Which Beta Blocker Is Best For Anxiety
Beta blockers are not a typical choice for treating anxiety conditions, and none are FDA-approved for this use. There are other options such as selective serotonin reuptake inhibitors , serotonin and norepinephrine reuptake inhibitors , and that are more preferred for treating anxiety.
Propranolol is the beta blocker that has been most studied for anxiety. In a 2015 review of available research, propranolol was found to lack benefit for some anxiety conditions while being effective for others. Due to the lack of high-quality studies, the studys authors couldnt recommend whether people should use propranolol for anxiety or not.
Propranolol is sometimes prescribed off-label for performance anxiety, but there is a lack of evidence for its use. This medication would most likely only be used if youve had no success with other anxiety medications or you have another condition that could be treated with propranolol, such as migraine headaches.
Calculating Your Target Heart Rate
Your maximum heart ratethe upper limit of what your cardiovascular system can handle during physical activitycan be estimated by subtracting your age from 220. So, if youre 35 years old, your estimated maximum heart rate is around 185 beats per minute .
It is recommended that you exercise within 55 percent to 85 percent of your maximum heart rate for at least 20 to 30 minutes to get the best results from aerobic exercise. In the example of the 35-year-old above, the target heart rate zone would be from 102 to 157 bpm.
Beta blockers can slow down your heart rate, but its effect is different for everyone . To use your resting heart rate as your guide, figure out the decrease in your heart rate as a result of the beta blocker. You will need to know what your resting heart rate was before you started taking the beta blocker.
For example, if your resting heart rate is 70 bpm without a beta blocker and 50 bpm with a beta blocker, thats a difference of 20. When calculating your target heart rate, subtract this number from the result. Thats your beta blocked target heart rate and is equivalent to what your target heart rate would be without the beta blocker. Again using the 35-year-old as an example, in this case the target heart rate zone would be reduced to between 82 and 137 bpm.
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
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What Other Drugs Interact With Carvedilol
If your doctor has directed you to use this medication for diabetes, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.
Severe Interactions of carvedilol include:
Carvedilol has serious interactions with at least 34 different drugs.
Carvedilol has moderate interactions with at least 240 different drugs.
Carvedilol has mild interactions with at least 34 different drugs.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.
Who Can Take Beta Blockers
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 theres too much acid in your blood
- lung disease or asthma
Tell your doctor if youre trying to get pregnant, are already pregnant or breastfeeding.
Its important not to stop taking beta blockers without seeking your doctors advice. In some cases suddenly stopping the medicine may make your health condition worse.
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Warnings For People With Certain Health Conditions
For people with asthma: If you have asthma or a related condition, you shouldnt use this drug. A single dose of carvedilol can be fatal in people with asthma.
For people with heart problems:
- Second- or third-degree heart block: Carvedilol can make your heart block worse.
- Heart rhythm problems: If you already have a heart rhythm problem, such as sick sinus syndrome, taking carvedilol can make it worse.
- Very low heart rate: This drug can slow down your heart rate even more, possibly to dangerously low levels. Dont take carvedilol if you have a very low heart rate unless you have a permanent pacemaker.
- Cardiogenic shock or decompensated heart failure: People with shock or decompensated failure that requires the use of certain medications shouldnt use this drug. It can make the condition worse.
- Chronic heart failure: Carvedilol can worsen heart failure or fluid retention, especially during dosage increases. Carvedilol can further decrease the force of contraction of your heart and slow down your heart rate. This may make your heart failure worse if your dosage is increased too quickly. Your doctor may need to lower your dosage or temporarily stop carvedilol if this happens.
For people with low blood pressure: Carvedilol can cause dangerously low blood pressure that may cause you to lose consciousness.
For people with peripheral vascular disease : Use caution if you have PVD and take carvedilol. This drug can make your symptoms worse.
Does Carvedilol Lower Blood Pressure More Than Metoprolol
Carvedilol may lower blood pressure more than metoprolol. This is because carvedilol has vasodilating properties that help relax blood vessels and lower blood pressure. No studies have directly compared the blood pressure lowering effects of carvedilol and metoprolol. However, carvedilol may help prevent cardiovascular events more than metoprolol in hypertensive patients.
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What Are The Main Differences Between Carvedilol And Metoprolol
Carvedilol is considered a non-selective beta-blocker. This means that carvedilol can block both beta-1 receptors and beta-2 receptors. Beta-1 receptors are found in the heart while beta-2 receptors are primarily found in the smooth muscles. Carvedilol also blocks alpha receptors in the arteries, which helps lower blood pressure.
Carvedilol is the generic name for Coreg. It is usually taken as a 3.125 mg, 6.25 mg, 12.5 mg, or 25 mg oral tablet twice daily. Carvedilol is also available in an extended-release form that can be taken once daily.
Metoprolol is a beta-1 selective blocker that primarily blocks the beta-1 receptors in the heart. However, it also blocks beta-2 receptors, although to a lesser degree. Selective beta-blockers may have slightly different effects compared to non-selective beta-blockers.
Metoprolol comes in two different salt forms: metoprolol tartrate and metoprolol succinate. Metoprolol tartrate, also known by the brand name Lopressor, is an immediate-release oral tablet that comes in strengths of 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg. Metoprolol succinate, also known by the brand name Toprol XL, is an extended-release oral tablet that comes in strengths of 25 mg, 50 mg, 100 mg, and 200 mg.
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.
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Im Still Worried What Do I Do
It is important to know you are taking these medications for a specific reason. But if you are still concerned, talk to your healthcare provider. He or she may prescribe a different beta blocker or another medication that has less of an effect on heart rate.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
How Does It Work
The heart is critical in the cardiovascular system and is needed to push the blood through your blood vessels and around your body. There are certain receptors that are found in your heart called beta-adrenergic receptors that send the message to the heart muscles, telling them to contract and push the blood out of the heart and around the body.
