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My newest cardiologist wanted me to try ivabradine, although metoprolol is doing fine for me - I had no idea it would be so expensive even with the drug discount card and partial insurance coverage. That’s a no go. 
 

He then suggested acebutolol, saying he had success in other patients. I have pretty bad asthma if it’s triggered. Has anyone used this one? I’m not sure how specific it is.

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I was on acebutolol for many years. It was one of the better beta blockers I had been on. It is a slightly different beta blocker than the others. It has intrinsic sympathomimetic activity. https://en.wikipedia.org/wiki/Beta_blocker#Intrinsic_sympathomimetic_activity

I stopped taking it after my blood sugars started to raise and I was worried it was playing a role in it. 

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If you are doing well, then it may not be worth trialing a new med. It's possible that the acebutolol would act less on the lungs, but that is definitely a question for your doctor. Acebutolol kept my heart rates down and calmed my nerves, but it is no miracle drug by any means.  I had tried metoprolol, propranolol, nebivolol and acebutolol.

Acebutolol was the best one I found for myself. If I do go back on a beta blocker it will be that one.

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That’s what I figured. He is excited that I could do better on acebutolol (I’m not doing well, as far as low BP, orthostasis, syncope...) but I doubt it. Metoprolol has not bothered my lungs and has controlled my HR nicely, most of the time.

 

I would love to know what made it your favorite beta blocker! I am definitely considering whether it’s worth a trial.

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Nebivolol did not stop the shakiness and jittery feelings I get, so that one was not good for me personally. That one only blocks Beta 1. My heart rate would be 90, but I was super shaky and anxiety ridden. In the end it did not increase my postural time. 

Metoprolol and propranolol both just made me super tired and lowered my blood pressure. I felt like I was pushing against a wall on those two.

Acebutolol stopped the jitters, lowered my heart rate and didn't make me quite as tired as the other two. It did help to increase my postural time.

Sadly though I really think beta blockers in general were making my blood sugars worse, so I probably won't go back on them for a while unless an echo shows an enlarged heart or something like that. I got to figure out what is going on with my blood sugars.

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Took my first dose last night and was up all night. I felt like I had some caffeine before bed. It did help with my rate and pounding, but like you said, I can feel terrible "heart wise" with a rate of 76. Neither it nor metoprolol changed my blood pressure.

 

Today will be the first daytime test and I’m going for a walk. Sorry about your blood sugars - my fasting is always 102-106, and while I knew beta blockers can raise it, I guess I didn’t think I’d have that. 

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Oh no that is not good. I always took my beta blocker in the morning. Perhaps the intrinsic sympathomimetic activity won't work well for you. If not, at least you know and can cross that off the list. :) 

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Yeah, I don’t think ISA is good for me at night. He has me taking it twice a day - I definitely need the help with HR and pounding most at night. It seems ideal to take this in the morning and metoprolol at night, but I bet they won’t let me do that.

I do think I feel better during the day, with a bit more energy and exercise tolerance. My BP hasn’t changed(but it didn’t with metoprolol either). I want this to work! I hate going back to doctors saying I can’t use something, and I like the daytime effects. 

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