Beta Blocker dosages

[Zener]

Hi, I may have Marfans syndrome. I may also have CHF. I spoke to a cardiologist because I have problems sleeping at night (I have nightmares that cause palpitation, my breathing seems to stop, and sometimes I breathe in oscillations of increasing amplitude when I just wake up after a nightmare).

My cardiologist prescribed Beta blockers and Telmisartan-40mg - my apnoea has disappeared some what, but there are issues - I am very worried about my beta blocker dosage.

Feb 1 - 12.5mg-0-0 Atenolol
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5months
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July 6 - 12.5-0-12.5
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2months
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Sept 10 - 25-0-12.5
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4months
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and now Dec 28 - 25-0-25 looks to be on the cards.

My dosage seems to wear off rapidly and that is what has me worried! In less than 1 year, I am at 50mg of atenolol.
What I am worried about is that if I run out of Atenolol, I'll have full-blown uncapped  CSA/CSR!
How are beta blockers prescribed/titrated? Has my cardiologist done the right thing? What corrective action need be taken - assuming something was done wrong?

Please help, I am very worried! Every time my dosage wears off, my nightmares return and my heart-rate goes up, and I need to up the dosage. What do I do?

[Zener]

Hi, thanks for the welcome :) BB's for pregnancy won't be the same thing because it's short-term. My heart-rate is 82 without BB's and 72 with them (resting rate), but as you said it varies during the day.

What is worrying me is that I'm not able to keep it at  72 resting. It wears off.. and goes back to 82 resting and it's normally after some time has passed at that dosage-level (like after 3 months).

Did you doc titrate to that 25mg level? How long were you on BB's? You said he "started you at 25mg" - so he didn't work up to that level from say 12.5mg??

In my case, I need to stay on BB's possibly forever (till I die) so.. it musn't wear off

[Encephalomalcia]

Atenolol levels peak than drop.  Atenolol levels do not remain constant.  Do you take the Atenolol before sleep?  Atenolol at 25mg is a low dose.  I have taken Atenolol myself while in my 8th month of pregnancy due to rapid heart beat of 160 per minute day and night.  My cardiologist started me on the 25mg dose.