New man off metoprolol

mark02tj · May 31, 2016

My doctor put my on Lisinopril about 8 years ago. About 2 weeks after being put on it, I was on the phone with my mother (both parents have high BP) and was coughing. Out of the blue, Mom says "Your doctor didn't prescribe Lisinopril for you, did he?" LOL! Gotta love moms!!

The reason I was initially put on Lisinopril was the cost. At the time, it was one of the "$4 drugs" and the doc said the insurance company wanted to try the cheap stuff first. He then put me on Cozaar (Losartan Potassium) which, at the time, was $90 per month. No more coughing and my BP stays pretty constant. About a year after being on it, some generics for Cozaar were released so the price dropped a bit. Being on a high-deductible plan I called around for the "cash price" on the drug. Found a locally owned pharmacy where I'm getting 90 pills for $35 cash - or I can go through the insurance company and get 30 pills for $20. I opt for the 90.

My 82 year old dad is on Metroprolol 12.5mg twice a day along with 10mg of Cozaar (I'm on 100mg). The cardiologist put him on the Metroprolol to stop his PVCs. I might talk to his new doc about taking him off of it.

2LaneCruzer · May 31, 2016

My Cardiologist has me on 50mg Metroprolol twice daily, also take a statin and another drug, Propaphenone. My problem is not afib, but Atrial tach. Don't know if it's the drugs, or just age, but I've contracted TB (that's tired butt), achy breaky joints, a beer belly and smoker's cough...

GLyford · May 31, 2016

Thanks for this, I was switched from Tartarate to Succiante and have been absolutely dragging since. Now I have questions for my Doc...

jlgurr · May 31, 2016

My wife is taking metoprolol for migraines and she talks of being tired almost daily. Her dose is 50mg.

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RalphVa · May 31, 2016

Ask him about putting you on carvedilol, Bird. My problems started with a (some doctors call it a baby dose) dose of 12.5 mg of metoprolol. You probably only need 3 1/4 or 6 1/2 mg of carvedilol twice/day.

The got me up to 250 mg/day while I was in hospital with CHF. An old fashioned heart doctor was in charge. That is a normal dosage for a male my size (180 #). I had ALL SORTS of side effects from that! Finally just stopped it and went to the ER. They literally almost killed me.

Ralph

RalphVa · May 31, 2016

Found a web site that I cannot seem to find again where a doctor listed 4 meds that should never be given. Lisinipril was 1st on the list. The site said that it causes accumulation of some sort of chemical that can only be shed by coughing. Next on that list was Toprol XL, which is exactly what I was on.

Ralph

RalphVa · May 31, 2016

Metoprolol is not a replacement for lisinipril. Losartin is. That's what I'm on in addition to carvedilol. The losartan is a tiny dose, about 20 or 25 mg/day.

Ralph

RalphVa · May 31, 2016

I was dragging initially on the 12.5 mg of metoprolol tartrate. Switched to the succinate (Toprol XL) somewhere along the line. Still with fatigue and weakness plus other side effects.

Ralph

gwstang · May 31, 2016

"The cough is due to a buildup of bradykinin (which builds up because the ace inhibitor blocks the ace enzyme, which breaks down bradykinin), an ARB would bypass that problem and just block the angiotensin receptor."

Also, "Bradykinin is a potent endothelium-dependent vasodilator, leading to a drop in blood pressure. It also causes contraction of non-vascular smooth muscle in the bronchus and gut, increases vascular permeability and is also involved in the mechanism of pain.[3] Bradykinin also causes natriuresis, contributing to the drop in blood pressure.

Bradykinin raises internal calcium levels in neocortical astrocytes causing them to release glutamate.[4]

Bradykinin is also thought to be the cause of the dry cough in some patients on angiotensin-converting enzyme (ACE) inhibitor drugs. It is thought that bradykinin is converted to inactive metabolites by ACE, therefore inhibition of this enzyme leads to increased levels of bradykinin, which causes a dry cough via bronchoconstriction. This refractory cough is a common cause for stopping ACE inhibitor therapy, in which case angiotensin II receptor antagonists (ARBs) are the next line of treatment." Bradykinin - Wikipedia, the free encyclopedia

I did find this about what the coughing is from. I have taken lisinopril for years and have that dry coughing. I have almost passed out before from coughing so hard. It can be very bad. I've never smoked and don't drink at all. I am going to speak with my general physician the next time I go about this. Maybe something else would help without the side effects.