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Heart Disease  (Expert Forum)
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Long-term use of Beta blockers
Answered by
Cleveland - OH
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.

Long-term use of Beta blockers

by Fran71, Sep 30, 2006 12:00AM
Dear Doctor, I’m a 35 year-old female, suffering for years with sinus tachy and uniform isolated PVCs documented by 2 holters, echo and blood work OK. I used to take inderal as needed, but since a bad episode my cardiologist put me on 20 mg Inderal twice a day, though I usually only take 20 mg. I have no side effects from the BB. Here are my questions:
1. Will taking a BB daily lesen its effect in the long-run as the body gets used to it? If so what will the option be: to increase the dose, or switch to a different BB?
2. On the other hand, may taking the BB daily help prevent bad exacerbation of symptoms, as the body absorbs the BB constantly every day?
3. Taking Inderal as needed always worked wonders for me. Then one night last Feb, after working out at the gym, my heart just couldn’t slow down and I was in constant bigeminy. I took 20 mg inderal, then 20 more in less than 2 hours. Still my HR and arrhythmia didn’t change so that I went to the ER. Could you explain to me why the BB didn’t work in that case, since it always had and it has eversince? I’d guess 40 mg in 2 hours is a lot.

I thank you so much for taking my questions and for this wonderful service.

Fran

by Cleveland Clinic, Sep 30, 2006 12:00AM
fran,

thanks for the post.

1. Will taking a BB daily lesen its effect in the long-run as the body gets used to it? If so what will the option be: to increase the dose, or switch to a different BB?

Generally not, while at the cellular level there are changes in the the number of receptors, clinically most do not develop major resistance to the drugs with respect to heart rate and blood pressure. If you happen to develop resistance, titrating the dose or finding another drug is fine.

2. On the other hand, may taking the BB daily help prevent bad exacerbation of symptoms, as the body absorbs the BB constantly every day?

I dont understand this question. There is nothing wrong with either intrmittant use or long term use of beta blockers. I would do whichever makes you feel best.

3. Taking Inderal as needed always worked wonders for me. Then one night last Feb, after working out at the gym, my heart just couldn’t slow down and I was in constant bigeminy. I took 20 mg inderal, then 20 more in less than 2 hours. Still my HR and arrhythmia didn’t change so that I went to the ER. Could you explain to me why the BB didn’t work in that case, since it always had and it has eversince? I’d guess 40 mg in 2 hours is a lot.

I cant explain exactly why, except nothings foolproof. I could posit alot of different scenarios such as dose, level of adrenaline, etc...I think its good you have a drug that works as well as it does.

good luck
Member Comments (2)

by Fran71, Sep 30, 2006 12:00AM
To: CCF-M.D.-bkj - Everyone
Thanks so much again, doctor.
I know my second question was hard to phrase. I meant to ask if there may be a good benefit associated with the long-term use of a beta blocker. I was just guessing that maybe next time I have a drastic rise in adrenaline, my heart might react better since my body has been absorbing the BB for months now, being on the BB daily.
I'm so happy to hear that the Inderal may continue to work for me. I agree I'm very lucky to get such big relief from Inderal, for now.

Thanks again. This service is priceless.

Fran
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