Thursday, April 18, 2024

Do Beta Blockers Slow Heart Rate

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Dosage Forms Of Metoprolol

Beta blockers

There are two different types of metoprolol: metoprolol tartrate and metoprolol succinate. Metoprolol tartrate is used in immediate-release tablets and comes in 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg pills. Metoprolol succinate is used in the extended-release capsules and tablets and comes in 25 mg, 50 mg, 100 mg, and 200 mg pills. The specific dose recommended by your healthcare provider will vary depending on the condition being treated, as well as your other medical issues.

Beta Blockers Are Busted What Happens Next

They have treated heart disease for 40 years, but it now seems that beta blockers dont work. What went wrong?

By Josh Bloom

IT IS very rare for new evidence to question or even negate the utility of a well-established class of drugs. But after four decades as a standard therapy for heart disease and high blood pressure, it looks like this fate will befall beta blockers. Two major studies published within about a week of each other suggest that the drugs do not work for these conditions. This is a big surprise, with big implications.

The first beta blocker, Inderal, was launched in 1964 by Imperial Chemical Industries for treatment of angina. This drug has been hailed as one of great medical advances of the 20th century. Its inventor, James Black, was awarded the Nobel prize in medicine in 1988.

The 20 or so beta blockers now on the market are very widely used almost 200 million prescriptions were written for them in the US in 2010. They are standard issue for most people with heart disease or high blood pressure. This may now change.

A large study published last month in The Journal of the American Medical Association found that beta blockers did not prolong the lives of patients a revelation that must have left many cardiologists shaking their heads .

The researchers followed almost 45,000 heart patients over three-and-a-half years and found that beta blockers did not reduce the risk of heart attacks, deaths from heart attacks, or stroke.

Cautions With Other Medicines

There are some medicines that may interfere with the way that beta blockers, including beta blocker eyedrops, work.

Tell your doctor if you’re taking:

  • other medicines for high blood pressure. The combination with beta blockers can sometimes lower your blood pressure too much. This may make you feel dizzy or faint
  • other medicines for an irregular heartbeat such as amiodarone or flecainide
  • other medicines that can lower your blood pressure. These include some antidepressants, nitrates , baclofen , medicines for an enlarged prostate gland like tamsulosin, or Parkinson’s disease medicines such as levodopa
  • medicines for asthma or chronic obstructive pulmonary disease
  • medicines for diabetes, particularly insulin beta blockers may make it more difficult to recognise the warning signs of low blood sugar
  • medicines to treat nose or sinus congestion, or other cold remedies
  • medicines for allergies, such as ephedrine, noradrenaline or adrenaline
  • non-steroidal anti-inflammatory medicines , such as ibuprofen. These medicines may increase your blood pressure, so it’s best to keep them to a minimum

Also Check: What Is A Typical Resting Heart Rate For A Healthy Individual

Can I Take A Beta Blocker If I Have Diabetes

Yes, you can take a beta blocker if you have diabetes. But a beta blocker may hide some of the warning signs of low blood sugar. For example, when you take a beta blocker, your heart rate may not increase in response to a low blood sugar level. You will need to check your blood sugar levels carefully after you start taking a beta blocker. If you have low blood sugar often, your doctor may want to change the dosages of your diabetes medicines.

Who Can Take Beta Blockers

Pulmonary Artery Catheter

Beta blockers are not suitable for everyone. To make sure they are safe for you, tell your doctor before starting a beta blocker if you have:

  • had an allergic reaction to a beta blocker or any other medicine in the past
  • low blood pressure or a slow heart rate
  • serious blood circulation problems in your limbs
  • metabolic acidosis when there’s too much acid in your blood
  • lung disease or asthma

Tell your doctor if you’re trying to get pregnant, are already pregnant or breastfeeding.

It’s important not to stop taking beta blockers without seeking your doctor’s advice. In some cases suddenly stopping the medicine may make your health condition worse.

Also Check: How To Calculate Target Heart Rate Zone

Which Drugs Interact With Metoprolol

Before starting metoprolol, or any other new medication, seek medical advice about potential drug interactions. Medicines that may interact with metoprolol include :

This list does not include all possible drug interactions with metoprolol and others may exist. Check with your pharmacist or healthcare provider for more information.

Concerns About Exercising While On Beta Blockers

Its important to remember that your heart rate is being slowed, and to adjust accordingly if before you took these drugs you monitored your exercise using heart rate, said Dr. Fletcher, who is also a volunteer with the American Heart Association.

Dont overdo it trying to get your heart rate up to previous levels, he said.

There are a couple of ways to monitor your exercise intensity.

  • If you have been using a target heart rate to get to the right intensity, your healthcare provider can help to determine your new target heart rate using a brief exercise stress test. This test is used because beta blockers affect everyone differently.
  • The second way to monitor your intensity is simpler: making sure youre not too exhausted.
  • Exercise hard to the point of being tired but not excessively hard, Dr. Fletcher said. If you reach a point where it is hard to talk, that is probably too much.

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    Low Heart Rate With Propranolol

    Hi, my doctor prescribed 10mg propranolol twice a day. My heart rate went down to 48. My resting heart rate is between 58 and 65 without propranolol. Has anyone else experienced this?

