How to taper off Atenenol?

Thank you for taking my question. Yes its about those dreaded PVC's again but this time a question about Atenenol and tapering.  I am male, 40, no CAD, all tests normal- echo, stress, holters etc ...but do have PVC's and many times runs of two or three in a row but for the most part get several hundred per day lasting a few days to now for the first time 2 months straight with some relief days here and there.

Questions: I was told by my cardiologist that i could take atenenol 12,5 mg on a prn basis (as needed) to help alleviate the symptoms. I have been taking the atenenol for about 35 days straight now but i cant say its helping all that much- it keeps my heart at a slower pace which is good because with the PVC's i often get bouts of tachy. Question #1: Thus, how do you taper when only taking 12,5 mg of the drug per day and how is it done safely? I do notice by the 21 st hour after having taking the drug before my heart paces around 90-95 until the next dose three hrs later and then goes back to 70 or so. Question #2: Can one build tolerance on such a small dose? Question #3: Is it safe to work out taking a small dose of beta blocker?
Question #4: Should I expect a rebound by solowley eliminating the drug - ie: tachycardia because i no longer have he beta blocker in my system? Question #5: How many days or weeks is normal rebound ie: tachy until the heart goes back to its normal rythum or bpm which mine is around 80/bpm w/out the drug?

Thanks Very much-

[CCF-M.D.-MJM]

Hello,

Question #1: Thus, how do you taper when only taking 12,5 mg of the drug per day and how is it done safely? I do notice by the 21 st hour after having taking the drug before my heart paces around 90-95 until the next dose three hrs later and then goes back to 70 or so.

It is safe to just stop 12.5 mg of atenolol.  That is a very low dose.

Question #2: Can one build tolerance on such a small dose?

It depends on what you mean by tolerance.  If you mean less side effects, yes, that can happen.  It will not stop blocking the beta receptors.  

Question #3: Is it safe to work out taking a small dose of beta blocker?

Beta blocker alone should not stop anyone from working out.  If  you take a beta blocker because of a severe cardiomyopathy, you should probably be careful.  For PVCs it is fine to work out.

Question #4: Should I expect a rebound by solowley eliminating the drug - ie: tachycardia because i no longer have he beta blocker in my system?

You will either notice a return of your heart rate to baseline or a temporary slight increase in heart rate.  This is should not be a concern though.

Question #5: How many days or weeks is normal rebound ie: tachy until the heart goes back to its normal rythum or bpm which mine is around 80/bpm w/out the drug?

IF you have normal kidney function, I would not expect a rebound tachycardia from that dose.  You may notice that you run a littel faster (10 to 20 bpm), but a not true tachycardia (>100).

Overall I would say just stop the atenolol and see what happens.  If you notice symptoms, you can try breaking it in half for a week and taking 6.25, but I doubt this will be necessary.

Good luck and thanks for posting.

[tickertock]

I take up to 100mg of atenolol daily in divided doses, like you when i have pvcs they are usually followed by a tachycardic event. I think it is very important to be active while taking beta blockers , it can help to ward off some of the side effects from them, also it can suppress exercise induced pvcs and tachycardia. I find brisk walking for about 30-45 minutes at least 5 days a week to very helpful. Good luck.

[stlcard1521]

I took 12.5 atenolol for about 2 weeks and didnt taper off, and i noticed my pvcs were worse for about a week or two. Drugs really didnt help me much so i quit taking it; what finally helped my palps was regular excercise. ive been swimming or jogging 2-3 times a week; after a couple weeks of doing that i bet ive reduced my pvcs by about 80%. i still notice them once in awhile though, especially if i havent got much sleep or if im stressed, but i use to notice them dozens, maybe 100s of times each day and since ive been doing that ive had a couple days i havent felt 1, and most days i feel less than 20. note you arent suppse to excersice when tapering off atenolol

[~*CaMeO*~]

I, too, was taking 12.5 mg. of Atenolol and HAD to taper off as my heart rate took off when I quit cold.  I am medication sensitive and it took me approximately 10 days to get off the medication with no problems.  Split the tab in half for a few days, then into quarters for another few days, then the quarter tab every other day and then stop.  I wish I could have continued taking Atenolol as it worked great for me for high blood pressure but I have peripheral vascular disease and beta blockers and PVD don't work together (as I found out the hard way - considering my doctor said it would be OK .........!)  You'll be fine stopping it from the low dosage you take.

