Atenolol Changed To Metoprolol Succinate

I have been taking Atenolol 50mg for about 4 years to treat my hypertension; it was working wonderfully, but I suddenly had to switch to Metoprolol Succ. ER 3 months ago because of a manufacturer shortage of Atenolol. I took it just as I did the Atenolol: which was whenever I woke up/got my day started, I paid no mind to missing a dose here and there (such as when I felt like sleeping all day) or whether or not I was taking it with a meal---so basically totally wrong. I realize now I was not taking the Atenolol exactly as indicated, but it never posed a significant problem. However, my BP levels are basically where they were before I ever started Atenolol now that I have switched to Metoprolol ER (135/85-150/90 something). The day I went to my doctor for my 3 month checkup (which was 2 months after he had to change me to Metoprolol), I had not taken the Metoprolol for 4 days prior. My blood pressure was something like 142/95, and he was concerned, so he upped my dose from 50 to 100 mg a day. I have been taking the Metoprolol inconsistently for the past 7 days (different times, possibly missed a day, with and without meals, and I actually took an extra half at some point through the day on more than one occasion because I felt so jittery). He is threatening to take me off of Ritalin, which I have been prescribed to for 15 years (since age 13), if my hypertension is not under control by my appointment 9 days from now...

Side note: Hypertension runs in my family. I know that stimulants commonly cause high blood pressure, but there is not a significant difference in my BP on the days that I do take Ritalin and the days I do not. I was taken off of it years ago for about 3 months to test this, and I still had hypertension. I have some serious attention issues and I'm having a lot of anxiety thinking about trying to get through my work days and everyday tasks without it. Essentially, I now understand what I've done---by skipping my dose, taking it without food, blah blah blah, I caused my blood pressure to spike. I do not believe my increase to 100mg is a problem, I had been thinking the 50 mg of Atenolol wasn't feeling like quite enough, but I'd really like to find out if there's anything short term (next 5-7 days) that I can do to fix this mess and get me back on track. First off, I have no idea what time I've been taking it each day. Second, I have taken half a pill about 12 hours after my first dose of 100 mg at least 3 days out of the past 7 days because I am missing a few, and I remember taking them after checking my BP that read high. If I just start taking this medicine exactly the way I was supposed to from the beginning, starting tomorrow morning, will this even out on its own? I checked my BP and it is currently 147/95 and I plan on going to bed soon (it's 12:43 AM). I was not trying to abuse this medicine, I just failed to do my homework and now I'm suffering the consequences. I just need some guidance.

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REPORT

It may improve by the time of your appointment, if you start taking it at regular intervals, and sleeping better, skipping doses, not taking it regularly, and having odd sleeping hours can all contribute to high blood pressure, according to NIH reports. Slight fluctuations are okay, such as taking your medication an hour or two different from your regular time, some days, and sleeping an hour or two later, but you do need to get things more regular.

As to taking an additional half pill, when your BP reads high, doing that only occasionally is a waste of pills. It doesn't work that fast to lower blood pressure levels. It must be taken regularly for about 4 to 6 weeks to reach its full level of efficacy in your body. These are all lessons I learned the hard way, after experiencing congestive heart failure 7 years ago.

The FDA lists the typical side effects as possibly including nausea, dizziness, headache, increased urination, and hypotension.

Your diet also plays a vital role in helping to control your blood pressure, eating healthier foods, such as more fruits and vegetables, as well as less fat and salt can help. Getting more exercise also helps.

Does anyone else have any ideas or suggestions that might help?

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It should even out. The bottom number is what's more important and it don't seem to be too high. I've seen worse! I would just explain to your dr and take notes of your BP when you wake up, mid day, and at night. It's aggravating but you will have a journal to show your dr and get an estimate of how your BP is. It sounds he's afraid Ritalin is causing it but different drs have different opinions! Some wouldn't even pay attention to those numbers. You also might want to look into another dr in case yours don't listen! A second opinion never hurts! That's just my opinion. Maybe someone else has a better answer for you! Good luck!

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First of all, I don’t think that there is a shortage of what you were taking before they switched you to this other BP med! Why would they run out of something you’ve been taking for 4 yrs. and all of a sudden run out? More like those snooty-nosed drug reps. dressed in suits who come in to they drs. office during office hours, which are supposed to be devoted to your appt. time with the dr. and look at you like you were a monkey in a cage, while waiting to steal your time that has been scheduled for your appt. and are welcomed right on in before you with their professional leather bags that are full of new drugs for the dr. to experiment with on you! Which they and your Dr. both get a financial kickback for experimenting with them on you! Ran out my butt! Then when they don’t fully explain how to use it because they themselves don’t know how, your condition gets all screwed up. So then they threaten to take away your ADHD meds if you don’t figure it out it causes you anxiety and panic which reek havoc on your blood pressure and your ADHD, because lord knows we should have grown out of that as an adult, because everyone knows that only kids have ADHD or ADD! Wrong! Ritalin, is for kids, But guess what ? You don’t grow out of ADHD or ADD as an adult! Because the reason you have it as a child is because something traumatic happened to you as a child even if you do not remember it! You may never remember it! Sometimes I think it’s better if you don’t recall what it was. Of course that is just my opinion, and many Therapists would disagree on the matter.

