Discussions that mention toprol

High & Low Blood Pressure board

[QUOTE=mabent;3664971]Hi Ace!
Your post did ease my doubts about Bystolic, and I thank you very much!
I hadn't realized that it had been used in Europe for many years before being approved by the FDA. I started taking 1/2 pill morning and evening two days ago. It does make me feel tired, and I'm hoping that the tiredness will disappear in time. I certainly do not want to gain weight, so I'll watch for that. I am especially happy that you found that it doesn't cause ankle-swelling. That was a terrible side effect with Norvasc! I could take 1/2 tablet of Norvasc with no problem, but when I started taking the whole 5 mg. tablet my ankles felt as if they would blow up!!! I sure hope Bystolic will work for me as well as it does for you. As I said before, I also take Vasotec and Hydrochlorthiazide. Does Bystolic also lower your diastolic B/P as well as your Systolic? Do you think that you will eventually be able to stop taking it? How long have you been taking it, and how much have your readings improved? Thanks. Mabent:)


I started Bystolic approx. 5 months ago. (At the time I was also taking a pill similar to Vasotec called Aceon). When my knees began to develop sharp pains (after about 3-4 weeks on Bystolic) I called my doctor and he switched me to another beta-blocker called Zebeta (Bisoprolol). My occasional knee pains disappeared, but I began getting these skipped heart beats, a little shortness of breath and feeling run-down after doing my usual chores.

I had to choose which pill side-effect I can live with better. I decided to give Bystolic another chance, besides it is hard to judge a pill and give it a fair chance unless you give it at least a few months. Often times, side effects can improve. On my last checkup my blood pressure was 130/85 taking only 5 mg of Bystolic. My mail-in pharmacy had phoned me about 3 weeks earlier to inform me that my Aceon prescription would no longer be available. So I continued taking only 5 mg of Bystolic, till I could speak to my doctor for an alternate medication. On my last visit July 9th, he told me to only take the 5mg of Bystolic and did not give me any other medications.

Aside from tiredness/fatigue, My knee pains have disappeared, I can perform all my daily chores without the heavy-leg feeling and my blood pressure numbers are pretty good. My last cholesterol test was much improved from my earlier readings in May. Sometimes things appear to get worse before they get better. In comparison tests, Bystolic was better than alot of other pill choices in lowering both Systolic and Diastolic pressure, but I think the Diastolic lowering is stronger.

P.S. Mabent, Unless your blood pressure numbers are really high, I mean (160/110+) I think that 3 medications is a bit excessive. Unless your doctor insists or their are special considerations. Beta blockers such as Bystolic, Toprol etc. work great with just a mild diurectic such as Hydrochlorthiazide. Vasotec works better with Norvasc (Calcium blockers). You mentioned, "When can we stop taking taking these pills?" I think to start, we should begin by eliminating one pill at a time, and try to be on the lowest dosage of only one pill. Ask your doctor if you can try the Bystolic and Hydrochlorthiazide (only) before your next appointment. This makes it easier to isolate pill side effects.

Drop the VASOTEC (if he allows). Apparently, either the NORVASC or VASOTEC were causing leg-swelling problems.

I hope this information was useful..

I'm glad to hear you are doing OK with BYSTOLIC. I think that certain drugs take a little longer to see the positive effects. Some drugs lower blood pressure within 1 week, others can take 7 weeks. This has to do with absorption, peak blood levels, metabolism etc.. I think BYSTOLIC needs more time to do it's stuff. Many previous posts all mention beta blockers in a very negative way. The thing to remember is that all those old beta blockers mentioned such as PROPANOL, METOPROLOL, ATENOLOL etc. are older 1'st and 2'nd generation beta blockers, though they are also well proven drugs and apparently a Cardiologist's best friend for lot's of positive reasons such as Post heart attack, Atrial fibrillation, Tachycardia, Heart attack prevention (especially early morning heart attacks), and angina prevention and relief.
How many HBP pills can boast all these benefits?? The thing to also remember is that the newer beta-blockers such as COREG and BYSTOLIC are known as 3'rd generation beta blockers. They don't cause vaso-constriction, cold extremities, and very slow heartbeat. They have strong Antioxidant properties, vasodilation and increased blood flow to heart and other organs.

Mabent - If BYSTOLIC continues to work fine, stick with the pill. Your blood pressure numbers appear pretty good and you don't appear to be suffering from the terrible side effects you were experiencing in the past. I am also new to this pill, I will also continue as long as all goes well. If not we still have other choices.
[QUOTE=mabent;3678316]Hi Ace -Thanks for your post. I do plan to keep taking the Bystolic for a while longer,but I just don't understand why it would cause my b/p to rise! Even the Amlodipine lowered it (while causing other problems!). Have you ever tried Coreg?

Hi Mabent,

I've never tried COREG, but it is also a newer beta blocker with the best results seen in heart failure patients. It is also a well proven drug. The only 3 beta blockers which have been approved in Europe and the U.S for heart failure are: TOPROL, BISOPROLOL and COREG. The good news is that COREG is now a generic drug called "CARVEDILOL". This can save you some money on a prescription. I think that COREG/CARVEDILOL needs to be taken several times a day, as opposed to once a day with BYSTOLIC. The problems with COREG are: having to take the pill several times a day and a very high rate of Male Sexual Dysfunction (especially for men).
[QUOTE=mabent;3700891]Hi Flowergirl and everyone - I haven't had high blood glucose readings since taking the Bystolic; but my systolic pressure has really gone way up! I'm still going to continue taking i for a while longer, mainly because I don't know what to do next! I'm hoping to hear from Ace and Macheon about their current experiences with Bystolic. The good news is that I'm not tired anymore, and the swelling in my legs has gone way down. I do still have some burning in my legs but it doesn't bother me. I feel much better, but I certainly do worry about the increase - today my b/p was 160/73. The diastolic has never been above 65. And my pulse is 56 - much lower than it's ever been. I hope I don't have to experiment with another drug! As I've said before, what I really am concerned about is having a stroke! :( Hope you all are doing well! mabent

Hi Mabent,

I'm glad to hear once again that the Bystolic is working for you. I believe the top number of your blood pressure will improve once you fully adjust to the medication. I always try to keep in mind that we all react differently to medications and the various side effects. Some on this board cannot tolerate TOPROL, while for others it is a remarkable life saving drug with almost no side-effects. My uncle always told me that we need to be our own doctors when it comes to high blood pressure. I believe he was correct. Doctors are trained to push medications recommended by sales reps. at recommended dosages. As Flowergirl mentioned, it becomes difficult to identify a side effect being caused by a particular medication. I think this was true approximately 10 + years ago before all the large research studies confirmed the dangers of calcium blockers and the cholesterol/glucose association with beta blockers. The Internet age has made all this research information readily available. Doctors cannot hide negative information or keep us in the dark. The FDA site is constantly recalling drugs and posting alerts. (Drugs which should never have been approved in the first place). Speaking of recalls... A beta blocker called KERLONE/BETAXOLOL was recalled by the FDA last week. If a recently prescribed medication causes weight gain, lipid changes, sore muscles, loss of vision and glucose increases within a certain period time, and a doctor tells you it is probably not the medication and to watch your weight and carbs. This is the ideal time to request another medication or do your own research or find another doctor. I'm a strong believer in "Cause and Effect".
Hi Mabent,

Personally I believe, that amlodopine is definitely not one of the better pills.
Calcium Blockers in general have not been proven to provide any mortality benefits at all. Certain calcium blockers were actually cited for causing an increase of over 25% in heart attacks (and no benefit in strokes). I will take my chances to always try and stay away from them. My brother in laws ankles are always swollen while taking amlodopine. How can this be a good pill?? The oldest and best known pills which have also been highly effective for over 35 years are diuretics and beta blockers. BYSTOLIC is one of the newest beta blockers and may one day prove to be just as effective as the other more well known researched beta blockers like TOPROL and COREG. I think it is fair to give a pill at least 2 to 3 months. For the past week or so I am giving TOPROL a try once again (BRAND of course) because I believe I was also substituted with the generic junk a couple of years ago while I was taking METOPROLOL and then TOPROL. In the beginning TOPROL was fine. I had great blood pressure numbers, I felt less anxiety, a relaxed heart rate, and eliminated my PAC's and PVC's. My doctor than added ALTACE for better blood pressure control, and my TOPROL XL tablet changed to generic and that's when side effects increased. I dropped the TOPROL and took only ALTACE which continued to give me side effects like dizziness, cough etc. I was then switched to COZAAR which gave me an almost daily tickle in my throat, was then switched to DIOVAN (which was not controlling my blood pressure) I was then swithced to BENICAR which gave me excellent blood pressure numbers, but I also started suffering from gastro-issues, stomach pains, irritabilty etc. my doctor recommended a colonoscopy which showed an inflamed colon/ulcerative colitis. Which my doctor found very odd at my age. I stopped the BENICAR and thats when my doctor gave me a sample of BYSTOLIC. Within 3 weeks the stomach pains ended, stomach and bowel movements returned to normal and I felt much calmer (the beta blocker effect) The problems as I mentioned in an earlier post with BYSTOLIC are the weight gain, higher total cholesterol, lower HDL, and a recent glucose increase. Another problem I am having is the constant fatigue I feel at work. If I close my eyes I will definitely fall asleep. I'm an IT System Engineer, I can't afford to fall asleep at work. Also some effects which I mentioned to my doctor (that mostly pertain to men) Though the pill manufacturer states that all these side effects are highly unusual for this pill, my body tells me different. I am also aware they are trying very agressively to push this new pill. After I started the TOPROL XL, within 2 days my energy level increased and all other functions returned rapidly to normal. The only side effect I'm having with TOPROL are vivid dreams, (which supposed to improve as your body adjusts) and my heart rate is not as controlled as the BYSTOLIC. The proper dosage for heart rate control is something I will discuss with my doctor on my next appointment. My cardiologist blieves that TOPROL/METOPROLOL is one of the best HBP/CARDIO medicines which exists.
I have to value his opinion. He has been a Cardiologist for almost 45 years. He is not alone because apparently about 80 % of Cardio doctors recommend TOPROL. I figure, it must be a pretty safe and reliable drug. (If we take the BRAND not GENERIC). Sometimes a very good pill could take a bad rap....
Hi Ace,

