Sotalol vs. Metoprolol for the heart crowd

[calmloki]

So about a dozen years ago I was having a burrito with the honey and keeled over. V-fib. She did CPR and kept my body and brain mostly present, several days in a couple hospitals and an implanted pacing/shocking unit later I was back on the street.

Time has passed. Several ablations, A-fib has made an appearance several times, Lisinopril, Amiodarone, Metoprolol, ran my AICD unit low on battery and got it swapped out. Maybe seven times I've had episodes where my heart tries to do the ineffective flutter routine and I check out until being re-awakened, normally followed by doctors adjusting/changing drugs or ablation. Haven't consciously felt the device shock yet. Great way to leave if it happens..

Did NOT like Amiodarone. Lisinopril made me dizzy when getting up, so not doing that currently. Currently on Metoprolol, but conked out up on our roof the other day - A-fib followed by V-fib doing an ineffective 400BPM. Had my typical good luck in falling in the right place rather than the longer drop.
Device kick-started me again, now the doctors want to double my Metoprolol dose and may move me to Sotalol, which would involve a few days of hospital monitoring to make sure I'm not one of the outliers who responds to that beta-blocker by going into V-fib and dying. Cool.

So do any of you have experience with Sotalol? Not really a fan of increased sluggishness or mental slowness - have enough of that as is.

 

[ivinsfan]

You might not care to answer but what is your current dose of Metoprolol..sometimes it just needs to be higher. Also it comes in a time release 24 hour dose which has worked very well for my DH.

 

[calmloki]

You might not care to answer but what is your current dose of Metoprolol..sometimes it just needs to be higher. Also it comes in a time release 24 hour dose which has worked very well for my DH.

Was on 50MG twice a day of the 24 hour Succinate, went to 50MG once/day about 6 months ago. They are talking about bumping back up to 100MG/day until/if they get me on Sotalol.

 

[ivinsfan]

Sounds as if maybe they shouldn't have lowered your dose. My DH takes the time release 100 once a day in the morning. It's always a balancing game..in fact lowering your dose abruptly can also cause the symptoms you had..

 

[KCGeezer]

Seems as if we have a similar history Calmloki although I haven’t fallen off the roof yet. ICDs, ablations, valve repair, and lots of drugs. Old Sparky has gone off a few times. It’s hard to describe but not really painful at least for me.

They put me on 160mg Sotalol twice a day years ago. No major complaints but they discontinued it after a couple of years (and another ablation) since it’s apparently hard on the liver.

Well fast forward another 3-4 years and they decided I needed to go back on it. At least the second time I didn’t have to sit in the hospital waiting to see if I keeled over.

Thankfully I’ve been stable for a number of years now. Still have 4 yrs on the current battery if I remember correctly. DM me if you want to compare notes in more detail. The advancements they’ve made in cardiac care in the last 25 years are truly amazing.

 

[westpac]

could we keep medical stuff off the board

could we keep medical stuff off the board.

 

[Qs Laptop]

So do any of you have experience with Sotalol? Not really a fan of increased sluggishness or mental slowness - have enough of that as is.

I was on Sotalol for 7 years to control Afib. The main side effect I noticed was the need to take a nap in late afternoon. Just a 10-15 minute break was all it took. It wasn't increased sluggishness throughout the day but rather a kind of accumulated fatigue that got to me after being awake for eight or nine hours. I never noticed mental slowness.

I had an ablation in April 2022, and so far so good, no more meds for Afib.

 

[OldShooter]

could we keep medical stuff off the board.

Why? we are blessed with so many experts.

 

[ivinsfan]

could we keep medical stuff off the board.

Are you taking any of these meds? Or do you have long term heart issues? If not it's really easy to just scroll right by this thread.

 

[Ian S]

First thing: I think I'd be avoiding going up on the roof! Second, I'm on Metoprolol but for PVC's (pre-ventricular contractions) which are supposedly benign but I'm not confident I can tell the difference between them and something more serious. 25 mg of Metoprolol once a day has done the trick for me and the only side effects are a lower heart rate and blood pressure.

This board always has "medical stuff" on it. IMHO, it's useful to have others' experiences discussed. I doubt anyone here is going to substitute the thoughts of SGOTI with their doctor's advice.

 

[aja8888]

Why? we are blessed with so many experts.

I'm not sure if I'd use the word "experts" (look its definition up sometime). but we are blessed with many people with true life experiences with medical conditions. We also have some retired MD's on the forums, too.

 

[OldShooter]

I'm not sure if I'd use the word "experts" (look its definition up sometime). but we are blessed with many people with true life experiences with medical conditions. We also have some retired MD's on the forums, too.

You missed my sarcasm attempt. I was referring to the SGOTI medical experts who swarm the medical threads with anecdotes and hearesay.

 

[ivinsfan]

You missed my sarcasm attempt. I was referring to the SGOTI medical experts who swarm the medical threads with anecdotes and hearesay.

Define SGOTI....the OP literally asked for posters with personal experience.

 

[aja8888]

You missed my sarcasm attempt. I was referring to the SGOTI medical experts who swarm the medical threads with anecdotes and hearesay.

Yes, I missed that! But I got it now. Add a /s after posts like that.

 

[calmloki]

Easy all - firstly, my apologies to member westpac for luring them in with a tantalizing title and then wasting their time as they tried to figure out in the health forum how two specific heart drugs could affect their early retirement. If they aren't in the heart crowd it won't. Having keeled over they will affect my retirement life.

But I didn't even early retire - so why have I been here for eight years? Mostly because there are some knowledgeable people on a wide range of subjects. There are also people who don't seem that sharp. Then there are some who are very sharp that have viewpoints or lifestyles or ways of doing things I don't agree with. When I ask for input from individuals that's all I'm looking for. I happily accept anecdotal evidence, consider the source, and add it to the other information. At this point in my life I feel pretty good about my ability to sort the gold from the dross - reading what people have written over the years kind of changes their status within undefined SGOTI.

Anyway, my sincere thanks to those who have shared their experiences - checking out of life for a while does affect me and change is always viewed with suspicion, so I'm a bit excitable these last couple days. I do appreciate you all

 

[MichaelB]

could we keep medical stuff off the board.

We have a health forum to discuss health related matters. Here members can share knowledge and experiences and give helpful hints. If you browse the forum archives you will find many useful and helpful discussions on health and related matters.

Health is a critical part of early retirement.

 

[badatmath]

could we keep medical stuff off the board.

I hope not.

 

[Koolau]

So about a dozen years ago I was having a burrito with the honey and keeled over. V-fib. She did CPR and kept my body and brain mostly present, several days in a couple hospitals and an implanted pacing/shocking unit later I was back on the street.

Time has passed. Several ablations, A-fib has made an appearance several times, Lisinopril, Amiodarone, Metoprolol, ran my AICD unit low on battery and got it swapped out. Maybe seven times I've had episodes where my heart tries to do the ineffective flutter routine and I check out until being re-awakened, normally followed by doctors adjusting/changing drugs or ablation. Haven't consciously felt the device shock yet. Great way to leave if it happens..

Did NOT like Amiodarone. Lisinopril made me dizzy when getting up, so not doing that currently. Currently on Metoprolol, but conked out up on our roof the other day - A-fib followed by V-fib doing an ineffective 400BPM. Had my typical good luck in falling in the right place rather than the longer drop.
Device kick-started me again, now the doctors want to double my Metoprolol dose and may move me to Sotalol, which would involve a few days of hospital monitoring to make sure I'm not one of the outliers who responds to that beta-blocker by going into V-fib and dying. Cool.

So do any of you have experience with Sotalol? Not really a fan of increased sluggishness or mental slowness - have enough of that as is.

