Anyone On Beta Blockers And Have To Carry An Epipen?

[JenniferInOhio]

Just wondering if there were any other people out there who HAVE to be on a beta blocker, and HAVE to carry an Epipen for anaphylaxis? Have you ever had to give yourself the Epipen and did it work ok with your beta blockers?

Everything I read about beta blockers and epipens is not good...that if you need an epipen, you should not take bb's. I have SVT and non-sustained ventricular tachycardia in addition to POTS, so I've got to have that BB. I have allergies to tree nuts, peanuts, and shellfish.

[Katybug]

When I was on bb's I had to carry an epipen although I never got bad enough to have to use it. However, my immunologist was clear that if I had to use the pen I had to be RUSHED to the ER because the bb's reduce the duration of the efficacy of the epipen. I ultimately had to stop the bb's because I was dx'ed with MCAS. When I stopped the bb's, my feeling of constant chest compression and air hunger improved by about 50%. Unfortunately, they put me on verapimil instead which isn't helping my pots as much.

[statesof]

I'm on a beta block and also have an epipen but its for shelfish and iodine allergies, i've fortunately never had to have used it. Personally i'm more affraide of what the adrenaline from my epi would ever do to me if i had to use it, but i have a couple of them so i guess if the first one did not work i could always used the second, but that might be alot of adrenaline. What is your epi for?

[flyingsquirrel]

I'm on a beta blocker and have severe allergies (and an epi-pen). You're right that they're not an ideal combination, but I need the epi for anaphylaxis and I've tried everything under the sun for my heart and beta blockers are the only thing that keep me functional. The tradeoff is that when I do have an allergic reaction (or an asthma exacerbation), they are more serious and more difficult to treat.

You might want to talk to your doc about prescribing a glucagon emergency kit. They are designed for diabetics to raise blood glucose when they can't take sugar orally, but it is also the drug of choice for beta blocker overdoses...which is basically what is happening when you are in anaphylaxis and the beta blocker is blocking the epinephrine.

a couple of caveats and things you should know:

- glucagon is really expensive (but no more so than epi-pens)

- it comes in a kit with a vial and a needle...you need to draw it up yourself and give yourself the injection (intramuscular)

- every ambulance in the US should carry at least 2mg (2 kits)

- every paramedic and doctor should know this, but their pharmacology classes may have been a really long time ago, so don't be afraid to remind them...nicely. see the excerpt below.

From uptodate.com (one of the most used professional medical references):

Glucagon for patients taking beta-blockers — Patients receiving beta-blockers may be resistant to treatment with epinephrine and can develop refractory hypotension and bradycardia. In this situation, glucagon should be administered because it has inotropic and chronotropic effects that are not mediated through beta-receptors. A dose of 1 to 5 mg in adults (in children, 20 to 30 micrograms per kilogram to a maximum of 1 mg) administered intravenously over 5 minutes is recommended. This dose may be repeated or followed by an infusion of 5 to 15 micrograms per minute. Rapid administration of glucagon can induce vomiting; therefore, protection of the airway, for example, by placement in the lateral recumbent position, is important in drowsy or obtunded patients.

[JenniferInOhio]

I'm on a beta block and also have an epipen but its for shelfish and iodine allergies, i've fortunately never had to have used it. Personally i'm more affraide of what the adrenaline from my epi would ever do to me if i had to use it, but i have a couple of them so i guess if the first one did not work i could always used the second, but that might be alot of adrenaline. What is your epi for?

Epi is for tree nuts, peanuts and shellfish.

[JenniferInOhio]

I'm on a beta blocker and have severe allergies (and an epi-pen). You're right that they're not an ideal combination, but I need the epi for anaphylaxis and I've tried everything under the sun for my heart and beta blockers are the only thing that keep me functional. The tradeoff is that when I do have an allergic reaction (or an asthma exacerbation), they are more serious and more difficult to treat.

You might want to talk to your doc about prescribing a glucagon emergency kit. They are designed for diabetics to raise blood glucose when they can't take sugar orally, but it is also the drug of choice for beta blocker overdoses...which is basically what is happening when you are in anaphylaxis and the beta blocker is blocking the epinephrine.

a couple of caveats and things you should know:

- glucagon is really expensive (but no more so than epi-pens)

- it comes in a kit with a vial and a needle...you need to draw it up yourself and give yourself the injection (intramuscular)

- every ambulance in the US should carry at least 2mg (2 kits)

- every paramedic and doctor should know this, but their pharmacology classes may have been a really long time ago, so don't be afraid to remind them...nicely. see the excerpt below.

From uptodate.com (one of the most used professional medical references):

Glucagon for patients taking beta-blockers — Patients receiving beta-blockers may be resistant to treatment with epinephrine and can develop refractory hypotension and bradycardia. In this situation, glucagon should be administered because it has inotropic and chronotropic effects that are not mediated through beta-receptors. A dose of 1 to 5 mg in adults (in children, 20 to 30 micrograms per kilogram to a maximum of 1 mg) administered intravenously over 5 minutes is recommended. This dose may be repeated or followed by an infusion of 5 to 15 micrograms per minute. Rapid administration of glucagon can induce vomiting; therefore, protection of the airway, for example, by placement in the lateral recumbent position, is important in drowsy or obtunded patients.

Thanks so much! My Dr. mentioned glucagon - but I assumed it would be administered in the hospital. I'll ask him what he thinks about a glucagon kit. By the time you call the paramedics and actually get to a hospital, it would probably be 30 minutes or more before you received the meds.