About arythmia meds

Hi everyone! I recently began using Propral (propranolol hydrochlorid) for arythmia. The doctor instructed me to take 1 tablet 1-4 times a day as needed when I feel the arythmia. That would mean up to 160 mg a day, whilst on other days none at all. The 'instructions' that come with the meds only mention using these meds on a daily dose that remains the same and warns against changing the dose or stopping to use the pills suddenly. Do you think that the huge daily change in the amount of this medication in my system is really safe? I mean it must be because the doctor gave these to me, but I don't feel completely convinced... I sometimes need several pills for many days in a row and then none for a week... Interestingly also the instructions say that you must stop using this medication immediately if you feel arythmia! Does anyone have any experiences to share about this? Thanks

7 Comments

Propranolol

by Bill T - 2010-08-04 05:08:26

PUPU, I would seriously question using propranolol (rythmol) on an as needed basis. I have chronic A-fib and until mid June it was relative controlled with flecainide (tambcor). I has several episodes back to back and my doctor put me in the Hospital to monitor the change to propranolol. Started at 150mg times a day. That wasn't getting the job done so he increased it to 225mg 3 times a day (675 mg/day). He said this would lower my heart rate into the danger zone and I need a pacemaker. It was implanted on June 28th. I was episode free until July 23rd. I have had 3 episodes since then, mild with 95-120 heart rate and lasting a few hours. I agree with J. B. that propranolol should not be used on an as is basic. When you are started on propranolol it is recommended that you are in the hospital for a few days to monitor the doses because is can trigger very rapid heart rate.

Bill T

propranolol

by sugar - 2010-08-04 05:08:48

I have been on propranolol aince 1995 for the irregular beat - then radio ablation - I went to only 10 mg. from 20 mg. and I was in such an irregular beat for over a month and only I found out what my problem was, not the dr. I went back to the 20 mg. and I am back to where I was before cutting it in half. It was either due to withdrawal even though I was at the lower dose or my heart really needed it. Your high doses sound strange to me so it is better to get more than one opinion and look it up on the computer to compare notes. Maybe I only need a small amount because I had the ablation many years ago which did some damage to the electrical system - now I have the pacemaker which didn't change my rapid heart beat but keeps me above 60 beats per minute.
Good luck with your search for info.
Sugar

Propranolol vs PROPAFENONE HCl TABLETS

by Bill T - 2010-08-04 09:08:42

I need to apologize for my post trying to answer pupu post about arrhythmia meds. I misread thinking is was PROPAFENONE HCl TABLETS that I take for A-fib. Sorry for my bad!

Bill T

Medicine Instructions

by J.B. - 2010-08-04 11:08:38

I think somebody made a mistake. At least this is the first time I ever heard of any beta blocker (propranolol is one) being prescribed on "as needed basis." Below are the instructions I got for taking propranolol.

"There have been reports of exacerbation of angina and, in some cases, myocardial infarction, following abrupt discontinuance of therapy. Therefore, when discontinuance of propranolol is planned, the dosage should be gradually reduced over at least a few weeks and the patient should be cautioned against interruption or cessation of therapy without the physician’s advice. If propranolol therapy is interrupted and exacerbation of angina occurs, it usually is advisable to reinstituted propranolol therapy and take other measures appropriate for the management of angina. Since coronary artery disease may be unrecognized, it may be prudent to follow the above advice in patients considered at risk of having occult atherosclerotic heart disease who are given propranolol for other indications."

Of course I'm not a Dr but I can read. So I woud suggest that you talk to the Dr or at least the pharmacist about the instructions you have for taking this medicine.

Thank you

by pupu - 2010-08-05 03:08:38

for your comments! I will talk to a doctor about this. All the best to you all! Pupu

Sometimes

by Genie - 2010-08-05 07:08:20

Propranolol is used 'as need'. For example, it is given to people to treat anxiety and is taken 'as need' in situations where this might happen.

It has a shorter duration of action and half life than other beta blockers, so clears the system more quickly, making it more appropriate for this use. So if it works for you in this way, it is probably ok. Because it works quicker that other beta blockers it should end the irregular rate.

But that's if it works: all beta blockers can cause withdrawal effects, which is why they are supposed to be taken continuously. So if you took lots over a couple of days and then just stopped this would seem to be a bad idea. It's very different to just taking it for anxiety say a couple of times a month. If you find you are using it a lot, I would see your doctor about a regular dose of a more long-acting beta blocker, such as bisopropol.

I've taken both these drugs: propronolol before my pacemaker, which made my heart block worse (then undiagnosed), bisoprolol after for fast heart rates. And I have had withdrawal when I stopped, so if were me I would only use them 'as need' if this didn't mean taking them a lot and them building up in my system.

Genie

Anxiety?

by pupu - 2010-08-07 03:08:29

Interesting... I did not even consider that, but maybe the doctor thought that I seemed anxious in the ER... The arythmia had suddenly gotten much much worse, and I was frustrated, because I have so many medical issues, I did not much care for yet another problem... I only take them when I have arythmia for a longer time, and I have to say that they do not even work well. One dose does absolutely nothing, usually I take another after an hour or so (as doctor instructed), but often even that doen't seem to do anything. I have gotten more used to the arythmia itself, and it doesn't cause me anxiety, at least I don't think it does. When I am anxious about something else, I don't get arythmia, so I have not made that connection. Thanks Genie!

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