philbob57

I'm trying carvedolil out after a trial with Toprol XR. Both of them knock me out. Toprol is worse overall than carvedolil, but carvedolil seems to make actually waking up and getting out of bed more difficult than it's ever been.

Anybody here with beta blocker experience? Can you recommend any that seem to have less impact on energy?

I've got a pacemaker, so probably none of them will kill me. If you recommend something and it doesn't work for me, I won't blame you at all.

Thanks in advance.

Hondo Gravel

I took a beta blocker for HBP and it was horrible for cycling. No energy and my heart rate wouldn’t get high enough to get blood to my muscles. Different doctor got me on Diovan and amlodipine. I forget the classification of the drugs but my cycling improved greatly.

canklecat

Yeah, same experience with beta blockers. Supposedly we get accustomed to them over time but I never did. I use them only as needed for migraines and the beta blocker will wipe out my energy for a couple of days. My BP is pretty well controlled with diet and exercise now.

philbob57

I was told I'd feel a lot more energetic with the pacer after a month, and that did happen. Then my doc added the beta blocker for BP and tachycardia, so I was back to my pre-pacer energy level. The tachycardia, like Afib, can create clots. Blood clots roaming around my 76 year old body scare me. A lot to think about....

Thanks for your comments.

sovende

Beta blockers have been around for quite some time but are still commonly used to manage a variety of heart rate and blood pressure issues. They are generally well tolerated and for the most part, do what they’re supposed to do. I think it’s safe to say they can be detrimental to performance in most athletic endeavors . Their primary function is to prevent too rapid of a heart rate. Obviously, that’s a major issue when we exercise and need increased delivery of oxygen rich red blood cells and other nutrients to our muscles as well as other high demand organ systems! Those muscles and organ systems become O2 starved and refuse to do what we need them to do.
Some of the older beta blockers are less specific to just controlling heart rate and can have a detrimental effect on lung tissue that prevents the bronchial dilation needed to get more air to the regions where O2<->CO2 exchange occurs. So, individuals taking the non-specific beta blockers not only have the inability to increase their heart rate, they also have a problem getting enough oxygen into the blood. A double whammy .

canklecat

Recently I've had to take metoprolol a few times for migraines. I usually start out with a fairly low dose -- half a tablet (25 mg) to a whole tablet. Wait a couple of hours, and repeat until effective. So far I've never needed more than 200 mg in a 24 hour period, usually much less.

As usual I was wiped out the next day -- sluggish, didn't feel like working out, but went for a walk and jog anyway.

And as usual by the third day taking metoprolol (sometimes migraines last up to a week, although fortunately they're less common now than when I was younger) I was feeling less sluggishness and more or less normal.

I suppose if I took them daily I'd get accustomed to them and be able to work out more or less normally.

I also noticed I got "better" results in my usual heart rate variability app (Elite HRV) taking metoprolol. But I'm not sure that reflects my "real" baseline HRV. Without metoprolol my heart rate variability is much more erratic. I'm tempted to try metoprolol daily for a few weeks just to see how I feel and whether I get accustomed enough that I can log the same average numbers on rides and runs. I'll check with my doctor and see what they say.

bruce19

Beta Blockers are horrible. I tried Coreg and it damned near killed me. I couldn't ride, I couldn't stay awake and I got depressed. I've NEVER been depressed in my life. I've resolved my BP issue naturally but if I needed meds I'd explore ACE-inhibitors. As always, explore these things with your doctor.

metalheart44

I've been taking carvedilol (Coreg) since my first heart attack in 2005. I began cycling seriously again in 2010 after my second heart attack. At first it was not clear to me why I was more tired than fellow riders and I had more difficultly on climbs than seemed appropriate for my level of conditioning. I also found that late afternoon rides were more tiring than morning rides. I was taking 25mg twice a day at that point. My dose was lowered to 12.5mg twice a day after I registered 35 BPM during an EKG at a regular cardio checkup. When my cardiologist began cycling we had a conversation about the effect of the beta blocker on my cycling performance and my dose was lowered to 6.25mg x 2. It still has an effect but over time I think the magnitude of that effect has diminished. Afternoon rides (when the drug starts to peak in my system) are still more troublesome than morning rides. I can keep up and do well in group rides, but it takes more effort, I just can't get my heart to pump enough blood to be very strong on climbs, but I do what I can. My experience is that I take a cog or two hit on performance and longer climbs can be slower than I like. I can live with the drug, but I wish I did not have to.

afm199

I take metoprolol for high blood pressure, and yes sometimes it can make you tired. When I started out on it, very tired. (Combined with some other drugs.)

Through a process of self monitoring blood pressure and working with my caridologist I found a happy medium.

One thing I discovered was to schedule rides and be rigorous. Often I don't "feel" like going for a ride, but I do anyway, and set distances. That helps, it turns out that once I am on the bike, my energy level often picks up.

And sometimes I am too tired to ride.

Good thing they didn't tell me about this when I was ten.

philbob57

I tried carvedilol with really awful results - tired, weak, muscular pains, but it was at the 25 mg twice daily dose. I stopped it after 2 weeks and went back to 100 mg of metaprolol with not too bad results, but my BP isn't governed as well as with 150. Seeing doc tomorrow.

rogerinnyc

I've got an enlarged ascending aorta, so my doc wants me on a beta blocker to reduce the lateral shearing pressure on the aorta (a rupture mid-ride would not be good!). I've tried a ton of different medicines. If you don't need a slower heart beat (just lower blood pressure), I found Lisinopril to be the best at not affecting my athletic ventures (but it gave me a dry, non-productive cough). Beta blocker-wise, I've tried metoprolol and coreg and hated both. I am on Bystolic now (not available generically yet) and feeling that it's pretty good -- keeps the heart rate down, but only slightly slows me down energy and VO2 wise.

zandoval 

Of all the beta blockers I have prescribed the best tolerated one has been BYSTOLIC (nebivolol). Most likely its not on your standard formulary and of course costs more. With a pace maker its not like you have a choice on whether to use a beta blocker or not...

Se if your cardiologist will consider a switch...

philbob57

Thanks, Zandoval. I'm still trying to get my BP under control, and I can't do that without compromising my energy. My insurance covers Bystolic, though at a higher cost than metaprolol.

terrymorse 

If you are an endurance athlete, you may want to consider seeking out a sports cardiologist. They specialize in the treatment of athletes and are familiar with drug treatments that don't impair performance.

From the few sports cardiology journal articles I've seen, beta blockers are not recommended for endurance athletes, as they reduce both maximal heart rate and the time to exhaustion.

Check out this article: ESC Study Group of Sports Cardiology Recommendations for participation in leisure-time physical activities and competitive sports for patients with hypertension

Excerpts:

dmanders

What Terry said above! I once was on a betablocker for my BP and tolerated it but didn't care for the effect on my riding. I am now on Losartan and Amlodopine and am comfortable with those. They are a renin-angiotensin system blocker and a calcium channel blocker.

Rhondito

I've taken Atenolol for years as part of my migraine prevention regime. I tolerate it pretty well and it doesn't seem to have much of an impact on my energy level.