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Selective vs non selective beta blockers


p8d
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Hmm that’s hard to say. Could definitely be a question for your doctor or pharmacist though. 

Have you tried different doses? Maybe you need something on top to help decrease your BP? Or perhaps these medications just aren’t for you? I think it all depends on each persons individual genetic makeup, or if there’s underlying conditions (for example MCAS). Dysautonomia patients are so incredibly unique and what works for one person most likely won’t work for another. I had to try numerous different beta blockers at crazy doses to finally realize that they were not the drug for me. 

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From what I understand, beta blockers may have be either cardioselective or not AND vasodilative or not. Basically, any combination of the two. Bystolic, however, is vasodilative so it should lower your blood pressure. Cardioselective just determines which kind of B receptors it blocks, B1 or B2. Both cardioselective and non-cardioselective should lower the HR, just in different ways. Which one works best for you depends on what's causing your fast HR. I can't explain why Bystolic doesn't lower your blood pressure, though. 

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@p8d - I was on metoprolol and Bystolic before trying carvelidol. The first two did not control HR or BP, neither did they stop PVC's. Carvelidol on the other hand helped immediately with BP and PVC's but my HR would still go up at times. How much do you take? I started on 3.125 mg and slowly increased to 25 mg which I still take today. Oddly - once we added diltiazem ( calcium channel blocker ) for breakthrough hypertension HR and BP were controlled except for flares. So - depending on your dosage - inceasing the carvelidol ( if approved by your physician ) might help with the tachycardia as well. 

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@PistolI started on 6.25mg which was too high, BP tanked.  Now on 3.125mg twice a day so increasing that won’t help.  I have a message in to the cardiologist and should hear from them tomorrow.  I probably will call the clinical pharmacist associated with my PCP at the local medical college and see what he says.  I would be happy to add the bystolic in addition to the coreg and wonder if a higher dose of that might lower BP.  I just find it interesting and baffling why one works on BP and the other on HR.  I think for healthy people there’s a reason but for us?

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@p8d - I have found that in my case I would respond highly to a lower dose and then suddenly it would stop working and we increased the dose at that time. 6.25 mg is A LOT for a dysautonomic to start a  brand new drug, especially one as potent as carvelidol. In my case we went from pediatric doses to high doses - but in tiny increments and only if the lower dose stopped working. -- If you want to add Bystolic and your doc agrees you can try but be aware that you will not be able to determine if the smaller dose of carvelidol will give your body  chance to adjust to the med and then allow increases over time. Our bodies do not adjust to meds as other people's bodies do - it takes a while for the ANS to adjust. I personally have found that giving a med a chance by trying - and observing the effect of - a lower dose over time is way more realistic than trying it and expecting a huge difference. Starting at the LOWEST dose - and then increasing it by halfs and even quarters - has been much more effective for me and that is how my autonomic specialist fine-tuned my meds. I think your BP tanked b/c you did not get started on the lowest dose.  

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@pistol, thanks for the info.  I have been on the carvelilol for about 8 weeks so we didn’t do anything quickly.  I agree that they started me too high and will be more vigilant in the future.  I have been giving each dose change at least two weeks before I ask for a dose change.  I completely agree with you that everything takes longer for us to adjust to, it’s just so hard to be patient!  

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10 hours ago, p8d said:

it’s just so hard to be patient!  

I know - ( don't we all? ) … however: why are we rushing ourselves? I do it all of the time but then again - maybe that is exactly why we keep disappointing ourselves. IMO if we have more good ( or even stable ) days then bad ones we are in a good place.  And that does not happen fast - so we should just take it easy on our imbalanced bodies and … but then again - who am I to preach? 

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1 hour ago, Pistol said:

I know - ( don't we all? ) … however: why are we rushing ourselves? I do it all of the time but then again - maybe that is exactly why we keep disappointing ourselves. IMO if we have more good ( or even stable ) days then bad ones we are in a good place.  And that does not happen fast - so we should just take it easy on our imbalanced bodies and … but then again - who am I to preach? 

This gave me a good chuckle - but it's SO TRUE!!! Such good advice to keep in our back pockets - take it easy and don't rush... So much easier said than done of course but one day at a time!!

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