Regarding the vivid dreams, when do you take Toprol? I've had similar problems with Inderal & Labetalol. It seems the closer I take my meds to bedtime, the more problems with dreams. But for now I am sticking to taking my last dose before bedtime because of all the benefits with this routine. One patient was a writer so she just incorporated the dreams into her books :). Fam
Hi Ace - I agree with you about Calcium Channel blockers! When I first started Amlopidine is when my ankles swelled for the first time. The swelling gradually increased, and you know the rest of the story. Do you think these drugs accumulate in our bodies and then start causing more side effects? For instance, you were doing fine on Bystolic at first.
Bystolic caused me to be anxious during the night, so I began to take in in the morning. That's working out fine. Yesterday I was very pleased to see that my systolic pressure ranged between 120 and 136; however, today it's bqck up into the 150's! I'm happy for you that Toprol is working (so far). I'll look into that drug for my next choice if I need to change again! I'm impressed by the fact that your cardiologist likes Toprol better than others. But, I'm still going to keep giving the Bystolic a chance for now... About the vivid dreams - are they like nightmares? I like to dream and usually do every night. I have never connected dreaming with drug-taking. That's interesting!
Thanks very much for your help with all of this. :) Regards. Mabent
Hi Mabent,

BYSTOLIC is still an excellent pill. I just want to see if my GLUCOSE, Total Cholesterol etc. improves with another beta blocker, such as TOPROL or BISOPROLOL. I took TOPROL some years back and I also tried BISOPROLOL right before my doctor gave me a sample of BYSTOLIC. All 3 are rather well tolerated drugs (for me that is). Others on this board have had big time side effects. When I took TOPROL, only my HDL chol. appeared lower. My weight and glucose were always fine. I was not on BISOPROLOL long enough to determine if my cholesterol or glucose were affected. BISOPROLOL is very similar to BYSTOLIC. They are both very highly beta1 selective, no ISA and
both come in 5 and 10 mg pill form. BISOPROLOL similar to TOPROL has been around a little longer and has been studied more thoroughly. They are also both approved for Heart Failure, Angina or after MI. BYSTOLIC does not have these approvals yet. I think the reason TOPROL is preferred to all other beta blockers is because TOPROL XL has been around for almost 40 years (brand name METOPROLOL/LOPRESSOR). The effective dosing for TOPROL is 12.5 mg till up to 400 mg. That assures a wide margin of safety and a proven record of tolerance. Also, most of the METOPROLOL/TOPROL studies such as MERIT were shown to benefit all types of heart disease and some results were so dramatic that the trials were stopped earlier. TOPROL is also rather cheap in price approx. $65.00 - $75.00 for 100 pills. In contrast BISOPROL (brand) is approx. $250.00.

P.S. I must mention that BYSTOLIC provides great heart rate control versus any of the beta blockers I tried, in the quickest amount of time. Other beta blockers give you a heart skip or a thump or occasional PAC and PVC's. Especially during the first few weeks. This does improve though, and should not be the main criteria in deciding on a beta blocker.
[QUOTE]P.S. I must mention that BYSTOLIC provides great heart rate control versus any of the beta blockers I tried, in the quickest amount of time. Other beta blockers give you a heart skip or a thump or occasional PAC and PVC's. Especially during the first few weeks. This does improve though, and should not be the main criteria in deciding on a beta blocker

There is a reason this drug has been approved for treating mild to moderate uncomplicated hypertension AND a mild to moderate heart failure in Europe.

