What Causes Low Blood Pressure While On Metoprolol?

Posted on Wed, 6 Aug 2014

Question: Hi, I'm 74, male, 5' 9", weight is abt. 80 kg, have had heart arrhythmia and am taking Metoprolol 23,75 mg, have done for almost three years. Normally 1 tab. in the morning and 1 tab shortly before sleeping. Recently here in Germany the weather has been quite hot. I measure my blood pressure regularly and by the afternoon on the first hot day my systolic value had dropped to 105 after I had taken the tablet. Once, just a few days ago, it was 95/58. Since then after enquiring from my home doctor I have been trying to balance out between a half tablet twice a day, a half tablet once a day or no tablet. I measure my blood pressure before taking a tablet, and if it's lower than 120 systolic - as advised by my doctor - I take no tablet to avoid having a too-low blood pressure. This is rather disturbing, because I'm aware that it is not advisable to simply leave out the beta blocker, but what should I do if the hot weather persists?

Answered by Dr. Rakesh Madhyastha (52 minutes later)

Brief Answer:
Ivabradine

Detailed Answer:
Hello

Thanks for the query

Tab Metoprolol is a beta blocker which has been prescribed to you for reducing the heart rate and peventing another bout of arrhythmia rather than for hypertension alone. It is quite risky for you not to be on a rate limiting drug. I understand your concern of becoming hyopotensive. I recommend Tab Ivabradine which is another drug which controls the heart rate without much effect on blood pressure. Please convey my recommendation to your treating doctor. It can be taken twice daily.

For now keep yourself well hydrated, it could be dehydration causing the fall in blood pressure

I hope I was of help, if you have any further queries please get back to me

I wish you good health and a speedy recovery

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju