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Burning sensation in lower leg, taking Dilatrend and Lipitor. Is it due to beta blockers?

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Practicing since : 1981
Answered : 922 Questions
I am experiencing lower leg burning sensations which worsen when I go to bed at night. I have had this problem for 12 months. I am 14 months post MI and currently taking Dilatrend 6.25mg morning and night. 10mg Lipitor noctec - 100 mg asprin noctec.
I ceased taking the Lipitor for one month and the sensation in my legs remained. Have just commenced the asprin after stopping Coplavix 2 months ago. have had NEP testing + EMG which were NAD.
I have read that Beta Blockers can cause this severe discomfort. May I have your thoughts please?
Posted Sun, 29 Jul 2012 in Medicines and Side Effects
Answered by Dr. Anil Grover 49 minutes later
Thanks for writing to WWW.WWWW.WW
I am a qualified and certified cardiologist.
I had been using all drugs for my patients (for two decades for most and decade and half for one). Therefore, I am quite familiar with side effects with these drugs.
Specific to your case and considering your question, let us first discuss side effects of generic drug Carvedilol (Trade name Dilatrend 6.25 mg) a B blocker either this or Lipitor is responsible for the side effects you are getting:
Side Effects(DILATREND) :
Commonly, side effects do occur, they are generally minor and either require no treatment or can easily be treated by you or a healthcare provider. Serious side effects are less common.
Possible side effects with carvedilol.
(still more side effects have been reported you can call number given in the end)

Serious Side Effects of Carvedilol: (They should be reported to your healthcare provider urgently)
The potentially serious side effects include but are not limited to:
•Unexplained skin rash
•Unexplained swelling and sudden weight gain (see Coreg and Weight Gain), or
difficulty breathing, which may be signs of worsening congestive heart failure
•Chest pain
•Dizziness, lightheadedness, or fainting spells
•Sweating, shaking, or extreme hunger
•An irregular heartbeat (arrhythmia)
•Signs of an allergic reaction, including:
◦Unexplained rash
◦Unexplained swelling
◦Difficulty breathing or swallowing.
•Fatigue -- up to 2 percent
•Low blood pressure -- up to 14 percent
•Diarrhea -- up to 12 percent
•High blood sugar (hyperglycemia) -- up to 12 percent
•Increase in weight -- up to 12 percent
•Slow heart rate -- up to 10 percent
•Nausea -- up to 9 percent.
Other common side effects of carvedilol (occurring in more than 3 percent of people with congestive heart failure or those following a heart attack) include but are not limited to:
•Swelling of the arms, legs, hands, or feet
Shortness of breath
•Fainting (syncope)
•Changes in vision

When given for treating High Blood Pressure
•Dizziness -- in up to 6 percent of people
•Insomnia -- up to 2 percent
•Slow heart rate -- up to 2 percent
•Drop in blood pressure when standing from either a sitting or lying-down position -- up to 2 percent
•Diarrhea -- up to 2 percent.
Side effects tend to get worse with increasing doses.
Some of these rare side effects include but are not limited to:
•Worsening angina
•Spinning sensation (vertigo)
•Increase in liver enzymes
•Low blood sugar
•Weight loss
•Impotence, also known as erectile dysfunction or ED (see Coreg -- Impotence and Libido Effects)
•Decreased sex drive (libido)
•Depression (see Coreg and Depression)
•High triglycerides
High cholesterol (hypercholesterolemia)
•Allergic reaction
•Ringing of the ears (tinnitus)
•Hair loss (see Coreg and Hair Loss).