[madgeOwens]

How about toprol xl 50mg..can you quit that cold turkey?
I been on it for a week following 5 weeks of Inderol 80....and I am real dizzy and have more pvc's not less........can I quit them

[Abeybaby]

tks for the answers Doc... just what i thoought. PVC's ...gosh i wish someone had something for these i would pay almost anything to get them to stop.

[tickertock]

Has anyone ever had a cardiologist suggest hypnosis for the treatment of tachycardia and PVCs? I had one very reputable cardio suggest this to me back in the 80s as we pinpointed some of my cardiac disturbances to an incident that took place when I was around 4 years old. A woman was practicing obeah(witchcraft), a serious crime was committed where I lived, she was accused of the murder of  her nephew, he was just about 4-5 years old, his heart was apparently cut out for this practice. My parents was afraid to let me go out the house because this woman was let go by a jury for lack of evidence. I was traumatised by this , it was from that time I instantly became aware of my heart beating and racing.It stuck with me for years resulting in a great anxiety from being so aware of my heartbeat. I just wondered if others might have had some experience in their childhood that triggered some of what they might be experiencing today. I cant say for certain that this is the total cause for my tachycardia and pvcs but the cardio back in my late teens and early 20s thought it might be a strong contributing factor and suggested hypnosis.I never did pursue, I was very skeptical at the time and still is to a certain extent.

[madgeOwens]

I do think that alot of doctors think its in OUR heads...like we would do better is psych unit, and that is alot of help!

[fearfactor]

I do think that the cause of my PACs/PVCs or at least my severe anxiety over them does have some psychological causes.  At the time they really started bothering me, I was worrying a lot about money problems, my school grades, not getting along with my husband and our family living way up here in Michigan isolated from all our friends and relatives down south.  My psychological issues have gotten better (I'm in therapy and on anxiety drugs) but the dumb arrhythmias are still there!  I'd be willing to try just about anything (except witchcraft!) to get rid of these stupid things. Maybe when I have more money I will try hypnosis or acupuncture or something like that.

[madgeOwens]

It is not purely psychological .  They make you feel that way but there are enough people in here to prove they are mistaken. I do also think anxiety over the palpitations and chest pain is true enough, but its indeed not the cause. I bet when you are completely relaxed and enjoying yourself you get them same as me. If it were not for the viscious symptoms I wouldnt mind so much.

[madgeOwens]

It is not purely psychological .  They make you feel that way but there are enough people in here to prove they are mistaken. I do also think anxiety over the palpitations and chest pain is true enough, but its indeed not the cause. I bet when you are completely relaxed and enjoying yourself you get them same as me. If it were not for the viscious symptoms I wouldnt mind so much.

[madgeOwens]

It is not purely psychological .  They make you feel that way but there are enough people in here to prove they are mistaken. I do also think anxiety over the palpitations and chest pain is true enough, but its indeed not the cause. I bet when you are completely relaxed and enjoying yourself you get them same as me. If it were not for the viscious symptoms I wouldnt mind so much.

[madgeOwens]

It is not purely psychological .  They make you feel that way but there are enough people in here to prove they are mistaken. I do also think anxiety over the palpitations and chest pain is true enough, but its indeed not the cause. I bet when you are completely relaxed and enjoying yourself you get them same as me. If it were not for the viscious symptoms I wouldnt mind so much.

[madgeOwens]

I am so sorry I don't know what the heck I did here.

[lance1881]

I have to agree with madgeOwens that it is not psychological.  I had thought for the longest that if I got enough rest, kept my stress level low, ate right, exercised, etc. that I could "control" my PAC/PVC episodes.  That worked for a period of time.  

Now I am on Toprol (150mg) and continue to have PACs/PVCs on a regular basis.  It doesn't matter what I do they appear and disappear at will without me having any control.  And, I don't care what other people say, if they don't have an irregular heart beat they DO NOT know what it is like sitting at your desk all day not knowing if that skipped beat is really a skipped beat or if that was the last time your heart will beat.  I have finally come to grips with this stuff and, for the most part, am able to hit it head on.  I have too many things going on in my life to have this hold me back. I am not saying it is easy but what can you do?

I appreciate all the posts on this site and the doctors responses.  It calms me down to know that others experience the same thing and that there is always someone experiencing PACs/PVCs somewhere in the world.  

This site lets me know that I am not alone.

[stlcard1521]

toprol is another beta blocker; yes youre suppose to taper off of it. when you take a beta blocker, they block specific receptor on your heart cells that influences heart rate. when those recepotors are blocked, your body makes more receptors to compensate, so when you quit any of those drugs your heart cells are ultra sensitive for awhile until they adjust back to normal, thats why you can get tachycardia, increased HR, and all that other fun stuff when you quit cold turkey

[fearfactor]

I agree with you - no one can know how debilitating PACs and PVCs can be until they have them.  It's the "not knowing" if this is THE time it will kill you that is so horrible.  When they say just ignore it it just doesn't work.  I'm glad you've been able to live with it to the best degree possible, though.

