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how much is too much - toprol XL

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I was released from the hospital yesterday after a two day bout of atrial tachycardia and off and on atrial fib. My Toprol XL was increased from 100mg to 150 mg. 100 mg in the morning and 50 mg at night. I have low blood pressure (90/60) and I'm afraid that taking the extra 50 mg at night will drop my blood pressure too low and I could die in my sleep from my bp bottoming out? Is this an unreasonable fear?

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Exercise Beta blockers Toprol XL Metoprolol Insomnia Digoxin

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Last year, I was placed on 200 mg a day (100 mg twice a day) of Metroprolol (Toprol XL). I too, started with relatively low blood pressure. On this high dose, my BP now averages 97/55, with a pulse rate of 60 bpm. I have to admit I hate the way I feel on this dose. My energy is so low. There are days when my BP gets as low as 80's/40's. I find that pumping up with fluids will usually bring it up a bit, but I still feel very lethargic on these days. I have a follow-up appointment with my cardiologist on Monday and intend to ask about how low is "too low" for my BP and whether he has any other suggestions besides the fluid intake for boosting it when my diastolic pressure gets in the 40's. If I learn anything of interest, I'll be sure to share.

Note: I used to take my doses at 10 am and 10 pm. My biggest complaint about taking the Metoprolol at night before I went to bed was the insomnia, so I switched my timing to 5 am and 5 pm, and that seems to help. You might want to try modifying your timing of when you take the Toprol to see if that makes a difference, but you should also talk to your doctor about your concerns.

Thanks for the advice, I have taken it for two days and I have been taking the 100 mg (around 8:00am) with breakfast and the 50 mg with dinner (around 5:00pm) and since I have been waking up every morning - it seems to be working :-). Like you the fatigue is a little daunting...but hopefully it will keep the tachycardia at bay.

Does anyone have suggestions for managing the fatigue that comes with heavy doses of beta blockers? I'm trying to eat healthy whole foods, exercise (although not as much as I should), and stay hydrated....but sometimes this just isn't enough. I know there are no magic answers, but if you've found some things that help, please pass it on!

Hi guys! I too have issues with the fatigue. The only thing that I have found that helps me at all is a nap in the afternoon. I'm on ToprolXL 50 mg twice a day. My BP rarely goes below 110/70 though. I hope all goes well for you and good luck!

I have started taking digoxin for the arrithmias and noticed lately that i am extremely fatigued,as well as very thristy I also take toprol xl and tambocor for the low b/p and arrithmias, I am due to go into the hosp. for a three day eval for anther med and hopefully discontinue the tambocor and or toprol as I have reached the limit for the tambocor.

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