For Those Who Take Beta Blockers

[cma]

I was just wondering after taking beta blockers what is the difference of you supine, sitting and standing heart rates?

Also does anyone know how fast they kick in and for how many hours beta blockers are effective? I couldn't find this info online.

cma

[firewatcher]

YES!!!! They make a huge difference (depending on the dose.) My docs took me off my night-time dose of BB because I already have supine bradycardia at night (low 40s.) My morning dose kicks in within 30-60 minutes and is done in 12 hours. It depends on the med, each one has a different "half-life" and works longer or shorter. Propranolol (Inderal) has a fairly short time of action, but there is an extended release version. With me, a very small dose brings my tachycardia into "normal" range (10-20mg.) Google Beta blockers or go to medicinenet.com or one of the other medicine sites and search the drug.

Al la' Wikipedia:

Propranolol:

Propranolol is rapidly and completely absorbed, with peak plasma levels achieved approximately 1?3 hours after ingestion. Co-administration with food appears to enhance bioavailability. Despite complete absorption, propranolol has a variable bioavailability due to extensive first-pass metabolism. Hepatic impairment will therefore increase its bioavailability. The main metabolite 4-hydroxypropranolol, with a longer half-life (5.2?7.5 hours) than the parent compound (3?4 hours), is also pharmacologically active.

Propranolol is a highly lipophilic drug achieving high concentrations in the brain. The duration of action of a single oral dose is longer than the half-life and may be up to 12 hours, if the single dose is high enough (e.g., 80 mg) {20mg will last me 12 hours!}. Effective plasma concentrations are between 10?100 ng/mL.

REMEMBER DRUGS ARE FAR MORE EFFECTIVE FOR SOME OF US AT SMALLER DOSES THAN FOR "NORMALS!"

[Guest brianala]

I'm on 25mg of Toprol. My doctor told me that it can take up to a couple of weeks for it to build up enough in your system to kick in, but that it's effective for 24 hours (I take mine once a day). My doctor also said that if it makes me feel too tired I should take it later in the day.

I don't know specifically what my heart rate is in each position but I do remember from my 24-hr monitor my cardiologist said it went up over 140 when I was just sitting around, but that was before I was on a beta blocker.

Edited to add: oops, that should be it's effective for 24 hours, not 8 hours!

[cvincent]

I am on Bisoprolol and cannot function without it. It took about two weeks for me before it started keeping my heart rate consistently under control. My heart rate is now in the 70's compared to 150's. As for what my heart rate is sitting/standing/laying down , it increases slightly when Im standing and laying down but not by much. It's been running between low 70's and high 80's. Im on 5mg in the morning everyday.

Candace

[jump]

I was taking 25 mg of Metoprolol ER (the generic of Toprol XL) once a day and I LOVED it.

I found that it lasted a full 24 hours. I took it at night before I went to bed so that it would be fully in my system by the morning, which is always my worst time. Sometimes if I was a few hours late for a dose I would notice my tachycardias coming back, but that was only after I hadn't had the drug for more than 24 hours.

On the drug, my resting (awake) hr was around 50-55, and my "tachycardias" would be around 100-110. I could sometimes stand without any tachycardias, with my hr around 70 or 75. But, even though the difference between 55 and 100 is still kind of a lot, I still felt a LOT better than when I was without meds, and my hr would go from around 60-65 to 120-140. Also, on the beta blocker I no longer had high or low bp upon standing -- my bp tended to stay the same (within the normal range) regardless of what I was doing.

Perhaps best of all, the BB also made a BIG difference in my heart palpitations. I had hardly any when on it, even when going to sleep or lying on my side.

I had no definite side-effects. My doctor took me off the drug because she thought it could have been causing other problems for me unrelated to POTS, but it's starting to look more and more like the drug wasn't the culprit after all. If my health continues to go on the way it has recently, I will probably start taking a BB again. It helped me tremendously.

[Guest tearose]

I did not tolerate BB's! It made my low go too low and I had terrible chest pain. I show a first degree heart block at times so it was irritating that. BB's may or may not work for you.

good luck,

tearose

[cma]

Thank you all for your answers.

I am on Bisoprolol myself, but only 1.25mg in the morning. I also couldn't manage without them. My heart rate at rest when sitting is around 75, but when I stand up it's around 95 with meds. I guess it's not bad, but it's still for some reason uncomfortable. I don't know if the higher dosage would do any good for me, because my bp at the moment is on the lower side and this kind of drug also reduces the blood pressure.

[bjt22]

I take labetalol. This, along with Catapres, has brought my heart rate down considerably. Without either, my sitting, resting rate was 100-120 bpm while standing would cause it to soar to 140-180 bpm. With the drugs, my resting rate usually stays in the 75-80 bpm range while standing rates are usually in the 100-110 range. I still have that 30+ jump in rates...but 110 standing can feel a heckuva lot better than 180 bpm.