It has a unique characteristic. Nebivolol enhances nitric oxide bioavailability. Basically, it functions as an antioxidant and decreases the markers of oxidative stress. In doing so, it may reverse endothelial dysfunction, so common in people with hypertension.

This third generation beta blocker lowers the heart rate and blood pressure, as well as improves the systolic and diastolic functions of the heart.
In people with heart failure due to a systolic left ventricular dysfunction, this drug has been shown to improve LV ejection fraction and reverse remodelling. In people with primarily diastolic dysfunction, morbidity and mortality were greatly improved. This and other interesting insights had been gained from a large Eropean study on Nebivolol use in elderly people with HF. The results were very favorable. Consequently, this drug has been approved for use in heart failure (in Europe). Hypertension often results in heart dysfunction, which can lead to heart failure. Its increasing occurence is raising concerns. The beta blockers currently used for treating HF (in addition to other drugs) in Europe are Carvedilol, Metoprolol (succinate), Bisoprolol and Nebivolol.

Trials are already underway for use of Nebivolol in heart failure in the US. I read about this just after the FDA approved the use of this drug last year. When one examines the SEC information of Forest Laboratories contained in its annual report and released earlier this year, there is a provision (I won't quote the section number) stating that Forest assumes the sole authority, cost and expense of all current and future developments of this drug, INCLUDING... all studies currently underway (two are named) ...for heart failure. I don't think it will be long before an application for an approval of Nebivolol (Bystolic) for use in HF is submitted to FDA. Time will tell. There is no doubt this is one of the better (if not the best?) beta blockers.

Hi Flowergirl,

Not to play devils advocate - but Alot of the information we are reading about BYSTOLIC/NEBIVOLOL is to sell and promote this pill. Most of this information is speculative. The primary difference between this pill and other selective beta1 blockers is the vasodilation effect, which many HBP pressure meds. provide(Relevance unknown). The supposed arginine/nitric oxide effects are mainly theoretical and performed on Animal experiments. CELIPROLOL, CARVEDILOL and others (also Ace inhibitors) also increase nitric oxide. The Nebivolol Heart Failure (SENIORS) did not produce such great results. TOPROL and CARVEDILOL results were significantly better. As far as neutral metabolic effects, I do not believe it. All my plasma lipids and glucose count worsened. Not to mention weight gain. Sexual function was definitely worse with BYSTOLIC versus TOPROL or BISOPROLOL. An interesting point I would like to mention is... The FDA site has cited the NEBIVOLOL/BYSTOLIC research team for: Keeping 2 sets of falsified records, Not adhering to testing standards, not assuring patient safety and numerous other violations during their Research studies. The Manufacturing Laboratories were also cited and fined before the final approval of the drug, because of inferior production and unsafe manufacturing practices. Perhaps the pill I am taking is an inferior or incorrectly manufactured pill, because all the proposed benefits and differences stated are not apparent.

For the Pill prescribing information. Nebivolol was shown to be toxic to laboratory animals and cause infertilty and irreversible sperm cell damage. Also an increase in LEYDIG Cells. Reproductive studies could not be performed, because none of the offspring survived. Scary!!

P.S. These are some of the reasons why I have some reservations about this pill at present and wanting to try another beta blocker. It may one day prove to be the best pill.. but now I'm weighing my options.
Hi again, Ace,
Thanks for your encouraging posts. I did call my doctor to ask whether I should keep taking Bystolic, despite the fact that it doesn't seems to be helping my systolic pressure - mentioning, of course, that my legs have stopped swelling (they still have a burning sensation without pain). He said, as you did, that I should continue taking it. Your posts have had a calming effect on me and thus on my blood pressure! Thanks so much!! I'm wondering if your vivid dreams might stop eventually if you decide to go back to taking Bystolic?Once you wake up do you feel all drained - or are you able put the dreams out of your mind after remembering them and feel relieved that the events didn't actually happen? What time of day did you take it? I've found that I feel better when I take it in the morning. So, I'll continue taking Bystolic and try not to worry about having a stroke :(. I have a dr. appointment next month.
Good luck with taking Toprol - that will be the next drug I try if necessary to change. Mabent
Hi Mabent,

I did not have sleep problems or dreaming episodes while I was taking BYSTOLIC. Only TOPROL caused this side effect. Apparently, this is due with the drugs ability to cross the blood-brain barrier. PROPRANOL is also similar in this regard. They consider these drugs LIPOPPHILIC. I think some are much more lipophilic than others. Oddly, this abilty to cross the blood brain barrier is what makes many pills remarkable for blood pressure control, and for diease prevention. PERINDOPRIL, ALTACE and even LIPITOR have this ability.