    0 likes, 36 replies

  • Posted 5 years ago

    Thank you both for your quick replies. This will sound silly but the doctor gave me propranolol for anxiety and at the start I did feel very chilled. I felt so relaxed that I felt like I was hardly breathing, if that makes sense. That’s when I decided to check my pulse and it was very low. This was only after a few days on just 10mgs. So now I feel more anxious because of the low heart rate!

  • Posted 5 years ago

    Yes, I’ve heard of heart rates that low. What was your blood pressure before you started taking it and what is it now?

  • Posted 5 years ago

    I couldn’t tell you. All I know is that my gp says ” that’s normal” I should pay more attention really. Anyway I have been in so much pain which is stressing me out that I decided to cut the 10mg in half and have been taking it in the morning and then in the evening if I need it. Even on 5mg my heart rate was 48 but it is doing the trick of keeping me calm at the moment

  • Posted 5 years ago

    Oh mine has never went that low the lowest mine has ever been is 58 but since that night I have worried ever since

  • Posted 5 years ago

    Thx for advice day I took 10mg 2 hours ago and my pulse is 64 I need to stop worrying lol

  • Do Not Suddenly Stop Taking Your Beta

    Heart Disease — Beta blockers, irregular heartbeat, and atrial fibrillation

    Do not suddenly stop taking your beta-blocker without talking to your doctor first. This can be dangerous and make you feel unwell. You may get the feeling of changes in your heartbeat , an increase in blood pressure and a return of chest pains. If you do need to stop taking a beta-blocker then your doctor may advise a slow reduction in dose.

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    While Pregnant Or Breastfeeding

    Beta-blockers may affect a growing baby by slowing its heart rate and lowering its blood sugar level and blood pressure. These drugs can also pass to an infant through breast milk, causing low blood pressure, trouble breathing, and a slow heart rate.

    You should tell your doctor if you’re trying to get pregnant or you become pregnant while on beta-blockers or are breastfeeding.

    What To Think About

    Check your pulse. Your doctor may ask you to take your pulse regularly to make sure your heart rate is not too slow. To learn how to take your pulse, see the topic Taking a Pulse .

    Diabetes. If you have diabetes, beta-blockers may cause higher blood sugar levels. Watch closely for symptoms of low blood sugar, because beta-blockers can hide your symptoms.

    Grapefruit juice. Grapefruit juice may affect how beta-blockers work. Ask your doctor if you need to make any changes to avoid problems.For more information, see Grapefruit Juice and Medicines.

    Cold weather. Beta-blockers may make you more sensitive to cold weather. Dress warmly and if needed, limit your time in cold weather.

    Sun exposure. Beta-blockers may make you more sensitive to sunlight. You might get sunburned easily or get a rash. To prevent problems, try using sunblock and/or wearing long-sleeved shirts and hats.

    Allergic reactions. If you have food, medicine, or insect-sting allergies, beta-blockers may cause allergic reactions to be worse and harder to treat. If you have a severe allergic reaction, tell your doctor that you are taking a beta-blocker.

    For tips on taking blood pressure medicine, see:

    High Blood Pressure: Taking Medicines Properly.

    Also Check: How To Calculate Target Heart Rate Zone

    Heart And Blood Vessel Conditions

    Because of their effect on the heart cells, beta-blockers may be used to:

    Dr Sarah Jarvis, 7th May 2021

    The National Institute for Health and Care Excellence has updated its guidance on the management of atrial fibrillation . Beta-blockers are sometimes used to control your heart rate if it is very fast as a result of AF and this is causing you symptoms.

    NICE recommends that if this is the case, you should usually be offered either a standard beta-blocker or a calcium-channel blocker that stops your heart going too fast. You may also be offered treatment with a beta-blocker to reduce your risk of AF if you are having heart surgery.

    Baseline Evaluations And Data Management


    Information collected at baseline included: demographics medical history risk factors and lifestyle results of physical examination HR current symptoms laboratory values and current chronic medical treatments .

    Data were collected centrally using an electronic, standardized, international case report form and sent electronically to the data management center where checks for completeness, internal consistency, and accuracy were run.

    Data quality control is performed onsite in 5% of sites chosen at random in each country with, at each site, monitoring of 100% of case report forms for source documentation and accuracy. The study is being performed in accordance with the principles of the Declaration of Helsinki and was approved by the National Research Ethics Service, Isle of Wight, Portsmouth and Southeast Hampshire Research Ethics Committee, UK. Approval was also obtained in all 45 participating countries, in accordance with local regulations before recruitment of the first participant. All patients gave written informed consent to participate, in accordance with national and local guidelines. The CLARIFY Registry is registered in the ISRCTN registry of clinical trials with the number ISRCTN43070564.

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    Whats The Difference Between Beta Blockers And Alpha Blockers

    Beta blockers block the hormone epinephrine which most of us know as adrenalin. So basically, Alpha blockers relax the muscles and open the veins to allow smooth blood flow to the heart. Beta blockers slow the heart rate and thus reduce the blood pressure from the heart. Beta blockers also help regulate the blood flow.

