Question: I am on 25 mg Metoprolol Succinate ER (1/2 tablet every 12 hours) and I have recently noticed that I am starting to get numbness/prickling and mild tremors in my left hand. Is this normal to expect with this medication? My feet/toes are also extremely sensitive to cold now which the doctor told me is a normal side effect and so I have been wearing thermal socks, shoes in the house and have had to keep a space heater near my feet when it is very cold out. Is this normal as well? My blood pressure is usually in the low 100s (sometimes is high 90s) systolic and 60s or 70s diastolic which my doctor says is a normal range. I was put on the medication a couple days after having a reaction to the flu shot (pulse went up to 165 at rest that night) starting at 40 mg which caused extreme fatigue to the point where I could barely function so it was decreased to 25 mg. The hope is to have me off the medication in a couple months, I have always had a rapid pulse and my resting heart rate is sometimes in the low 90s or 100s. Echo and holter monitor results were normal, EKG is always normal and blood work from back in November (including thyroid are normal). Unfortunately I just have not felt "normal" since the day of the flu shot (i.e. fatigue, occasional dizziness and then the numbness/tingling), could this be related to the medication? The doctor said being on the extended release version will increase the chances of side effects especially fatigue. Before all this my pulse was usually in the 70's during doctor visits but cardiologist said that is too high (my pulse does go up during visits, have family history of that) but I have always had to avoid any cold/flu medications or decongestants/codeine because they have always caused my pulse to go up.

I am on 25 mg Metoprolol Succinate ER (1/2 tablet every 12 hours) and I have recently noticed that I am starting to get numbness/prickling and mild tremors in my left hand. Is this normal to expect with this medication? My feet/toes are also extremely sensitive to cold now which the doctor told me is a normal side effect and so I have been wearing thermal socks, shoes in the house and have had to keep a space heater near my feet when it is very cold out. Is this normal as well? My blood pressure is usually in the low 100s (sometimes is high 90s) systolic and 60s or 70s diastolic which my doctor says is a normal range. I was put on the medication a couple days after having a reaction to the flu shot (pulse went up to 165 at rest that night) starting at 40 mg which caused extreme fatigue to the point where I could barely function so it was decreased to 25 mg. The hope is to have me off the medication in a couple months, I have always had a rapid pulse and my resting heart rate is sometimes in the low 90s or 100s. Echo and holter monitor results were normal, EKG is always normal and blood work from back in November (including thyroid are normal). Unfortunately I just have not felt "normal" since the day of the flu shot (i.e. fatigue, occasional dizziness and then the numbness/tingling), could this be related to the medication? The doctor said being on the extended release version will increase the chances of side effects especially fatigue. Before all this my pulse was usually in the 70's during doctor visits but cardiologist said that is too high (my pulse does go up during visits, have family history of that) but I have always had to avoid any cold/flu medications or decongestants/codeine because they have always caused my pulse to go up.

Forgot to mention that the tremors/numbness/prickling worsen when I'm exposed to cold temperatures

Forgot to mention that the tremors/numbness/prickling worsen when I'm exposed to cold temperatures

Thank you Doctor. My blood pressure was 102/61 (4 hours after taking meds) at the doctor about two weeks ago and 117/77 (3 hours after taking meds) at last week's ER visit for a sinus infection (was 144/82 when I first got there but they attributed that to nervousness), then was 118/75 (4 hours after taking meds) at the doctor visit a week ago. At what numbers should I start being concerned? Two different doctors have told me that systolic in the 90's is not a problem and even 90 is still okay as long as I'm able to function. The cardiologist told me to check it at home twice a week within a 2 hour timeframe of taking the meds and keep track of where it stays. I was on 12.5 mg in the morning to start 2 months ago a few days after the reaction to the flu shot but my pulse was still high so the cardiologist increased it to 12.5 mg every 12 hours. My pulse was still over 120 at rest a few days after so he then increased it to 25 mg in the morning and 12.5 at night but that only lasted a couple weeks before the fatigue became too much and I have been on the 12.5 every 12 hours since a few days before Christmas. The fatigue and dizziness/tiredness are better on certain days, just depends. I am getting ready to travel to Florida this week and I will be curious to see if the feeling cold/tremors get any better with the warmer temperatures. Also, I am due for my menstrual cycle on Saturday, can that increase the fatigue as well?

Thank you Doctor. My blood pressure was 102/61 (4 hours after taking meds) at the doctor about two weeks ago and 117/77 (3 hours after taking meds) at last week's ER visit for a sinus infection (was 144/82 when I first got there but they attributed that to nervousness), then was 118/75 (4 hours after taking meds) at the doctor visit a week ago. At what numbers should I start being concerned? Two different doctors have told me that systolic in the 90's is not a problem and even 90 is still okay as long as I'm able to function. The cardiologist told me to check it at home twice a week within a 2 hour timeframe of taking the meds and keep track of where it stays. I was on 12.5 mg in the morning to start 2 months ago a few days after the reaction to the flu shot but my pulse was still high so the cardiologist increased it to 12.5 mg every 12 hours. My pulse was still over 120 at rest a few days after so he then increased it to 25 mg in the morning and 12.5 at night but that only lasted a couple weeks before the fatigue became too much and I have been on the 12.5 every 12 hours since a few days before Christmas. The fatigue and dizziness/tiredness are better on certain days, just depends. I am getting ready to travel to Florida this week and I will be curious to see if the feeling cold/tremors get any better with the warmer temperatures. Also, I am due for my menstrual cycle on Saturday, can that increase the fatigue as well?

I have my next doctor appointment on Valentine's Day so I'll see what the numbers are then. My primary ideally wants me off the medication due to side effects and pulse stabilizing but is leaving the decision up to the cardiologist.

I have my next doctor appointment on Valentine's Day so I'll see what the numbers are then. My primary ideally wants me off the medication due to side effects and pulse stabilizing but is leaving the decision up to the cardiologist.

Hello doctor,
The side effects such as cold feet as well as the prickling in my legs got much better in Florida, was so nice not to have to wear thermal socks all the time! Even the AC didn't bother me and I was actually able to go without socks in my tennis shoes one night going out to dinner. However the fatigue is not any better and has actually gotten worse, it's to the point where I can barely function especially in the evening and I constantly have to walk around doing things without nearly collapsing with fatigue and wanting to sleep all the time. Even just sorting through some photographs yesterday afternoon made me extremely tired to the point where I felt like I had to take a nap and that's not normal for me. This is how I felt before when I was still on 25 mg in the morning and 12.5 at night so that's when the cardiologist reduced it down to 12.5 twice a day. I had talked to him recently about reducing or eliminating the medication altogether but he was not very receptive and suggested my primary do blood work to rule out causes of fatigue, everything is normal and I have not been bleeding in my urine or stool so they know my hemoglobin is fine. Saw my primary today and she agrees that I'm being over-medicated and wants me to stop the evening dose for the next 3 days to see how I feel, during those three days I would just be doing 12.5 mg in the morning and then if I feel better after 3 days she wants me to completely stop the 12.5 mg in the morning. Is this a safe approach to safely wean? I'm concerned about rebound tachycardia as both of my parents experienced that completely stopping their beta blockers although they were on much higher doses and did not wean. My primary said because I'm on such a low dose this is a safe approach but I wanted to get your opinion first. I have also been reading about the medication and have experienced other side effects that have been reported such as constant muscle cramps in my legs, pain in my left knee, bulging veins, shortness of breath and occasional shoulder or arm pain. Never experienced any of these before going on the medication.