In my case I would rather not know all of the lovely details, unfortunately I didn’t get to choose, it just started coming back, through dreams and information that some of my siblings remembered. And although I didn't want to believe them, I noticed how closely they matched my nightmares, because that’s really what they were, not ordinary dreams. But then I, as a child just assumed that everyone’s dreams were like mine, gruesome, gross, bloody, demonic, scare the crap out of you in full color! So I decided to do research on my siblings memories and my dreams that matched them so uniquely and guess what? To my disappointment the gosh dang things were real! And I have always had ADD and did not even know it! So I didn’t begin treatment for it until I was about 41 years of age and had 3 kids. Nor did I find out that not everyone dreamed in color. Or that I had OCD, COMPLEX PTSD WITH EWA (early waking anxiety), DID (Disassociative Identity Disorder) used to be referred to as MPD or Multipersonality Disorder), And Spiritual Abuse (otherwise known as Satanic Worship), which yes does exist like it or not. And I’m not talking about people who wear black nail polish & black clothes & make-up for shock value to adults. I’m talking about hardcore, human sacrifice, infanticide with cannibalistic practices several times a year. For every Holiday Christians have they have 6. Halloween for them starts the 2nd week of October and lasts through the first week of November. Their practices you are better off not knowing! They changed the name because there are different types of it.

One of my sisters has the the type where her people have names and ages, some come and stay and some have gone and not come back and she knows that they are gone forever. One is a boy and one is a giraffe. Hers came out later in life too as many do. Mine have titles. Some of my siblings do not know they even have it because traditionally the core person is not aware that their are others and don’t remember what they may have said or done while another alter is out. You probably wouldn’t recognize them either unless you knew that person well. I always keep notes of various secrets that they tell about when we were young because I have few memories but many informative creepy dreams. Whereas they switch and someone else comes out and tells all kinds of secrets, so I write them down and use them to piece together my own past. If you mention it to them later when they switch back, they deny having ever said it. My oldest brother is the best of all the memory keepers! You can notice it in your friends and relatives if you know them well and are quite familiar with them. You will notice a change in the expression of their eyes, like when a child is telling you a story and their expression is rather wild-eyed and they gesture more than usual or childlike. Or flair into an angry moment that does not match the mood of your present conversation. Sometimes if you can catch it quick enough you can play along with them to get them to stay around longer, sometimes they are out just to put their 2 cents in. Animals are also very keen to their presence. Anyway, back to the dr. and the med change...remember, they work for you, not vice versa! My dr. put me on Vyvanse...an adult form of ADD med. Time release, made for adults, however, many insurances will not pay for it as they still believe that after 21 ADHD magically disappears! Wrong! The trauma that caused it doesn’t have to be a major one either. The company that makes it is called. “Shire”, and they will help you pay for it if your insurance won’t cover it! They also use it for Narcolepsy too. Do not let your dr. dictate your health!

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It sounds like you have memory issues and that makes sense with the ADHD you seem to suffer from and the need for Ritalin. Most adults anymore have been switched off Ritalin and put on Vyvance in our offices. Atenolol is what I take. Thank god I have several more months worth. I don't care for Metoprolol myself, it works differently for me and my problem is not CHF like my husband has from ankylosing spondylitis. I have Ehlers Danlos Syndrome so I make too much Adrenalin which it causes tachycardia and high blood pressure so a combination of lisiniopril and Atenolol is magical in my case. Metoprolol is not as forgiving as Atenolol when you miss doses or take extra 1/2 doses plus it doesn't last as long. Atenolol is faster acting, within 1 hour my heart rate drops 25-30 points and my blood pressure is lowered, actually Lisinopril helps more with my blood pressure than the Atenolol and that's why many are on this combination. Atenolol is popular because it's also wrote off label for anxiety, Metoprolol is not. Since taking your medication on time every time seems to be a big issue can you set an alarm on your phone so you take your medications exactly when you're supposed to and take them no matter what, even if you sleep all day, you still need your medications. Hopefully Atenolol will come back soon and you can switch back, if Metoprolol doesn't lower your blood pressure when you take it as directed then you could have the doctor add lisinopril to your protocol or even Propanolol which may be more helpful instead of Metroprolol. You've been on Ritalin so long that it's doubtful that it's your problem, not taking your meds as directed and not being on Atenolol is most likely your issue. The reason why there are so many choices out there in these types of drugs is because everyone reacts differently, those with CHF will react differently than those who do not and the fact that my making too much Adrenalin is yet a different reaction so all of us are different cases. I find Metoprolol for me is much shorter acting than Atenolol and far less forgiving. I never eat when I take my Atenolol and I have zero problems the last 10 years, my daughter who has the same issue that I do (hereditary) was just switched from Metoprolol to Propanlol and both my sons take Atenolol and elected to go off meds until Atenlol comes back on the market since one son already tried Metoprolol and hated it, my mother and grandma have taken Propanolol for over 30 years, I call it old faithful. Good luck to you. If he takes you off Ritalin no matter what at least ask about Vyvanse since it's the newest, safest option that doesn't cause blood pressure problems and most people like it far more than Ritalin and Adderall. My grandchildren are on it and doing much better on it.

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