I know nothing of Sotalol but I'm up to 150mg/day of the M-Succinate. It's a relatively benign drug which seems to be w*rking for A-fib (most of the time.) It does slow my heart rate to 55 or less so I'm occasionally a bit "off my game." I think I'd stick with the Metoprolol if that is an option - just because of the potentially severe side effect of Sotalol.

DW was on 25 mg Succinate and was going into A-fib several times a week. Her doc upped her to 50 mg which seems to have done the trick. Not pushing Metorprolol Succinate, but I'm usually one who likes to make small changes if possible.

Good luck and I hope you and the doc figure it out. We want you posting for many years to come.

 

[Zona]

could we keep medical stuff off the board.

I hope not.

Exactly! I learn so much here. There are several valuable things to learn on this thread -- not least it has reinforced my inclination to stay off the roof.

Seriously -- I'm only a few years into RE and want to know about medical stuff that could come down the pike sooner or later so that I can do what I can now to be proactive about my health. Thanks for this thread!

 

[Koolau]

could we keep medical stuff off the board.

As you've heard by now, we have several forums within the FIRE Forums and each has a following. You are free to pick and choose what is appropriate to your needs. I for one appreciate the info I get on the Health and Early Retirement Forum.



Feel free to browse the forums and choose what interests you. Also feel free to participate (or not) as seems appropriate. We are a "big tent" here.

 

[Nightcap]

I’ve been on Sotalol (120 mg 2X daily) for over 25 years. For the past few years it’s been paired with Diltiazem. Except for the fact that it’s very difficult for me to get my heart rate up over 100, I haven’t noticed any issues.

 

[Car-Guy]

2 things.
(1) I've been on Toprol 50mg for decades now and seems to be working great for me.
(2) I've been staying off roofs for several years now that that seems to be working great for me too.

 

[mountainsoft]

I’ve been on Sotalol (120 mg 2X daily) for over 25 years. For the past few years it’s been paired with Diltiazem. Except for the fact that it’s very difficult for me to get my heart rate up over 100, I haven’t noticed any issues.

I've never heard of Sotalol but was on Metoprolol for about a year. Similar to the problem you had, I couldn't get my heart rate up much above 60 which made it extremely difficult to do anything physical. Even mowing the yard would just exhaust me. My heart rate often dropped into the 40's and my BP was down to 90/60. I also started having memory issues and blurry vision after I had been on it several months. Doc switched me to Atenelol which was even worse. I only tolerated that about two days before switching back. Worst of all, despite all the negative side effects, it did almost nothing to calm my PAC's (premature atrial contractions).

A couple years ago doc switched me to Diltiazem. I went through a few different doses until I reached 300mg a day which is what I've taken for about two years now. Pulse averages around 55-60 with no side effects that I can see. BP is usually around 120/70 or so. It didn't do much for my PAC's either, but it least it keeps my BP in check without the side effects all the other meds gave me. The only downside is the 300mg pill is rather large to swallow.

 

[Koolau]

It always amazes me how peoples reactions to various drugs can be so different. I guess that's why it's so important to monitor ones self (heart rate, BP, general well-being, etc.) and report to the PCP/specialist.

 

[mountainsoft]

It always amazes me how peoples reactions to various drugs can be so different. I guess that's why it's so important to monitor ones self (heart rate, BP, general well-being, etc.) and report to the PCP/specialist.

It's also important to watch for side effects and not just ignore them.

My wife had been on Lisinopril for years and developed the typical dry cough side effect. I don't think she even noticed but I frequently told her she was coughing a lot. She finally had her doctor switch meds and now she doesn't cough anymore, and her BP is better now too. If I hadn't said anything she would probably still be ignoring that side effect today.

Ironically, her doc switched her to Metoprolol which she seems to tolerate fine with no side effects so far. Each person reacts differently. Before I found Diltiazem I was the king of side effects. Every drug I tried made me feel worse than the condition I was trying to help.