Beta blockers stop this process from occurring as usual because they attach to the beta receptors in the heart and prevent the normal molecules from activating the receptors.
What happens? The heart muscles dont contract to pump the blood around the body as often and when they do, it has less force. This leads to a drop in heart rate and blood pressure when you take carvedilol.
This is beneficial because it helps to relieve the stress placed on the heart and blood vessels, protecting you from cardiovascular events, like a heart attack or stroke.
High blood pressure means there is too much blood pumping around the body too fast, putting a lot of pressure on the heart and the rest of the cardiovascular system. Nifedipine allows the blood vessels to relax and expand slight, letting the blood flow through more easily.
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How Do Beta Blocker Drugs Affect Exercise
Beta blockers are a type of cardiac medication prescribed after a heart attack or to treat abnormal heart rhythms and other conditions. They slow down your heartbeat, and that raises a common question about them: Do they affect your ability to exercise?
The answer can vary a great deal, depending on the severity of your condition, so checking with your healthcare provider is vital. Its also important to understand how these drugs affect your heart.
Carvedilol May Cause Hyperglycemia Call Your Doctor Immediately If You Have Any Of The Following Symptoms Of Hyperglycemia:
- extreme thirst
- difficulty breathing and swallowing
Carvedilol may cause other side effects. Tell your doctor if you experience any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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Cautions With Other Medicines
There are some medicines that can affect the way carvedilol works.
Tell your doctor if youre taking:
- other medicines for high blood pressure when taken together with carvedilol, they can sometimes lower your blood pressure too much
- other medicines that can lower your blood pressure these include some antidepressants, nitrates , baclofen , medicines for an enlarged prostate gland like tamsulosin, or levodopa
- medicines for an irregular heartbeat such as amiodarone or flecainide
- medicines for asthma or chronic obstructive pulmonary disease
- medicines that 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, diclofenac and naproxen these medicines may increase your blood pressure
How Coreg And Beta Blocker Drugs Work
Coreg belongs to a class of medicines known as beta blockers. These drugs work by obstructing the impact of the hormone adrenaline , which causes the heart to beat faster and blood pressure to rise. By causing the heart to beat more slowly and with reduced strength, blood pressure is decreased.
Hypertension is a very common condition, in both industrialized nations as well as developing countries. The American Heart Association estimates that there are some 76 million U.S. citizens age 20 and above, i.e. one in 3 adults, who have high blood pressure.
Beta blocker drugs, commonly prescribed in combination with other medications, are used for the treatment of the following conditions:
- High blood pressure
- Irregular heartbeat
- Chest pain
- Congestive heart failure
- Heart attack
Coreg is not recommended for children under the age of 18. For adults, the drug is usually started at 3.125mg twice a day, with the potential of increasing the dose every two weeks to the higher dosages up to 25mg twice daily. Patients weighing over 187 lbs. can be given the maximum dosage of 50mg twice daily for mild to moderate heart failure. Dizziness may preclude such patients undertaking hazardous tasks including driving and using industrial machinery, until the dizziness dissipates and they feel back to their normal state of alertness.
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What Is It Used For
Carvedilol is usually used to help lower blood pressure in people with hypertension, or as an additional treatment for people with heart failure.
As a result of the way it works, reducing the heart rate and blood pressure, carvedilol is a good option for people with high blood pressure to reduce the load on the heart.
Carvedilol can also be used in the treatment of heart failure, in addition to medications from other drug classes, such as ACE inhibitors and diuretics.
Tell The Healthcare Professional About All Medications
Drug interactions are another common source of carvedilolside effects. It is generally a good idea to keep a list of all medications that are being taken. This should include not only prescription drugs but over-the-counter drugs or supplements, too. Share this list with the prescribing healthcare provider and the pharmacist.
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Change In Hr And Sbp After 4 Months
Mean HR decreased from baseline by 13.3±13.4b.p.m. in the carvedilol group and by 11.7±13.5b.p.m. in the metoprolol tartrate group at 4 months . HR was slightly but significantly lower in the carvedilol group when compared with the metoprolol tartrate group also at 8 and 16 months after randomization . No significant differences were observed at further visits during the 5 years after randomization. SBP decreased from baseline by 3.8±17.4mmHg in the carvedilol group and by 2.0±17.7mmHg in the metoprolol tartrate group at 4 months. The difference remained significant during most of the follow-up .
There was no relationship between changes in HR or SBP during the first 4 months of treatment and mortality. A HR 68 b.p.m. and a SBP > 120mmHg at 4 months were associated with a better outcome . Exclusion of patients with atrial fibrillation and/or those with a permanent pacemaker did not change these results .
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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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.
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.
Which Beta Blocker Is Most Effective
The best beta blocker depends on the health condition you have. Some beta blockers work better than others for certain conditions this often depends on whether the medication is a selective or non-selective beta blocker and if it has alpha-blocking effects.
Selective beta blockers also known as cardioselective beta blockers only block beta-1 receptors in the body. These receptors affect your heart rate and how much blood your heart pumps out.
Examples of cardioselective beta blockers include:
Beta blockers can also come in combination tablets or eye drops, where the beta blocker is combined with another type of medication that treats the same condition. These combination medications are typically less common than plain beta blockers but can be more convenient for some people.
Usually, when beta blockers are used for heart conditions, cardioselective beta blockers are preferred because they are more effective at treating the condition and lower the risk of heart-related complications. They may also cause fewer side effects for some people, especially those with lung conditions, such as asthma.
Based on research studies, there are three beta blockers that are best for heart failure: carvedilol, metoprolol succinate , and bisoprolol. These beta blockers have been shown to lower your risk of dying from heart failure complications.
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