospital is the one who prescribed the beta-blocker. I read it's also good for anxiety as well, but to tell you the truth i'd rather just go back on a SSRI for my anxiety ( taking nothing at the moment) then have to take this. My last doctor wouldnt precribe me anything for my anxiety/BP and said i need to see a psych. It's funny too cause i was always mad he never prescibed me something for my BP saying "i'm not putting you on a beta-blocker cause that would cause more harm then good" I kinda want to see him for a second opinion, but my doctor kept my hospital results/ekg/blood work. But like i said, the doctor in the hospital and my main doctor said even if it is going up due to anxiety/white coat it's still dangerous being that high, even though it may not happen all the time. I just don't see why i can't work out, thats whats making me the most frustrated.i don't want to 'relax" for a month


    Thanks for the help flowergirl and famnd. Here is a list of my last few BP readings on my home machine in the memory, taking at different times throughout the day. What do you think? Good thing i was put on 50 mg of lopressor right? lol

    122/66 pulse 63
    128/71 pulse 66
    131/67 pulse 67
    119/69 pulse 70
    126/70 pulse 68
    123/75 pulse 79
    132/71 pulse 82


    maybe i would be better off splitting the 50 mg and just take 25 mg in the morning if i feel my BP is up? or is this type of medicine not the kind that works when you take it and have to get it into your system first? I really don't know what to do, i don't want to take it at all. I only took one yesterday and the day before that they gave it to me in the hospital.

    Last edited by Lourage; 07-09-2008 at 10:09 AM.

     
    Old 07-09-2008, 10:19 PM   #10
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    Re: 50 mg lopressor twice daily?!?!

    Quote:
    i'd rather just go back on a SSRI for my anxiety
    How did the SSRIs work for you and why have they been discontinued? Too many side effects? Did you have occassional blood pressure spikes while on the SSRIs? If they seemed to work well in controlling your anxiety, and your blood pressure was fine on the SSRI therapy, perhaps you should talk to your new doctor about them. Sometimes changing doctors is really all that's needed for gaining a new perspective and an unbiased review of an existing treatment protocol. I am glad to hear you've changed doctors!!! So have I. I regret not having done that a long time ago. Anyway, it wouldn't hurt to ask your doctor for an opinion on which of the two drugs would be more appropriate for you. If the anxiety (which seems to be a big issue) is under control, you might not have to worry about your blood pressure.

    Quote:
    the doctor in the hospital and my main doctor said even if it is going up due to anxiety/white coat it's still dangerous being that high, even though it may not happen all the time. I just don't see why i can't work out, thats whats making me the most frustrated.i don't want to 'relax" for a month
    That is very true. Blood pressure spikes can be just as dangerous as sustained hypertension over a period of time. The same type of organ damage and cardiovascular events can occur.

    Your blood pressure readings (sans any meds) are awesome! With your diastolic in the 60's you cannot afford an additional reduction in diastolic pressure. You could become symptomatically hypotensive. How about calling your doctor's office? A nurse should be able to advise you. Should you need to reduce an elevated blood pressure, beta blocker must be taken regularly to be effective (full benefit is seen in about a week). The occassional dosing might be OK for reducing anxiety though I am not sure about that. The short release (regular) form of Lopressor peaks in about 1-2 hours after it is taken orally, so it is really fast acting. Your heart rate and blood pressure seem to be nearly perfect when you are not anxious.

    take care,
    flowergirl

     
    Old 07-11-2008, 02:25 PM   #11
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    Re: 50 mg lopressor twice daily?!?!

    Well i been taking the lopressor, and even took both doses yesterday. It seems like just thinking about my BP causes it to spike, and i feel my face flush and a tingling in my neck. I guess i get to look forward to these spikes everyday until the cardiologist visit. I find it weird how it happens when i think about it, it's like i'm giving myself white coat syndrome even when i shouldn't. If this keep up i'm going to end up actually having damage by the time i see the cardio!

