In general, Calcium Channel Blockers (CCB) are not simultaneously prescribed with Beta Blockers (BB). Yet, had I not gone to an E.P., my Cardiologist was going to prescribe Verapamil (CCB) with a low dose of Atenolol (BB).
The first E.P. I went to prescribed the Verapamil, I took it for one day and quit. (going back on Atenolol). The reason was the impression that my heart beats were very strong. I walked to the top of the steps and I felt like I just got off a stress test.
It turns out that although the Verapamil lowers your heart rate, it does not inhibit the sympathetic input to the heart like Beta Blockers do, so that anger, exertion, etc., will be able to more significantly stimulate the heart into a faster rhythm. This is the reason I think my Cardiologist wanted to keep me on a Low Dose Beta Blocker with the Calcium Channel Blocker. I looked up Metoprolol, it is used in doses up to 450 mg/day (likely in divided doses), so, in my non-professional opinion, 50 mg/day of Metoprolol is a low dose. In that sense, you shouldn't have problems.
ACE Inhibitors and ARBs are an alternate way to lower blood pressure, but you and your physician would need to determine if they are right for you. Both are prescription medications and act on vessels throughout the body. Here is a link about them, Beta Blockers, and Calcium Channel Blockers.
It was actually an EP that gave me that little cocktail he said the verapamil would be better for my PSVT but wanted me on the combo for the elevated BP. I know 50 MGs of metoprolol tartrate is a very low dose and it still affects me adversely . It makes me super tired and a little unsteady. I was on propanolol before that but the cardiologist I work for change that to the Metropolol.
I take Lopressor 25mg twice daily in addition to Altace for PVCs and CAD and I can tell you that sometimes I feel really dragged out. It is a something that you get when taking these Meds. May your Doctor titrate your dose until you feel better. Hope you feel better.
Best to you
Thanks. I'm also instituting some significant dietary changes such as a limitation as much as possible of sodium and increase of exercise to help with the BP so hopefully I don't have to be on this for too long.