Questions about Beta Blockers

[trus75]

Hello everyone.

About six months ago a doctor prescribed me Propanolol 10mg but I didn't want to take them and never did.

But my ectopics are getting worse and worse, especially after exercising, and I'm getting even more anxious about it, so I decided do give it a try.

My Big question here is:   I have a box of 40 pills of Propanolol 10mg..    I remember he told me to take only one pill of 10mg in the morning per day,   but isn't it a too low dose to have any effect on ectopics?  Even inside the box they say the regular dose for arrhythmia is between 30mg - 160mg.    

Can I take, for example, 30mg a day safely? And if the answer is yes, how? All of them at same time in the morning, or 3 x a day?

Thank you for your help

[lkjons]

Hey Trus, So you didn't take propranolol when given. I would start out with 10 mg if it works then take it, that is what was prescribed. If a small dose works then great. At least when you talk to the doctor you can say you are taking or have taken the med. If you tell them you did not take what they gave you then the doctor tries to act like god and you will be treated like a peon so to speak. I'm a palpitation survivor since 13 Y.O.

[trus75]

Hi Tom, you're completely right about it.

My decision wasn't brilliant.

But I had a reason for that: this particular doctor was not a cardiologist, and I had an appointment with a cardiologist in the next week.  This doctor told me my average HR from a 24H Holter was a little high (81) and considering what I told him about PVCs, he decided to give me 10mg daily for a few months (according to him).

But once I had a visit to the cardiologist in the next week, I decided to wait. The cardiologist didn't take my complaints very seriously, he said that even if I had bigeminy with exercise, it was all caused by anxiety!  He gave me some anxiety medication and told me to "forget about my heart".  Ok , I took the anxiety meds for a while but it didn't help at all.

And that's the reason why I decided to try propanolol right now

[tom_h]

I think your physician is being cautious in starting you out on the low side. Now I have a question for you.  Who's the physician here? I think you made an error in judgement by self-doctoring.  He prescribed this to you for a reason.  To not take it at all, is (I'm sorry, but) foolish.  There was an occasion when my physician prescribed Sotalol.  This stuff is getting into serious antiarrhythmic territory.  I took it as directed, but I didn't like what if was doing with my heart rhythm.  I just didn't feel right.  I called him, discussed it with him, and it was immediately discontinued, and I was back on the (useless)Metoprolol.  So you should at least try what is prescribed and be in contact with them while your visit is at least somewhat fresh.  Your physician has now no doubt forgotten about your visit when it was prescribed for you.

Propranolol has a bit of a confusing half life.  The primary metabolite, 4-hydroxypropranolol has a half-life from 5 to 7 hours.  There is another compound in the drug which has a shorter half life of 3 to 4 hours but is also pharmacologically active.  By the end of the day, your 10mg dose has been metabolized to a point where it probably has little effect.  So a daily dose would probably be broken down into perhaps two doses daily, or perhaps a time release once a day pill if available.

[trus75]

I know there's the "placebo" effect as well, but it can't be coincidence..

I was experiencing PVCs all day (not many, but I always felt a few per hour for the past few months)

Today I felt ZERO pvcs so far. I know the effect of the pill is probably over, but it can be the effect of getting less anxious about my heart and feeling more safe.   Less stress = Less PVCs for sure.

[trus75]

Hello,

thank you.

They're not getting worse in frequency, I just have more bouts of PVCs and I really feel it's because of my anxiety. Anything about my heart is making me anxious, I can't even climb some stairs without getting anxious.. and them BOOOm... PVCs.. !

By the way, I have tried one pill of 10mg today and it has some incredible effect on my heart rate.   After two hours of taking the pill, I had a fast walk for 10 minutes. In a normal situation my HR would go to 120+ easily. But just after I stopped , I measured and it was 85 only! Really unbelievable. Right now I'm sitting and my HR is 64, which never happened before during the day.   And i had ZERO Pvcs so far (ater taking propanolol).

Well... so far it's awesome, but I'm just concerned about the dosage..

Anyone else can give me an opinion?

[trus75]

Hello,

thank you.

They're not getting worse in frequency, I just have more bouts of PVCs and I really feel it's because of my anxiety. Anything about my heart is making me anxious, I can't even climb some stairs without getting anxious.. and them BOOOm... PVCs.. !

By the way, I have tried one pill of 10mg today and it has some incredible effect on my heart rate.   After two hours of taking the pill, I had a fast walk for 10 minutes. In a normal situation my HR would go to 120+ easily. But just after I stopped , I measured and it was 85 only! Really unbelievable. Right now I'm sitting and my HR is 64, which never happened before during the day.   And i had ZERO Pvcs so far (ater taking propanolol).

Well... so far it's awesome, but I'm just concerned about the dosage..

Anyone else can give me an opinion?

[TimRo]

You really should go back to your Doctor if they are getting worse.  Never adjust medicine yourself, there may have been many factors as to why he put you on just 10mg.  If they are getting worse, you want to check to make sure your condition has not changed, he may put you on a higher dose, but since you never took them to begin with, he may start you on 10mg again and adjust as needed. Good Luck