Fatigue & Coreg...Alternatives?

I was dx with cardiomyopathy 7-2006, I've been on 50mg Coreg since 9-2006, along with 20mg Enalipril, a statin, metformin and glipizide.  I'm 57, 277#.  My ejection fraction has been measured in the last two years from mid 20s to  mid 40s, most recently LVEF 30% from heart cath. I have been suffering severe fatigue for four years.  A few months ago my family doctor did an Epstein-Barr four part panel which he said showed chronic fatigue.  On my own, I have experimented with taking only the night time coreg and other meds.  The next morning I had more energy.  Is there another medication I can take that would give me the benefits of coreg without the fatigue?


Thanks, John
New Mexico

[BoulderJD]

Sorry for the duplicate posting.  I "thought" I was posting this to the doctors' forum.  I don't see how to delete it so I'm attaching this explannation.  John

[alleycat2]

I also was taking 50 mg of coreg I felt fatigue and just not feeling good. I cut to 25 and feel much more energy plus just plain  feel better. I also am now on lexapro which really helps.

[kenkeith]

It can be confusing...no problem.  Try cutting back, and it is not unusual for the heartrate not to increase very high with exercise.  I believe you asked about another beta blocker as a substitute for coreg.  Coreg as a dual mechanism as it also has an ACE inhibitor effects that helps dilate vessels. It is highly recommended for heart patients. Take care.

[Flycaster305]

I'm in the CHF area where you are, also take 50mg of Coreg as of last week, it was increased as a recent test showed my EF was lowering.  My Ranexa prescription was increased to 2000mg and that really helped.  Ranexa maximizes the amount of blood/oxygen  that reaches the stunned or ill areas of the heart as I understand it, and works with beta blockers.  Others on this site who are swifter arrows in the quiver can probably describe how it works, but it helps me.  I do believe Coreg is a miracle drug.  As much as I hate it, I love it.  Ask your doctor if Ranexa will help you.

[Flycaster305]

I forgot to mention, since all my heart problems came on I've lost almost 45 pounds and it really helps.  Recently I've lost five pounds and can feel more energy already.  

[BoulderJD]

Alleycat2, Kenkeith and Flycaster305,

Thank you so much for the kind responses.  I'll certainly mention Ranexa at my next meeting with the cardiologist.  Until then I'll stay on Coreg, but may do the AM/PM dosages with half a 25mg pill each.  

Thanks again,

John

[oldie]

50mg of Coreg? I've been on 6.5mg. That's te stength of the Roche product and the cardio's prescription. Are we talking about carvedilol-COREG? Am I missing out on what you all say is a top rate medication? 50mg???that sounds like dynamite.

[Flycaster305]

50 mg is very often prescribed for Cardiomyopathy and Conjestive Heart Failure.  Often the dose is bumped up over a period of time.  I was inititally prescribed 3.175 mg twice a day, and it made me very tired, but as my body got used to it, I started taking larger and then again larger dosages until I reached 50 mg.  It's a very effective medication for many people, but some people just can't tolerated it.  

[kenkeith]

I started with 3.175 mg, and I been taking 12.5 twice a day for about 6 years. I had HCM, low EF and was never on a dose higher than 25 mg.  Currently, LV normal size and EF is 59%. My recovery was quick and there never has been any adjustment to dosage of coreg or ace inhibitor.

The recommended starting dose of COREG is 3.125 mg twice daily for 2 weeks. If tolerated, patients may have their dose increased to 6.25, 12.5, and 25 mg twice daily over successive intervals of at least 2 weeks. Patients should be maintained on lower doses if higher doses are not tolerated. A maximum dose of 50 mg twice daily has been administered to patients with mild-to-moderate heart failure weighing over 187 lbs.

[Flycaster305]

With an EF of 35% I was advised to take the full monty, 100mg dose of Coreg after my Pacemaker insertion.  I just couldn't handle it, I'm 6'3" and weigh 195.  50 mg is all I can do, but I also take Lisinopril and also I think Ranexa maximizes the effect of Coreg and minimizes my angina.  

[kenkeith]

Your medical condition certainly qualifies for the medication in the higher range, and from what I have read,  Ranexa, is a beneficial medicaion as well.  I am only 6 ft and 170 lbs. and the dosage you take for coreg would probably cause side effects for me, but fortunately my present regimen of medication serves me well.