Side Effects with LIPITOR trade name (Atorvastatin generic name), I am aware you did stop this drug for a month and no change in effects occurred.
Less common but reported side effects
Check with your doctor immediately if any of the following side effects occur:
Less common or rareCough
Difficulty with swallowing
Fast heartbeat
Muscle cramps, pain, stiffness, swelling, or weakness
Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Shortness of breath
Skin rash
Tightness in the chest
Unusual tiredness or weakness
Incidence not knownBlistering, peeling, or loosening of the skin
Dark-colored urine
Joint pain
Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
Red skin lesions, often with a purple center sore
Red, irritated eyes
Sore throat
Sores, ulcers, or white spots in the mouth or on the lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More commonHeadache
Lower back or side pain
Pain or tenderness around the eyes and cheekbones
Painful or difficult urination
Stuffy or runny nose
Less commonAbdominal or stomach pain
Back pain
Belching or excessive gas
General feeling of discomfort or illness
Heartburn, indigestion, or stomach discomfort
Lack or loss of strength
Loss of appetite
Trouble sleeping
Incidence not knownAppetite increased
Black, tarry stools
Bloody nose
Bloody or cloudy urine
Blurred vision
Continuing ringing or buzzing or other unexplained noise in the ears
Difficult, burning, or painful urination
Difficulty seeing at night
Excessive muscle tone or tension
Fruit-like breath odor
Groin or scrotum pain
Inability to have or keep an erection
Increased body movements
Increased sensitivity of the eyes to light
Increased sensitivity to touch or pain
Increased thirst
Increased urination
Loss of bladder control
Loss of sexual ability, drive, or desire
Mental depression
Menstrual bleeding occurring earlier or lasting longer than usual
Pale skin
Pinpoint red spots on the skin
Slurred speech
Swollen or tender lymph glands in the neck, armpit, or groin
Unable to move or feel face
Unusual bleeding or bruising
Weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects in Australia to

Therapeutic Goods Administration (TGA)
TGA is Australia's regulatory agency for medical drugs and devices. ...
Contact TGA: e YYYY@YYYY | t 1800 020 653
If you have any further query, please ask, I will get back to you as soon as possible.

With Best Wishes
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
Follow-up: Burning sensation in lower leg, taking Dilatrend and Lipitor. Is it due to beta blockers? 20 minutes later
Thank you for your reply Dr Gover and I am very comforted that I am communicating with a Cardiologist.
However, your reply has left me a little confused - you state that either Lipitor or Carvedilol is responsible - however, in the Side Effects that you have listed for both drugs - none of my symptoms are mentioned. However, researching online I have read a lot of reports of people taking a Beta Blocker that are experiencing similar symptoms to me.
As previously mentioned I ceased taking Lipitor for one month (under medical supervision) - and symptoms remained stat. What would be a suitable alternative to use in place of Carvedilol? - to enable me to exclude that it is the Carvediol that is causing my extreme discomfort. I am finding the constant discomfort is also disrupting my sleep.
Answered by Dr. Anil Grover 23 minutes later

For a moment I disbelieve you. You would have read reports of symptoms attributed to a drug. However, even if one case in one hundred thousand has that symptoms, US
Food and Drug Administration issues an advisory. I did not come across any advisory where these symptoms have been recognized as side effects. Cavedilol is older drug, B blockers have been around 50 years, it would have been officially recognized. That is why my suggestion was to call Australian Authority.

On the other hand lipitor has been relatively much newer. Event this year it was recognized by the FDA that liver damage as they had claimed was an overstatement. Hyperglycemia which was casually mentioned now Atorvastatin is considered responsible for causing Diabetes Mellitus! So, I consider this drug is in evaluation.

For you there is simple solution, half the dose of Carvedilol to 3.125 mg instead of
6.25 mg. If you feel lesser side effects you have the culprit. Personally, I do not think you need another B Blocker as substitute. In my opinion you can do without this drug. But I have not examined you and as a policy of health care magic we are not supposed to give prescription drugs. This is a call your doctor will have to take and decide whether you need a substitute or not.

I am sorry, if my answer was confusing. If you need further clarification please ask, I will answer as soon as possible. Regards.

With Best Wishes
Dr Anil Grover,
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
Follow-up: Burning sensation in lower leg, taking Dilatrend and Lipitor. Is it due to beta blockers? 22 minutes later
You are correct Dr XXXXXXX - the reports I read online were attributed to a beta blocker drug - it was not a stated fact. Please excuse my incorrect remark.
thank you so much for your assistance. I am most grateful to you.
Answered by Dr. Anil Grover 45 minutes later

Your remark was not in correct for a layperson, it was a perfectly legitimate query.
Thank you for your kind words about me.
May you get well soon.

Unless you have something more to ask, which I will happily answer. It was pleasure interacting with you. You may close this query with comments and score.
Thank You.

Anil Grover
Above answer was peer-reviewed by
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