    The No 1 Reason People Stop Taking Beta

    The top reason patients stop using beta-blockers is admission to the hospital for various conditions, not just heart failure, Dr. Tang says. However, most people should not stop, even if they are hospitalized, unless the doctors decided that it is more harm than good.

    Research shows that patients fare better when they continue taking beta-blockers while in the hospital, even with acute heart failure.

    An inability to tolerate beta-blockers indicates a worsening heart condition, says Dr. Tang. Other testing may be necessary to determine if the heart is too weak for beta-blockers.

    This may even apply for patients whose heart function has recovered to the normal range. Recent clinical studies have shown that, even in those with full recovery of their heart structure and function, stopping drugs like beta-blockers can reverse the recovery course and can be detrimental, he adds.

    Also Check: Can Ibs Cause Heart Palpitations

    How Beta Blockers Affect Your Target Heart Rate

    If you have high blood pressure, treatment often requires medication with a beta blocker, a common type of blood pressure medication that lowers your resting heart rate. Exercising regularly, another important component of managing high blood pressure, also lowers your resting heart rate. Hence, if you take a beta blocker, you will need to make some adjustments when calculating your target heart rate while doing aerobic exercise.

    Where Do Beta Blockers Work In The Body

    What are beta blockers?


    How do beta-blockers cause bronchoconstriction? Heart. Beta-blockers bind to beta-adrenoceptors located in cardiac nodal tissue, the conducting system, and contracting myocytes. What is the difference between an alpha blocker and a beta blocker? Summary. Alpha-blockers work on the blood muscles to open up the blood vessels, while beta-blockers work on the heart to ease the

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    Selective Vs Nonselective Beta Blockers

    There are two main types of beta blocker medications: selective beta blockers and nonselective beta blockers.

    Selective beta blockers are designed specifically to block the 1 receptors, which are primarily located in the heart. Because the action of these beta blockers is more specific, theyre usually safe for use if you have diabetes.

    Common selective beta blockers include acebutolol, atenolol, bisoprolol, betaxolol, bevantolol, celiprolol, metoprolol, esmolol and nebivolol.

    Because selective beta blockers only affect the 1 receptors, which are concentrated in heart tissue, they tend to be used to treat heart conditions and arent a popular treatment option for anxiety.

    Nonselective beta blockers are designed to block the 1, 2 and 3 receptors. This means that as well as targeting beta receptors in the heart, they also affect the veins, liver, pancreas and a range of other parts of the body.

    Common nonselective beta blockers include alprenolol, carteolol, oxprenolol, propranolol and sotalol. As well as being used to treat certain heart conditions, nonselective beta blockers can be used to treat some physical effects of anxiety.

    Unlike selective beta blockers, nonselective beta blockers are not considered safe to use if you have diabetes.

    Beta Blockers For Fast Heart Rate


    Hello there im alex as some of u may know me already.. i was recently put on beta blockers fpr my fast heart rate .. i was put on metoprolol 25 mg 12.5 in the morning and 12.5 at night.. does this actually help? I have an extremely fast heart rate most of the time normal rythm just fast.. dr put me on beta blockers. Will this help me? I also have really bad anxiety so i know that palys an awful role.

    0 likes, 4 replies

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    Learn More About Beta Blockers

    Beta blockers are some of the most widely used medications in the world, prescribed for heart conditions, anxiety and more. Safe, easy to use and effective, they provide fast and noticeable results that make them ideal for preventing chronic anxiety and panic attacks.

    Our guide to propranolol goes into more detail on how one of the most widely used beta blocker medications works, from its history to major benefits, potential side effects, drug interactions and more.

    This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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    Can I Take A Beta Blocker If I Have Asthma Or Chronic Lung Disease


    Beta blockers are generally not used in people with asthma. A beta blocker can cause asthma attacks.

    Sometimes people with a chronic lung disease such as emphysema or bronchitis can take beta blockers. If you have lung disease and are taking a beta blocker, call your doctor right away if you start having breathing problems.

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    Do Beta Blockers Affect Exercise

    Beta blockers and exercise can both be helpful to lowering blood pressure levels. If you have high blood pressure, your healthcare provider might recommend exercising more as one way to help lower it naturally. Is it safe to exercise if you have to take medication? Since most beta blockers lower your blood pressure, and slow your heart rate and cardiac output , they can affect your exercise goals.

    Whether the effect is significant enough to limit exercise is usually patient-specific, says Joanna Lewis, Pharm.D., the founder of The Pharmacists Guide. Many studies have shown that people can exercise as normal, but it really depends on the athletic state of the individual.

    Your healthcare provider may recommend an exercise stress test, which checks heart blood flow during exercise and measures how hard the heart pumps on beta blockers. They can then use this information to figure out your target heart rate.

    Experts also suggest the Borg scale as a simple way to measure how hard someone is exercising. The scale matches how hard you feel youre working with numbers from six to 20. The higher the number, the harder youre working. Then, multiply the number by 10 for a rough heart rate estimate. People who take beta blockers run the risk of being unaware when theyre exercising too hard they can use the scale to prevent overexertion.

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