[yogini]

The good effects of beta blockers kick in right away - controlling HR and BP. Maybe your dr was referring to side effects when he mentioned 2 weeks, because it takes a while to get used to the beta blocker. Actually the side effects keep decreasing over time, even months down the road. The BB does not build up in your system, but rather stays in your system for 24 hrs or so.

In terms of how much your HR number is affected, it really depends on the person. We all have different numbers to start off with and respond differently to meds you have to change your doseage or change to a different beta blocker or add another med to get the desired effect. You have to try to see how it works for oyu. But they are one of the most effective meds for POTS and help many. Good luck!

[turtlefairy5]

I still have an increase of heart rate when I stand, but since taking my beta blocker there has been one important change thus far: I haven't been in the ER with an enormously high heart rate.

Now, part of that is I've gotten used to/come to accept/don't freak out as much when I see my heart rate in the 160's or even 170's (I do still get nervous, but not as much) - I've become desensitized, at least so far as my anxiety is concerned.

I think it keeps my heart rate from reaching the really high high's that it used to.

Amber

[ramakentesh]

I think for POTS patients that seem to have very excessive sympathetic overactivity BBs are great. For me they are the best med pretty much - although the dosage is important as anything above 20mg and it will make me more dizzy, although I just wont tremble as much...

I used to take these as needed but since last october ive been on 10mg or 20mgs every morning. Im planning on eventually weening off them but I must admit that when i miss a dose I really really notice.

[valliali]

i am so with you ramakentesh. definitely the best for me too. and i totally notice the second it starts to wear off.

[flop]

I'm not on a BB right now but I took them for 4 years until just last month. The only reason I have switched off my BB was worsening allergies, otherwise BB was the most effective medicine for me. I started off on Bisoprolol 1.25mg once daily. When my cardiologist increased my dose he had me take 1.25mg twice daily to spread out the dose - there were 2 reasons for this: less likely to wear off between doses, and to reduce the chance of my BP going too low at the peak action of the medicine.

Over the years my dose gradually increased to 2.5mg twice daily wich is still only half of the maximum dose.

Some people take a BB with fludrocortisone or midodrine as well to raise BP.

Flop

[iheartcats]

Some people take a BB with fludrocortisone or midodrine as well to raise BP.

Flop

Flop - This is what I'll be doing and I don't quite understand it...the BB + Midodrine. Does keeping the BP up help get your blood around?

I want to make sure I'm getting enough blood to the brain/body (ie, blood pools, heart goes crazy to pump it up, etc = POTS).

I guess taking too much would make one dizzier than usual?

[iheartcats]

I was taking 25 mg of Metoprolol ER (the generic of Toprol XL) once a day and I LOVED it.

I found that it lasted a full 24 hours. I took it at night before I went to bed so that it would be fully in my system by the morning, which is always my worst time. Sometimes if I was a few hours late for a dose I would notice my tachycardias coming back, but that was only after I hadn't had the drug for more than 24 hours.

On the drug, my resting (awake) hr was around 50-55, and my "tachycardias" would be around 100-110. I could sometimes stand without any tachycardias, with my hr around 70 or 75. But, even though the difference between 55 and 100 is still kind of a lot, I still felt a LOT better than when I was without meds, and my hr would go from around 60-65 to 120-140. Also, on the beta blocker I no longer had high or low bp upon standing -- my bp tended to stay the same (within the normal range) regardless of what I was doing.

Perhaps best of all, the BB also made a BIG difference in my heart palpitations. I had hardly any when on it, even when going to sleep or lying on my side.

I had no definite side-effects. My doctor took me off the drug because she thought it could have been causing other problems for me unrelated to POTS, but it's starting to look more and more like the drug wasn't the culprit after all. If my health continues to go on the way it has recently, I will probably start taking a BB again. It helped me tremendously.

I started by Inderal/Propranolol BB today (I can take 20mg three times a day but today I took it at lunch to see how I reacted). My heart rate is already better...70s/80s sitting and 90-115 standing rather than 80s/90s sitting and 115-140 standing.

If it's doing this well at this dose I think I may only need 20mg in the AM and 20mg after lunch...I'll see. My doctor is flexible with what works for me.

I also take Midodrine to keep my BP up, usually 10mg in AM and 5mg at lunch, and if needed 5mg in the evening.

I have a headache...but I also just switch BC to the IUD from the pill yesterday and am thinking the headache is due to that.

I have allergies so I hope they don't worsen...is it true the lower your BB dose, the less interference it has with allergies so I'd be best to use the lowest BB that's effective? I'm hoping 20mg two times a day will help me enough!