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Beta Blockers And Allergies/asthma

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My allergist told me I should really avoid beta blockers with my severe allergies and some asthma. Has this come up for any of you?

I think in part the reasoning is that epipens don't work so well if you take bbs, but that they can also actually make allergies and asthma worse???


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My pulmonologist would prefer me to stay away from betas because of my asthma, but unfortunately my HR with anything other than betas is over 200 and not condusive to anything other than being flat on my back in bed. So, they have agreed that the asthma seems to be the lesser of the two evils, so I remain on 100 bid of Atenolol and check my peak flows 2x a day and am religious about my asthma meds. So far so good as long as I have my rescue inhaler around for emergencies. I am a bit concerned about this Spring and Summer as it will be the first allergy season I have been on such a high dose of betas and my allergies tend to induce asthma attacks....so fingers crossed.


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So far all of my doctors refuse to put me on beta blockers. My very first asthma attack was while I was on Propranolol, a non-selective beta blocker, and I was taken off that med right away. After that, my asthma attacks were never as bad (was breathing at 25% at that first attack, never got worse than 50% after). I think the doctors blame the severity of that first attack on the beta blocker. There are selective beta blockers, however, that interfere less with breathing and focus on the "betas" associated with the heart. Those are supposed to be much more safe - but it depends on the study. Some doctors advocate selective beta blockers for asthma patients with heart conditions while others say it is dangerous and should be avoided.

It does make me think we asthmatics with POTS are missing out on a crucial med for POTS. I'm going to a new Pulmonologist soon and plan to discuss it with him. Getting the tachycardia under control would be so wonderful. There are times my heart is chugging along at greater than 180 beats per minute, and on average, standing, it's usually at least 140. Not horrible, but it makes me really tired!

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I have the combination of POTS, asthma, eczema and allergic rhinits. Of the allergies it is the hayfever that is the worst and I have needed to take steroid tablets the last two summers. My asthma has been bad in the past (~8years ago) but now it doesn't bother me unless I get an infection (needed home nebs over the winter as I had pneumonia), infact I haven't touched an inhaler at all for weeks.

My cardiologist had a discussion with a respiratory physician before deciding to start me on a beta-blocker. They choose bisoprolol which is cardiac selective (is acts more on the beta1 receptors in the heart/blood vessels than it does on the beta2 receptors in the lungs). The cardiac selective betablockers are safer than the non-selective ones but they shouldn't be considered "safe" in asthmatics.

I think that it is up to your doctors to weigh the risk against the benefits in each person's individual case. Personally if I had allergies severe enough to need to use an epi-pen I would be very wary of trying a betablocker.

There are other drugs that can limit heart rate, I'll start a separate topic ....


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