Jump to content

Recommended Posts

Does anyone have any info to share with me as to why Propranolol seems to be the beta-blocker of choice for a lot of people here? I think I might need to switch beta-blockers, so I'm trying to gather info.

In addition, my EP told me that using midodrine with a beta-blocker can be VERY difficult to regulate, but I have see several people here doing just that. Anyone have experience to share there?

Link to post
Share on other sites

I'm half awake - so forgive any incoherency! :)

This one seems to help me feel about 40% better, I'd guess. I also have allergies and sensitivities, and they didn't get worse on Propranolol. I only take it 2-3 times a day (depends how early I get up) and use the 20mg pill. 40-60mg a day is a low dose of this, but yet enough to really help me.

You can Google it and see what else it's used for off-label, but it seems to have been around a while and used for a variety of things so I personally feel 'safer' on it because it's been in use and tested for so long. I just think it's less likely to sneak up on me later with weird side effects that were unknown because it's a new drug.

I'm fortunate I got a BB I really like on the first try. (And of course I researched here first because I had to start somewhere and start with one of them).

Link to post
Share on other sites

Hi,

I think Propranolol is the "go to" beta blocker to start with for many reasons. Most of the dysautonomia specialists recommend trying it first. It is one of the older BB, so I think drs feel more comfortable with it. I also believe it has lower side effect risk in comparison to some of the other BB. It is a non-selective BB as well. It also has fewer other meds that should not be used at the same time as Propranolol.

I am sure there are more reasons, esp. more scientific reasons...

:)

Link to post
Share on other sites

It's the one that he started me on and I think it's the one with the less amount of side effects. I love my Propranolol. It's made such a difference in my life. [hugs it] The only problem is you do have to up it every six months.

Link to post
Share on other sites

hi darcy

i was first put on it in may of this year. i was so anti-drugs before this time. but i go very ill so i took whatever was given to me.

i was very lucky as i seem not to have any side effects to the drugs given. im on a low dose 40g a day. although in the hospital my heart rate was 185 when standing, its still quite high after 10 minutes, but at least i can get around the house for a short time now.

the only problem with me is that when i lay down my pulse is around 50bpm. so i cant have a higher dose to control my heart rate whilst standing.

good luck.x

Link to post
Share on other sites

Hi Darcy,

I put this in the wrong post for you.

GOING TO FIX IT NOW1

Sorry sweets!

Hope you figure this all out.

bellamia~

Link to post
Share on other sites

I was originally started on the lowest dose of this med and after 2 days I could barely get out of bed. It took my bp too low and I thought I would pass out every time I was up. I do not really know why alot of drs start with this one though. I was then afraid to try any bb but tried the next one, Bystolic, which was much more expensive, even with insurance, so perhaps it is a factor they consider,as well as what someone else said about it being around a long time so drs are familar with it. Good question.

Link to post
Share on other sites

In reference to the person who mentioned you have to "up" the dosage of Propranolol every six months:

It's important to remember that POTS has so many root causes, most of which we understand so poorly, that it is impossible to make any general statement about its treatment. For example, I have been on Propranolol since early 2007 - for the first 3 months, it was 20mg a day, now it is 40, and I have remained on that dosage for over two years, with no lessening of effectiveness. I have good days and bad days, but overall, on my typical day, I feel somewhat better after two years on the drug - not worse.

So - the rule of thumb with POTS medicine is - "your mileage may vary"

Link to post
Share on other sites

Dr. Low at Mayo recommends propranolol - I think that's why many people use it. I've never understood the difference between beta blockers, selective/non-selective, etc. but I think it and atenolol are most likely to work for POTS. I think people on the forum use lots of different betas tho.

Edited by yogini
Link to post
Share on other sites
In reference to the person who mentioned you have to "up" the dosage of Propranolol every six months:

It's important to remember that POTS has so many root causes, most of which we understand so poorly, that it is impossible to make any general statement about its treatment. For example, I have been on Propranolol since early 2007 - for the first 3 months, it was 20mg a day, now it is 40, and I have remained on that dosage for over two years, with no lessening of effectiveness. I have good days and bad days, but overall, on my typical day, I feel somewhat better after two years on the drug - not worse.

So - the rule of thumb with POTS medicine is - "your mileage may vary"

Ooh, they told me that the effectiveness lessens due to tolerence and the fact that your body tries to get around it so it was every six months it had to be revisited. All I know is at three and six I've had to up the dose, but I have high tolerance levels. My body likes to work around things because it's stubborn. XD

Link to post
Share on other sites

Hi,

A couple of days ago I started remembering a discussion with a dysautonomia specialist (I forget at this moment who it was...). It was that they have started seeing more and more positive data for using propranolol over other BB's. So, at some point they thought I could think about switching back, even though I had previous negative side effects with it. It sounded like there had been a recent conference on the topic and that it would be in a journal. So, it will be interesting if we see this information published...

:rolleyes:

Link to post
Share on other sites

I have taken several beta blockers- the best one for me now is nadolol. My BP goes up and down and I have hyperadergenic ( still don't spell it right) POTS.

Some of the others just wiped me out- this one has helped a lot. good luck

Link to post
Share on other sites
  • 4 weeks later...

My daughter is on propranolol and midodrine. She started first on propranolol, increasing to her current dosage of 120/day. Then they added midrodine and increased the dosage until it's current state of 10 mg/3 times a day. She has had good luck with both of these meds and doesn't seem to have any problems with the two combined.

Link to post
Share on other sites

I can't explain why this one BB seems to be the drug of choice but I can explain a few things about beta blockers. There are 2 different beta receptors that are pertinent to the heart. THe beta 1 receptor when stimulated by adrenaline(and other hormones) causes increased heart rate, increased heart contractility(the force with which your heart contracts) and lipolysis(the break down of fat). The beta 2 receptor when stimulated by adrenaline causes vasodilation(relaxes your blood vessels) as well as bronchi dilation. There are other actions of these receptors but these are the important cardiology ones. Selective beta blockers only prevent the beta 1 receptor from being stimulated by the adrenaline(and other hormones). Nonselective betablockers block both beta 1 and beta 2 receptors from being stimulated by adrenaline. Propranolol is a nonselective bb so it decreases heart rate but blocks the beta 2 receptor so it can help prevent vasodilation(which could cause low blood pressure). Propranolol is also able to cross the blood brain barrier and decrease the central nervous system's release of adrenaline.

****the receptors are stimulated by hormones other then adrenaline

****the receptors have other actions then those i specifically stated

****people with high blood pressure are often(not always) given a selective beta blocker so the vasodilation receptor is not block.

****non selective BB are generally not given to people with breathing problems as they can prevent the bronchi dilation(opening of the airways)

Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...