Weaning off Toprol XL

[DrCain]

What is the safest way to wean off Toprol XL? I was on 50 mg and went down to 25mg. This is my 4th day. The second day was horrible. I had extreme anxiety, elevated pulse, heart pain, tremors, and I felt like my heart was going to pump right out of my chest. I have not been able to reach my doctor. Yesterday symptoms were about 1/4 of what they were the day before. Today they are gone. Blood pressure is still 117/76. I'm scared to death to drop the other 25mg and wondering how to go about doing it. I have been on Toprol XL 7 months but recently went on a high-protein, low-carb diet (on my doctor's advice) and that was what dropped my blood pressure.

[Kat399]

A related discussion, Weaning off of Toprol was started.

[DrCain]

Not a good day. Just got back from the emergency room. I cut back to 1/2 of 25mg tablet Toprol XL yesterday morning. I did not take any today as my blood pressure was 117/76 for the second day. I was sitting reading, very relaxed, and stood up only to find I was very dizzy. I didn't think anything of it. A little later my heart started pounding. I took my blood pressure and it was 136/82. I was pleased and went back to reading. Suddenly I felt chest tightness or fullness, and sudden heart burn that crept into my neck. I hadn't eaten anything and never get heart burn. I also started feeling some malice or anxiety. I checked my blood pressure and it was 179/105. I immediately took 25mg of Toprol XL, an asprin, and a glass of red wine (it always lowers my blood pressure). Fifteen minutes later my blood pressure started dropping steadily until it was normal. We laughed about it and went about watching some football. About half an hour later symptoms started building again. I took my blood pressure and it was 196/117. We went to the emergency room and I was given 2 mg Clonodine and am fine now. I did neglect to tell you that I was diagnosed with neuromediated syncope in March after a bout of a double ear infection, sinusitis, and bronchitis. I passed out driving 79 miles an hour on the interstate. Life has not been the same since. Another doctor said it was dysautonomia and said the infection may have knocked out my blood pressure thermostate. Although my blood pressure has typically been about 165/95 during the day, in the morning and evening it drops considerably. Many nights it has been 80/60 before going to bed.

[Cleveland Clinic]

DrCain,

There really shouldn't be much of a weaning period.  Toprol XL is an extended release version of lopressor. When the medicine is completely released over a 24 hour period, the last effect of the medicine last several hours into the next dosing. Overall, stopping the medicine or weaning the dose should be accomplished in several days. Im not sure why your rebound was so significant unless there is some other part of your history not mentioned.

Since you are having such symptoms, I wouldnt change your dose any further until you speak with your physician.

good luck