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Beta Blockers...Why are there so many?


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I'm curious after reading about the beta blockers (BB) everyone has been/is on, which have/have not worked for each of you.

Is there a real difference between them? And if not, why are there so many to choose from? If one doesn't work, then should we keep trying them all?

What beta blockers have you all tried, which ones did and didn't work. at what dosage and how many times a day did you take it?

Beta Blockers that DIDN'T work, dosage, how many X's a day used:

Atenolol 25 mg - didn't notice a difference

Nadolol 10 mg - slowed heart rate but felt like it was having to beat through glue

Inderal 2.5 (2-3 times a day) - so far feel muscle pain and diarrhea

Beta Blockers that DID work, dosage, how many X's a day used:

None so far

Thanks for your input!! Blessings!

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I only take a BB (propranolol) on a need basis for adrenaline rushes ("autonomic storms" as some call them). I take just one 10 mg dose and it works wonders. It's the only prescription I use.

Many years ago I took a BB (don't remember which one for sure, but I think it was Inderol) twice a day but it just made me feel even more tired and did nothing for the heart-related symptoms - a few months of hefty Vitamin B6 finally did the trick for the palps, gurgles, etc.

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Opus88, Propranolol and Inderal are the same beta blocker. Propranolol is the generic name for Inderal. Can you remember which beta blocker you took that made you worse years ago? If not, no biggy, just wanted to make sure everyone knew those were the same drug. Thanks for posting.

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I do know they are the same thing, just the generic vs. real name - I was merely giving the actual name on the bottle. :-)

It was about 16 years ago when I took a BB on a regular basis, so I have little memory of the names of them. They tried me on 3 or 4 different ones for maybe only a couple of weeks each - Inderol is the only one that seems familiar from that time - but they all made me feel worse so I told the doctor I wouldn't take them any longer.

As long as I take mine as need only, I don't get the side effects. (I never have to take more than one dose when I do need it, and I've improved so much over the past 3 years that I rarely use it.)

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I take Toprol XL, 50 mgs a day. I get some relief but still have symptoms. At one point I took Atenolol at 50mgs a day but got no relief at all.

I was also on Norpace at 150mgs twice a day that worked for a while but seemed to stop being effective, so I stopped taking it about 2 months ago.

One little thing I would like to add, there IS a difference in generic vs. brand name. I took the generic of Norpace(Disopyrominde) and felt better on the generic than the brand name and my mother is the exact opposite, she can't handle the generic. Go figure.


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I'm with Blackwolf--same drug (Toprol XL), different dose (25 mg daily); still have some symptoms.

Tammy--I wonder if those symptoms you describe w/inderal are due to something else entirely, like, say, virus.

BTW, re: not noticing a difference--does that mean when taking beta blockers you notice that your heart beats as quickly as it did without the drug? Or does that mean that you don't really pay much attention to the way your heart is beating altogether during the periods when you're taking it?

If it's the former, then perhaps a slightly higher dose is in order... if you've still got palpitations on a particular dosage, then going up might help. If it's the latter, and you can't really tell what's going on, then maybe that's a good thing and you're actually doing better on the bb than off. (That's the case for me. The most uncomfortable times, though, are when my heart really wants/needs to beat faster than the drug will allow.)

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No I don't have a virus, this has been going on for years trying to find a beta blocker so I stopped for a couple years and trying them again. That is a very good question about what people mean when they say it didn't make a difference or didn't work. When I say something didn't work, I mean it made my symptoms MUCH MUCH worse!

So to clarify.

Nadolol even at the 2.5 mg made my heart feel TOO slow like it was beating through glue.

Propranolol made me WORSE because my heart felt like it was faster and then slow and the faster and then slow.

Atenonlol - I didn't feel any difference good or bad.

I guess what I'm looking for is something to make it (the fast heart rate) better and not worse. Any body take a beta blocker that noticed RIGHT away it helped?

