Timing of medicine effectiveness and natural blood thinners

What are the medical advantages/disadvantages of metoprolol vs. toprol besides the convenience? I am taking toprol in the a.m. but many of my palpitations are when I'm sleeping (I wake up in the middle of the night with them) and am wondering if taking the toprol in the evening would be more effective. I know that it is supposed to last 24 hours but it must tail off toward the end, which would be when I need it the most.

I'm taking aspirin now but what do you think of vitamins E and C and garlic supplements as blood thinners? My episodes don't last anywhere near the 48 hour mark which is supposed to be the point when clotting becomes a concern (is this still correct?)but the episodes are frequent and the cardio is bringing the issue of coumadin at some point.

I read where someone said that he believes via his MD that exercising while in afib helps decrease the chance of clotting because it increases the circulation. Opinion?

Thank you!

[CCF-M.D.-KE]

Dear Kevett,

Sorry to hear about your atrial fibrillation. When seeing patients who experience symptoms in the evening such as yours, we sometimes prescribe a twice a day dose of Toprol XL. However, you should discuss this with your doctor.  

Vitamins E and C are ineffective blood thinners. Though your episodes don't seem to last over 48 hours it is possible for you to be experiencing asymptomatic episodes which last longer.

Atrial fibrillation is associated with a yearly ~5% risk of stroke in high risk individuals. People who are over the age of 60, have diabetes, hypertension, prior stroke,congestive heart failure or structural heart disease should be treated with coumadin.  I would recommend discussing your concerns with your cardiologist. You may also consider seeing an electrophysiologist (EP), which is a cardiologist specializing in rhythm disturbances. Hope you feel better.  


Thanks for your question,


CCF-MD-KE