Hello doctor,
The side effects such as cold feet as well as the prickling in my legs got much better in Florida, was so nice not to have to wear thermal socks all the time! Even the AC didn't bother me and I was actually able to go without socks in my tennis shoes one night going out to dinner. However the fatigue is not any better and has actually gotten worse, it's to the point where I can barely function especially in the evening and I constantly have to walk around doing things without nearly collapsing with fatigue and wanting to sleep all the time. Even just sorting through some photographs yesterday afternoon made me extremely tired to the point where I felt like I had to take a nap and that's not normal for me. This is how I felt before when I was still on 25 mg in the morning and 12.5 at night so that's when the cardiologist reduced it down to 12.5 twice a day. I had talked to him recently about reducing or eliminating the medication altogether but he was not very receptive and suggested my primary do blood work to rule out causes of fatigue, everything is normal and I have not been bleeding in my urine or stool so they know my hemoglobin is fine. Saw my primary today and she agrees that I'm being over-medicated and wants me to stop the evening dose for the next 3 days to see how I feel, during those three days I would just be doing 12.5 mg in the morning and then if I feel better after 3 days she wants me to completely stop the 12.5 mg in the morning. Is this a safe approach to safely wean? I'm concerned about rebound tachycardia as both of my parents experienced that completely stopping their beta blockers although they were on much higher doses and did not wean. My primary said because I'm on such a low dose this is a safe approach but I wanted to get your opinion first. I have also been reading about the medication and have experienced other side effects that have been reported such as constant muscle cramps in my legs, pain in my left knee, bulging veins, shortness of breath and occasional shoulder or arm pain. Never experienced any of these before going on the medication.

Can this medication cause shortness of breath, mild chest discomfort and occasional shoulder or arm pain? This didn't happen until going on the medication so that's why I wanted to check, I have read articles from other patients who did experience these side effects including a couple who said their asthma symptoms got worse until they stopped the medication

Can this medication cause shortness of breath, mild chest discomfort and occasional shoulder or arm pain? This didn't happen until going on the medication so that's why I wanted to check, I have read articles from other patients who did experience these side effects including a couple who said their asthma symptoms got worse until they stopped the medication

Thank you Doctor. I completed the 3 days of eliminating the evening dose and my pulse has remained stable in the 70s and 80s sometimes even in the 60s so the cardiologist is fine with just keeping me on the morning dose for the next 2 weeks, however if my pulse drops below 40 that's a concern. If all continues to go well he said we can discuss eliminating the medication altogether. He cautioned me to take a 12.5 mg dose immediately if my pulse goes over 130 at rest but we're not anticipating that to happen, also said to keep checking the BP a few times a week and it's too low if systolic goes below 80 and too high if it goes above 190. He said to expect fatigue, shortness of breath and chest discomfort to continue for the next 2 weeks as it will take up to that long for my body to adjust, however he advised me to push through the fatigue and keep track of when I feel it the most. My recent holter monitor results came back and everything was fine, it did record some PVCs but cardiologist assured me everyone has those and some can feel it more than others (I have been feeling some fluttering on occasion). Can weaning off the drug cause insomnia? I've unfortunately suffered from that the past couple of nights although last night I went out to a birthday celebration and ate a couple of items I normally wouldn't at the same time (gluten-free French fries and gluten-free dessert) so I figured that might have disrupted my sleep.

Thank you Doctor. I completed the 3 days of eliminating the evening dose and my pulse has remained stable in the 70s and 80s sometimes even in the 60s so the cardiologist is fine with just keeping me on the morning dose for the next 2 weeks, however if my pulse drops below 40 that's a concern. If all continues to go well he said we can discuss eliminating the medication altogether. He cautioned me to take a 12.5 mg dose immediately if my pulse goes over 130 at rest but we're not anticipating that to happen, also said to keep checking the BP a few times a week and it's too low if systolic goes below 80 and too high if it goes above 190. He said to expect fatigue, shortness of breath and chest discomfort to continue for the next 2 weeks as it will take up to that long for my body to adjust, however he advised me to push through the fatigue and keep track of when I feel it the most. My recent holter monitor results came back and everything was fine, it did record some PVCs but cardiologist assured me everyone has those and some can feel it more than others (I have been feeling some fluttering on occasion). Can weaning off the drug cause insomnia? I've unfortunately suffered from that the past couple of nights although last night I went out to a birthday celebration and ate a couple of items I normally wouldn't at the same time (gluten-free French fries and gluten-free dessert) so I figured that might have disrupted my sleep.