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I guess I'd have to say good things about the toprol xl. I've been on it 2+ months now. (I was diagnosed with POTS a year ago after a lifetime of symptoms, including tachycardia. I'm 43.) The 25 daily mgs is bringing my hr down from the 115-150 range to the 85 - 115 range. (Or at least that's how it's been when I've stopped to check my pulse--I don't wear a monitor or anything; I check it sometimes if I'm at work and feel my heart racing even tho I'm seated--or I check it when I think it's going slower and I'm just bored and curious. I try not to get too obsessive about such things--it's beating, I'm alive, all's well and good enough. ;)

Maybe it would work for you? Sounds like you're eager to give something else a try, so talk to your doctor!



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i took toprol for a while and it helped in the beginning, but over time, lost its effect, so now back to taking atenolol which i took years ago and it definately makes a difference in tachycardia, but i guess when it loses its effect will have to switch to something else, they dont eliminate the harder beating or faster pulse but they definately help and i couldnt manage without them, and i have to be extra careful about how much i take coz i have low bp, and someone mentioned a high dose of b6, how much did you take and how often? thanks


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Hi Tammy,

I am on Nadadol and my doc. started me out at 10 mg and I got very sick. Then he lessened it to 5mg. This worked much better. Then as my body adjusted to it, and started acting up again, more and more my doses slowly went up, 10 mg 1 time day, then 15 mg, now 20 mg in morning and 20 mg afternoon. I did not tolerate it well to start with. I woul talk to your doc. and see if you can start on one very slowly, very little mg and see if this helps. I know with out my nadadol I am so shaky and feel anxious due to the racing heart. B)

Hope you find some thing to give you relief. There are so many out there as we all are different and what works for one makes anouther sicker. Its all trial and error.

Best wishes!


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I take Toprol XL -- I actually take 1/2 of the 25 mg dosage. (I seem to react to everything) This small amount (12.5 mg) makes my heart go from the 120's to the 60's.

Hope you find something that works for you!


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I take Toprol XL -- I actually take 1/2 of the 25 mg dosage.  (I seem to react to everything)  This small amount (12.5 mg) makes my heart go from the 120's to the 60's.

Lisa: I wouldn't have believed such a tiny dosage (pediatric dose) of a beta blocker could make such a dramatic difference, but I have the same exact experience! I actually take Betaxolol (aka Kerlone), but only on an 'as needed' basis. With less than a quarter of a 10 mg pill, my exercise HR will run about 30 BPM lower than where it is for the same effort level without the 'crumb" of Betaxolol. My resting heart rate isn't impacted as much, but, then again, my resting HR is by and large (at least at this stage of my battle with ANS troubles) pretty normal.

Originally, my EP actually perscribed Toprol XL to me at the same 12.5 mg dose you take, but another doctor (who is a fellow marathon runner and understood my concerns about not taking something that would impact my exercise tolerance) felt that the Betaxolol might be better. I know they are both cardio-selective beta blockers, so chances are Toprol XL would be fine for me, too. But I chose the go with the Betaxolol instead. (I sided with the runner! :-)) So far, I haven't had any troubles when I've taken it.

Tammy, as you can see, we are all so different. Best thing to do is just experiement (starting with small doses, as others have suggested) and find what works for you.

Good luck in finding something that helps you!

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  • 2 weeks later...

Beta blockers differ by their lipid solubility, and by how many types of beta receptors they block. The more lipid soluble beta blockers get into the brain better. They cross the blood-brain barrier better. Inderal (generic is propranolol) is more lipid soluble than toprol, atenolol, and corgard, but it has more cognitive side effects for some patients. Dr. Low thinks inderal works the best for POTS. Cardiologists like to use toprol because they are most familair with it. Neurologists tend to be more familair with inderal because it is also used for migraine prevention.

I take toprol 150 mg XL daily plus metoprolol 50 mg daily(generic immediate release form of toprol). The immediate release metoprolol gives me a little jump start in the morning, I think. Inderal made me fall asleep like a sleeping pill.

Hope this helps. Of course, you should always ask your own doctor this question.


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Interesting thread. I have taken corgard in the past, worked o.k. Also took bisopropal(can't recall the brand...brainfog) and now taking 12.5 of tenormin..take a full dose and I feel like I have bricks for legs and am so fatigued. It seems to work some days and keeps the heart rate low and other days even 25mg can't control the rate well.

Still searching.

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