    Could the lopressor actually be causing the spikes? i have so far noticed no lower reading while taking it although my last reading a few hours ago was119/70 pulse: 65. But it doesn't help with my sudden spikes, as they seem to come on only when i think about it! and i have been thinking about it 24/7 thinking when my face gets red and i feel hot i'm going to have a stroke. Heck when i thought i felt fine yesterday and felt cool and relaxed i took my BP again and it was around 134/84! and like i said i felt fine, when i get spike and feel myself turn hot god only knows how high it gets but at the hospital i felt like that and the readings were real high! diastolic in the 112's!

    With the SSRis it's weird, i mean i always noticed the spikes, but when i was on SSRI's i noticed they were few and far between! like months without ever having them. I would still get them occasional, but not as bad now on nothing! But i didn't really notice anything else when on them and figured they weren't working, so i tried others, then went onto benzos and nothing. Sometimes i think no medication works on me! I got off them cause none of my doctors since then liked prescribing anti-anxiety meds, so now i'm waiting on a psychologist, but every time i call for an appointment i get the answering machine.

    Whats bothering me is in the meantime i am going to have to deal with this crap everyday until then! and now i also on top of that have to worry about this beta blocker, and if it doesn't even work i'm taking it for nothing and will still have to be weaned off it. I really don't know why if my tests were fine at the hospital my doctor still wants me to see a cardiologist when i told her flat out it's cause of the anxiety. Why else did i feel perfectly fine after the hospital, then after her telling me i should see a cardio and take the beta blocker i feel like crap again and driving myself crazy? cause it's most likely all in my head! I don't see why before ANYTHING i wasn't told to wear a holter monitor to check my BP readings before doing anything else. is that something a cardiologist prescribes and a normal pcp can't? I think i just need some sedatives to calm me down. I'm in such a rut that am contemplating having a few beers to unwind ( it would help, but also make my BP rise and heart race, so not a good idea) But i'm not going to do that. It says on the hospital discharge to return if symptoms persists, but they have just been spikes and not constant high BP, plus i would feel like a hypochondriac and feel as though i'm wasting their time.

    Whoever says anxiety can't/doesn't kill lied! i was always told that growing up from various docs! It really is ruining my otherwise healthy life!

     
    Old 07-11-2008, 11:05 PM   #12
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    Re: 50 mg lopressor twice daily?!?!

    Lourage,

    Quote:
    I guess i get to look forward to these spikes everyday until the cardiologist visit
    please do not expect your blood pressure spikes to miraculously stop after your visit to a cardiologist. These guys are not magicians. Somehow they always seem to be in a rush. Feel lucky if the doctor sits down with you to review your file and if he takes another ECG. One quick look at the new ECG and a comment that everything is fine (or not bad at all!) will wrap things up. I hope that your doctor will spend some time going over your situation and that your cardio appointment is a productive and pleasant experience for you.

    When sinus tachycardia (heart rate greater than 100bpm) is caused by normal physiological factors, such as exercise, anger, stress, anxiety, fright, fever etc., no treatment is required. Of course, determining its cause and treating the underlying condition, where applicable, is the important part.

    Quote:
    i have been thinking about it 24/7
    I know how that feels. Whenever I think about a test I will soon be having, (which requires anesthesia) I feel considerable anxiety. The test does not bother me in the least. I worry about my breathing during the procedure. Consciously, I know there is absolutely no need to feel anxious and that my fear is unfounded because everything will be monitored. Yet I still worry. We can make ourselves sick worrying. It gets us nowhere.

    There are trained health care professionals who specialize in teaching patients how to handle the stress of everyday living (especially work-related stress) effectively. These one-on-one sessions are superior to the stress management seminars, where the speakers' qualifications are often questionable and which are more entertaining than educational. You sound like a perfect candidate for a session or two with one of these professionals. If successful, it could change your life profoundly. It has changed mine.

    Quote:
    my doctor still wants me to see a cardiologist when i told her flat out it's cause of the anxiety.
    You have a good doctor and should be grateful for the referral to a cardio. It can't hurt! Your doctor just wants to cover all bases by making sure your tachycardia was a response to a normal physiological factor. I hope everything works out for you.

    Good luck,
    flowergirl

    Last edited by flowergirl2day; 07-12-2008 at 07:22 AM.

     
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