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Propranolol Dosage Question


monica
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My Doctor has asked me to take Florinex 0.1 mg and Propranolol 60 mg(one tab every day)for P.o.t.s.

I have started taking Florinex but I'm extremely sensitive to medications so, only starting with 0.05 mg and maybe build up the dosage later. My doctor said that I could do this.

I haven't started the Propranolol yet as I'm very scared to try it ( The doctor said it will help with my Tachycardia and prevent Migraine/headaches). The Pharmacist said it's extended-release and I should take it at night as it can cause side-effects like drowsiness etc.

I'm wondering if anyone has tried Propranolol 60 mg? Is 60 mg too high a dose? I mostly see people here mention that they only take 10-30 mg.....Thanks!

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Thanks for replying! Yes, I think I want to start with a lower dosage for sure, so when I asked the Phramacist if I could cut the tab in half/quarter, she said that I shouldn't do it with this tab. The paper attached to it also says that it shouldn't be cut..so I'm not sure what I should do now?!

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Monica,

You can't split long acting meds because it disrupts the slow release mechanism. Since you are so sensitive to meds, you should talk to your doctor about starting with the short acting form of propranolol. The lowest strength is 10 mg. You might also discuss doing one med at a time so if you have trouble you will be sure about which medication may have caused it.

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Yes! That's a great idea :) You are right...If I start having problems, I will never know which medication is causing it. I think I will see for sometime how I do with Florinex ( on it for 2 days now and so far I'm doing good!). I have an appointment again with the doctor in 2 weeks and I will ask about a low dose of Propranolol. Thank you!

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Hyperpots8 is right. Extended release formulas should not be split, so your best option might be to ask your dr to start you on a lower dose if you are sensitive to meds.

You can always take more if you start with a low dose and you think it is not helping.

i started the florinef and the propranolol at the same time, as i'm normally hypotensive, and my tachy episodes were out of control. I was told that the 2 meds have to work together - the propranolol to lower both my hr and bp, while the florinef counteracts by increasing the bp - in your case the numbers might indicate a different scenario though.

If it helps I take 0.15 mg florinef (which I supplement with potassium) and 20 mg propranolol (sometimes 30 mg if I need an extra dose due to a spike in HR or BP).

Good luck.

Alex

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I started on propanalol 10 mg 3x/day. My PCP moved me to 60 mg LA as he said that was the lowest dose that could be used to help prevent migraines. It didn't help with the headaches. When I saw my POTS neuro he was shocked that I was on "such a massive dose". He immediately started weaning me down and now I'm on 10mg 2x a day. His opinion was that the 60 mg LA was a very high dose for a POTS patient and that in general most of us needed "a whiff" of a beta blocker.

Good luck!

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Thanks Alex, Chaos :)

Yeah, 60 mg did seem high to me. Good I asked you guys before starting it! I tachy into 110-120s on standing usually but after eating/hot showers, I sometimes tachy into 130-140s. I am trying to eat very small meals these days to control that.

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Not everyone on,florinef needs propranolol. For me, the severe hypovolemia was the main cause of my tachycardia and when my volume status is improved, my tachycardia is improved.

yes, there is an article I think by Dr Satish Raj cards at Vanderbilt that says specifically 10-20 mg propranolol 3-4 x daily is the best dose for pots, that increasing the dose more makes most people worse.

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Thank you Hyperpots, I will search for the article and take a print-out to my doctor too. I'm hoping Florinex works for me and I won't need to take a beta-blocker....:)

Just curious, how long you took florinex/ other med before you saw an improvement in your symptoms/less tachycardia ?

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I noticed a difference in the first 24 hrs with florinef taking 0.1 mg daily. I was not told at first however that it is important to also increase your salt and water intake for florinef to work optimally. I still had some orthostatic tachycardia until I increased the dose to 0.2 mg daily with a lot of salt (I take 12-15 of the 1000 mg NaCl tabs daily) and water. I know I have very severe hypovolemia by blood volume anaylsis, however, so my experience won't apply to everyone. I knew before I was even tested that I was hypovolemic because my weight just quickly dropped (104#-->97# in five days) and I was urinating excessively and it just looked like water. Also, my clothes fit the same so I knew I had not really lost all that weight. If you haven't already tried it, consider Dr Levine's exercise protocol which also recommends 10 gm sodium diet and large amt of fluids. This has really helped a lot of people and maybe you wouldn't need any meds?

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Thank you Hyperpots for the awesome information! I already drink lots of water and add extra salt to my food but will make sure now that I drink even more and will also try the salt tabs. I will definitely look into Dr Levine's exercise protocol too! I am willing to do anything so that I don't have to take meds. I have tried my best all these years to avoid them but it had come to a point where I really needed some serious help.

One thing that is helping is eating lots of small meals throughout the day... I don't seem to tachy that much when I do this.

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I would check with your doctor before doing anything 60 mg seems like a really high dosage, but definitely don't try and take a quarter or try and self-medicate. Beta blockers are nothing to mess around with. If you think your doctor gave you something too high, talk to him/her about it, but don't take any actions without consulting your physician

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I agree that you might want to start on a smaller dose of propranolol. But I did want to mention that a small dose does not work for everybody. My daughter started on a small dose and worked up to 120 mg, which she has been on for several years. It wasn't until she got on that dosage that she finally stopped vomiting every time she tried to do anything. So larger doses do work and may be necessary for some people.

Edited by corina
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The 60mg is time release so it will slowly release into your system over time. In my opinion night time is the best time to take it. I take 40mg a day. 20mg am & 20mg pm and they are not time release. that is why I have to take them 2x's a day.

Edited by corina
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Dear members,

I'd like to ask you to be very careful when answering these kind of questions as it's so easy to fall into a dr's role and give medical advice which isn't allowed per the forum rules. You can avoid that by writing from your own experience, like: "my doctor told me to this or that" or "I am told that" or "I've (never) experienced that"

I'm asking this as there's been a lot of medical advice over the last days and it's taking us a lot of time to correct things. Not correcting could open DINET up to liability which we all are trying to avoid!

What might help as well when starting a topic is to ask what has worked for others when trying this or that.

Thanks everyone for working with us!

Corina

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