Coreg - need for continual monitoring

I am a white male, will be 70 next February. I have had a pacemaker for 6 yr. My ejection fraction was recently found to be 35. About 5 years ago it was 40. I have a neurological problem which has been diagnosed as due to anything from hereditary neuropathy to pinched nerves; in any event my legs are weak so it is dificult to climb stairs etc. independent of heart problems. I continue to try to play (poorly) tennis doubles as my main exercise because I enjoy it despite getting severely out of breath during the 1 1/2 hour play period - no chest pains. I passed persantine stress test about a year ago. My cardiologist wants me to take Coreg. Potential problem - my wife and I like to travel so that at times I might not be available for monitoring for 3 - 4 weeks. My internist is against my taking Coreg for this reason; says I should be monitored regularly. Cardiologist says it is not a problem because if I have stabilized at a given dosage I can stay at that dosage past the time when the dosage might normally be increased. Wait till I will be around for a while before increasing the dosage so I can be monitored at the new dosage for a while. I had thought that even after stabilizing at the highest dosage I would be taking, or at any dosage, that I should be available for frequent monitoring. Please comment on this. The disagreement between internist and cardiologist is confusing. Also, cardiologist says I am good candidate for Coreg because the pacemaker will keep my heart from slowing down, thus minimizing the initial fatigue side effect. If this is so, then the heart will not get the benefit of rest from a slower rate that I thought was one mechanism Coreg uses to improve things??? Cardiologist also says I should continue to play tennis despite getting out of breath because the exercise is good, then gives me a bookle to read which says, in part, to avoid overexertion which is defined as exercise that results in getting badly out of breath. Pardon the long post but I am confused as to what to do. Thank you in advance.

[CCF CARDIO MD - DLB]

I think all of your cardiologist's advice is sensible and I agree. If you have stabilized on a particular dose of Coreg, travel should not be a problem. Tennis, since you enjoy it, is something I think you should continue. It should help keep you and your heart healthy. You should not continue to the point of exhaustion though. The pacemaker does make therpay with Coreg easier and safer, but should not make it less effective.

[Dorothy Wolfe, ([e-mail]]

I am a newcomer to the Coreg medication, specifically for a five
week period.  I feel at the point of my mg doseage I am feeling
a bit better without getting so tired and out of breath.  As all
medications of to-day, the purchase price of named brands is totally blown out of proportion.  Is there available a generic
brand of medication for "Coreg"?  And if so has there been any
info available as to whether "generic" vs" named brand is just as good for the patient, or, no significant difference between the
two?  Thank You.

[Ted]

I have just recently been taking Coreg for CHF at a Heart failure clinic, I have had two coronary by passes (three each time), suffered a cardiac arrest and have a difibrillator AICD implanted in Oct. 1997. Since taking Coreg 3.125 for about 6 weeks I have had the usual side effects of loss of pep, and short dizziness ( less than 5 seconds)usually when lying down and putting my head on the pillow. I can live with this, if it helps me. The question I have is, does Coreg increase the Creatinine levels (from 1.6 to 2 mg.) and Bun Levels  ( from 36 to 48)and Uric Acid( from 8.2 mg/dl to 10.8) I have noticed since taking it that these  levels have increased and am I sacrificing my kidneys and liver for this drug. I am sheduled to have the first increase in the level of Coreg later this month. I am a white male, age 70, non smoker for 30 years and have an occasional beer or glass of wine now and then, but not very often. I have not had any shortness of breath in normal activities, swelling of feet or sudden weight gain.

[Ted]

I have just recently been taking Coreg for CHF at a Heart failure clinic, I have had two coronary by passes (three each time), suffered a cardiac arrest and have a difibrillator AICD implanted in Oct. 1997. Since taking Coreg 3.125 for about 6 weeks I have had the usual side effects of loss of pep, and short dizziness ( less than 5 seconds)usually when lying down and putting my head on the pillow. I can live with this, if it helps me. The question I have is, does Coreg increase the Creatinine levels (from 1.6 to 2 mg.) and Bun Levels  ( from 36 to 48)and Uric Acid( from 8.2 mg/dl to 10.8) I have noticed since taking it that these  levels have increased and am I sacrificing my kidneys and liver for this drug. I am sheduled to have the first increase in the level of Coreg later this month. I am a white male, age 70, non smoker for 30 years and have an occasional beer or glass of wine now and then, but not very often. I have not had any shortness of breath in normal activities, swelling of feet or sudden weight gain.

[Ted [e-mail]]

I have just recently been taking Coreg for CHF at a Heart failure clinic, I have had two coronary by passes (three each time), suffered a cardiac arrest and have a difibrillator AICD implanted in Oct. 1997. Since taking Coreg 3.125 for about 6 weeks I have had the usual side effects of loss of pep, and short dizziness ( less than 5 seconds)usually when lying down and putting my head on the pillow. I can live with this, if it helps me. The question I have is, does Coreg increase the Creatinine levels (from 1.6 to 2 mg.) and Bun Levels  ( from 36 to 48)and Uric Acid( from 8.2 mg/dl to 10.8) I have noticed since taking it that these  levels have increased and am I sacrificing my kidneys and liver for this drug. I am sheduled to have the first increase in the level of Coreg later this month. I am a white male, age 70, non smoker for 30 years and have an occasional beer or glass of wine now and then, but not very often. I have not had any shortness of breath in normal activities, swelling of feet or sudden weight gain.

[Jeffrey M.Crooks]

I had read in another "side effects" site about some people experiencing tingling and numbness in the extremities, my dad gets it in his leg, I get it in both arms and now since I've been on Coreg for a while, I'm getting numbness in my back. I get spasms and it gets so tight I can't walk. I never had this problem before the drug, and it's very pronounced numbness, like novacaine in my back muscles, it really interferes with my main form of exercize, tae kwon do. I don't stand on one leg like I could 8 mos ago, I got thru the dosage increase just fine, a little tired but satisfactory. I would like to take advantage of the increased stamina but it hurts.My hands get very numb sometimes. Comments anybody?

[Jeffrey M.Crooks]

I had read in another "side effects" site about some people experiencing tingling and numbness in the extremities, my dad gets it in his leg, I get it in both arms and now since I've been on Coreg for a while, I'm getting numbness in my back. I get spasms and it gets so tight I can't walk. I never had this problem before the drug, and it's very pronounced numbness, like novacaine in my back muscles, it really interferes with my main form of exercize, tae kwon do. I don't stand on one leg like I could 8 mos ago, I got thru the dosage increase just fine, a little tired but satisfactory. I would like to take advantage of the increased stamina but it hurts.My hands get very numb sometimes. Comments anybody?