Brief Answer:
Nothing to worry, however routine and timely follow-up to continue..

Detailed Answer:
Hello XXXXX, Welcome to HCM,

I've gone through your query and understand your concern,

First of all, it's good that your early morning HR is in the low 50's, it's a sign of a good resting heart..

Why were you prescribed Metoprolol ER even though your Heart rate was in the lower 50's ? have you informed the cardiologist regarding this on thursday ?

Please let me know at what time you're taking the Metoprolol ?

Were you on any other medication for rate control before this ?

Was Metoprolol ER prescribed alone or with some other medications too ?

Finally, are you experiencing any symptoms like dizziness, weakness, low blood pressure along with the low heart rate ?


Let me know these information so that I can guide you more specifically ..

Awaiting your response..

Kind Regards

---

Brief Answer:
'Metoprolol ER' should be taken in the afternoon not in the evening..

Detailed Answer:
Hello XXXXX, Welcome Back,

Thanks for following up quickly with these details,

The whole purpose of prescribing a Cardioselective beta blocker like Metoprolol in it's Extended Release form(ER) is to have the desired effect by evening (as by virtue of Diurnal rythm, the evening metabolism is at the highest peak in our body thus there's a surge in everything starting from BP to respiration, heart rate, enzymatic activities and several others), so when your taking it in evening only, then that desired effect is not reached in time (in fact it's reaching late at night on/ before the bedtime)..

Modifications of timings :

Simvastatin should be taken at bedtime (post dinner around 10 pm) and not in the evening..

Metoprolol ER should be taken in the afternoon (on or around 4 pm) to achieve the desired effects in time..

Please note that I've mentioned timings as "around", simply because in my patients I don't want to make them feelings any time-constraints as it causes unwanted anxiety which is bad for the precious heart..

So you can simply take it around that time only (half an hour plus minus is just fine depending on your daily routine and convenience)..


Good that your BP is in control and you don't experience any of those symptoms also..

I hope now the doubt is cleared, please let me know if your having any further, I'll be glad to clarify..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041


Take Care
Kind Regards

---