Changing time of taking metoprolol safely ?

[Mayobarber]

Hi. I'm a 24 year old female. I was put on metoprolol about a month ago for fast heart rate. No other issues as proven by chest X-ray, 30 day monitor, and echo... Just to regulate my heart rate ... Because if this I only take 12.5 mg once a day... I usually take it about one pm but I have realized it makes me feel horribly fatigued and dizzy and I HAVE to lay down for a few hours.. This is said to be a normal side effect.. But I want to start taking it at night to lessen side effects.. I read if you don't take it at the same time every day it can really send your heart into shock or something bad can happen. So, should I maybe just take it an hour later each day until I get til the time I want to take ( about 9 pm ) I am going to ask my cardiologist as well but it's the weekend and I want to start the process ASAP since the side effects are pretty bad

[Jerry_NJ]

I second DD's support for Antenlol from Metoprolol.  I requested the same switch from my cardiologist and he agreed.  Antenlol is much longer acting, longer half life, and that reason alone would be a good reason to request the change be approved.  Then, if you take it a bed time you will be asleep during the highest level of medication (assumed side-effects) but would still have some help during the day with lowering your HR.

I suffer from some fatigue for both of the above, but that is my opinion, my age may be the main source of my low energy level.

I use BB to lower a high HR driven by atrial fibrillation, Antenolol keeps me below 70 at rest, and even in the 50s when resting/in-bed.

[Mayobarber]

Yes - I have been to a total of 8 doctors and 2 er visits to try to figure this out. I have Rocky Mountain spotted fever and a few of the doctors believe that may be affecting it. Thank you.

[tom_h]

When we first enter the world, our hearts are zipping along at a startling rate.  But soon after, the "pacemaker" within our heart sets up shop and begins to regulate the speed to what we would consider normal parameters.  This can vary fairly widely from person to person.  We think of 72 bpm as being "normal", but in fact most cardiologists would look at 90bpm, and think nothing of it.  All that said, an assumed resting pulse off120 to150 bpm is not normal.  I began to take Metoprolol years ago for awakening in the middle of the night with an elevated pulse 115 to 125bpm.  It turned out to be severe obstructive sleep apnea that had my heart rate elevated.  So I'd have to wonder why your heart rate is so elevated without the medicine?  Has anyone looked into this?

[Mayobarber]

Before being prescribed or taking daily ? Before being prescribed it was 120-150 on a regular basis. Now that I take it daily it constantly stays between 60-85 both Before and after taking

[tom_h]

You didn't say how fast your pulse was prior to taking Metoprolol.  Did you measure is ,and how fast was it, beats per minute?

[Mayobarber]

Thank you :)

[DeltaDawn23]

Just a thought -- you might want to ask your doctor about Atenolol.  I switched to it from Toprol because my new ep said it does not pass the blood-brain barrier and would result in less dizziness.  I do much better on Atenolol with a lower dose.    

[Mayobarber]

Thanks for the advice... But I am taking the dosage as given by my cardiologist. It was originally twice a day. My cardiologist was hesitant to put me on the med to begin with because I have no issues other than slightly elevated hr. but since it has been going on for years and he didn't want it to cause a long term effect, he put me on metoprolol to regulate it. Thats why mh dosage is so low... i was having worse fatigue when i took it twice a day and so he advised me to cut it to once a day. I've been monitoring my heartrate and blood pressure both very closely both before and after taking and keeping a log to turn in to him and it consistly stays normal even with taking it once a day so I don't think the dosage is my issue. I have been told by two other doctors that metoprolol is very known for causing fatigue and dizziness.

[tom_h]

Unless you're taking the time release version of Metoprolol Succinate, ie. Toprol XL, you are not taking it correctly.  Metoprolol has a relatively short half life of 3 to 7 hours.  In other words, when you take it, its medicinal benefit begins to lessen rather quickly. By taking it only once a day, you get a spike followed by a rapid lessening of its effect.  People taking Metoprolol Tartrate usually take if twice a day to maintain a relatively stable level of the drug in their system.

Another thing I wanted to point out is your dosage is extremely low. Body mass could play a factor on your dose. By contrast, I'm on75mg a day and have been as high as 200mg.  At 75mg., I feel nothing at all.

I take mine at "5 and 5".  On occasion i've take the pm dose as late as 10pm when turning in, and suffer no ill effects. If you want to modify the time that you take it, you can move a couple of hours per day to get it on the time that you desire.  But talk to your cardiologist about the single dose per day.  It not providing you with a uniform level in your body.

Now, it's very possible that people are effected differently by Metopoprolol, but if you're feeling fatigued, and dizzy on 12mg, consider the possibility that you're having an adverse reaction to it, or perhaps it's being caused by something else.

[Mayobarber]

Great ! Thanks so much for your help

[DeltaDawn23]

I think it would be safe to slowly adjust the time you take it, like you said, an hour at a time.  I take my beta blocker at night and it helps me sleep.  I think you will bypass most of the side effects that way.  Good luck with this.