Beta Blocker Advice: Switching From Non-Selective To Selective Due To Asthma

[iheartcats]

I take Propranolol which really helps me function - I do not think I could work without it. It really makes a difference dropping my HR from 140-180 to 70-90 and letting me function.

I've looked up a list of CardioSelective Beta Blockers. Does anyone have experience with any of these? I did try Metoprolol once...it made me vomit all day so I'll avoid that one.

But, anyone's experience with any of these would be help.

I see my Cardiologist later this month and will be switching at that time.

I'm quite upset as I really depend on my Beta Blocker!

• Acebutolol (Sectral^®)
  
• Atenolol (Tenormin^®)
  
• Betaxolol (Kerlone^®, Betoptic^®)
  
• Bisoprolol (Zebeta^®)
  
• Esmolol (Brevibloc^®)
  
• Nebivolol (Bystolic^®)
  
• Metoprolol (Lopressor^®, Toprol-XL^®).
  

[peregrine]

Cat_Lady - could you explain a bit about the asthma issue? I've been short of breath somewhat on propranolol and am curious to hear more. I was on atenolol beforehand (before they wanted me on something less selective, heh), and while it was a wonder drug from a functionality point of view, I was very tired all the time. But it did work very well otherwise! And no other side effects.

[iheartcats]

I noticed I'd been more short of breath than usual (also my allergies are acting up more than usual, so that could be part of the problem). I know I get a bit winded on POTS so I didn't terribly worry about it. But then my Doctor had some concern over this lingering cough I get - especially after a bad cold. It'll hang on and isn't bronchitis. He told me I really needed to get a Pulmonary Function Test. I had one about 4-5 years ago and it was all clear so I was able to take Propranolol. This medicine is very helpful. While not making things perfect, it's one of the meds that at least allows me to work. I do get exhausted some days...but I'm able to function.

Now, apparently the Pulmonary Function test I just had is indicative of Asthma! I'm so distraught. I see my PCP later this week then go meet with my Cardio at the end of the month and I know she's mentioned selective Beta Blockers, but it's hard to find one that works. I know Metropolol didn't work - Atenolol is another one that was mentioned so I just want to go in with a list of a 'top 3' to her and be like hey, can we give this a go or do you have more suggestions?

She also suggested Cymbalta...so I'm wondering if I'll really need that now that I'm going to be on a selective Beta Blocker. I refuse to add more than 1 medication at a time, so I'll start with the new BB.

It's double stressful as I'm probably going to have to take a leave from work and I don't know if I'll have my job to come back to. I need it. But I need at least a week to adjust on a new Beta Blocker so I'm hoping to get through this. I don't want to be back to how bad I was feeling three years ago.

I'm glad to know Atenolol was helpful to you...that makes me a bit more calm. I'm having such a rough time right now!

But...if you have asthma I've always been told you shouldn't be on Propranolol! I am taking mine until I see my Cardio at the end of the month (I'm at the spot where I've been on it 3 years, what's a couple of more weeks), but I don't think it's the best idea for me to stay on it long term.

[Anoj]

i take betaxolol and it works pretty good for me. my doc says in his experience, his patients complain less about this one than others.

[iheartcats]

Thanks, Anoj. I'm adding that to my list to discuss with my Cardio. Do you find it lowers your HR well?

[peregrine]

I'm glad you brought this up - I've been having dyspnea (shortness of breath, I guess) since not too long after I started the propranolol - never really connected the two (I assumed it was edema from the Lyrica, which seems to not be the case). The increase from 20mg twice daily to 30mg twice daily has dropped my heart rate something impressive - my sitting heart rate is now around 55, which is low for me (sitting these days is around 75 normally), so I decided it was time to back off. Sadly my neuro is out of town until 6/18, but she's given me the authority to mess with the dosage myself within reason (and is the one who told me to watch for the bradycardia with the increased dose), so I'm comfortable. Thanks for bringing this to my attention!

[Anoj]

Thanks, Anoj. I'm adding that to my list to discuss with my Cardio. Do you find it lowers your HR well?

tbh, my heart rate isn't as much of an issue for me as pre-syncope. however, i do feel that betaxolol lowers my heart rate and adrenaline surges. it does help me. a few years ago i tried metropolol and propanolol, and i noticed immediately that they made me short of breath! i could not tolerate them at all.

it took a few years, testing and trial and error for me to find this one. betaxolol is a beta1 receptor blocker, so it only affects the heart and another organ (i forget which one), instead of slowing down your whole body. i think this is why my doc has found more patients tolerate this one better. it did take me a few weeks to get adjusted, but now that i am things are going smoothly. at first i felt like a ton of bricks. i'm glad i stuck it out.

[goldicedance1]

Hi, CatLady,

I have Asthma and COPD:

I use Labetolol with good success. Instead of Cymbalta, I use Pristiq and Topama. I also have fibromyalgia in addition to POTS. For asthma, I use Symbicort and my rescue inhaler is xopenex. Xopenex does not accelerate HRs as fast as the usual rescue inhaler.

My pulmonologist oked the use of a betablocker even with asthma. It was Dr. Grubb who switched me to Labetalol for the POTS.

If you are concerned about the asthma part, you should really see a pulmonologist rather than rely on your internist as pulmonologists have loads of experience with people with high blood pressure on beta blockers. They may not have experience with people with POTS.

Let us know how you are doing.

Goldie