[madgeOwens]

I was on Inderol 80mg(time release) for 5 weeks and toprol xl
50 mg for ome week......they told me to stop it that it would be ok(maybe because I was not on it that long and they say "I have a healthy heart" .......I will be watching for anything weird....I go to see my doctor Wednesday for anxiety med.  I suppose if my heart is "healthy" then I do not need "heart" meds...right? so I am going to try it this route and hope it helps. I am under stress lately and the weeks my darling has chemo, I get pvc's every other beat, so maybe for me atleast it is caused by anxiety! Do know you are not alone out there, and keep chatting in here it atleast makes you feel sane,to know you are in such great company!

[madgeOwens]

Thanks so much you are great!  I am off the toprol and the dizziness is slowly subsiding......however I am getting pvc's like crazy haha..I don't know what else to do. I can't take a med that makes me unable to care for my husband now so we will see what my doctor says tomorrow. Thanks for being such a dear. I have been nuts lately I know from re reading my posts haha

[c123]

Perhaps you may want to try the Coreg I've been trying for one month now. I take 6.25 (I think this is equivalent to 12.5 Atenolol). I can sleep normally now with the Coreg. Atenolol gave me an insomnia problem (woke up after 5 hours and couldn't return to sleep). The Coreg seems to help some with anxiousness too. The side effects for me are water retention with Coreg and some tingling. If I drink more water it helps with the water retention which is usually in my fingers and toes and sometimes in my legs.

[Momto3]

You're welcome and thank you too!!  I'm glad you are getting some relief from the dizziness.  I think I'd rather have the pvcs...I think.  You may actually find that the pvcs disappear as quickly as they appeared.  Strange how they work.

Sorry to hear your hubby is not well.  I'm sure it's easier to care for him absent the dizzy spells.  Good luck with your doctor appointment.  Has the SOB or chest discomfort subsided at all?  Hope so.  Take care.

Hey, you're not nuts...That would make us all nuts : 0

[madgeOwens]

Hey, she pit me back on the Inderol and added a nerve med with it.  Already I feel a bit of relief. I was having pvc every twp beats in her office and the nurse couldnt even get my pulse, or b/p...........anyway......I will pay out of pocket for Inderol as long as it works, I just want to feel good again.  The nerve med is to help me cope with alot of stress with hubbys illness.He is really sick and the most important thing, so its important that I can feel well to care for him. Thank you so much for the kindness you have shown, I appreciate that more than you know.

[Momto3]

You're welcome.  I've got my fingers and toes crossed that this new combination of medication works to abate the pvcs.  Of all the medications I was on for the arrythmia, I found Inderal to be more ageeable and "usually" effective.  Sometimes, it would stop being effective (don't really know why), but I would be back on it weeks, months, years later, and it worked well again.  Today, I can take it as needed and it works within 20 minutes.  

Take care of yourself and your hubby.  Hope things improve for both of you.

connie

[madgeOwens]

Hi,
Well within two hours of the Inderol it stopped them about 80%...after having 1 every 2 beats that was great, as you well know. The only thin with the nerve pill it makes me feel a bit hi for a little, which is better than dizzy haha..it goes away after about an hour, but wow right now I feel whoopee.......where the partay? I know my husbands cancer has stressed me big time. SO we will give this a go.
Thanks again, your so sweet.

[madgeOwens]

The anti anxiety drug is klonopin(clonazepam).5 mg\man that doesnt sound like much but it sure makes me like weeeeee, and then where is my beddie byebye haha....I need to lie down.I am asuming after awhile these will not be as potent.....I do not ever seem to do well on medicines............but the Inderal (knock on head) has helped so far. I wish it to be so for everyone in here...................it stinks when you cannot get an illness resolved........I wish them and the symptoms on non believers or unempathetic dinks.   oh my I better go hahaha...love ya

[tired heart]

Hi everyone. I started to have PVC's the end of Oct. Went through all the test-normal. I am thankful for that but I just wonder why I have them. It was such a confort to find this website and know that I am not the only one with this. I am on antenolol 25mg. It has helped, but I still have them. When I have a lot I feel so tired. My dad died of heart disease at 61, so that scares me. They say all the tests are normal, but why do we have these then. Thanks so much for letting me vent. Take care everyone!!