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What causes increased heart rate after taking Betaloc?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 424 Questions

My father used to take Betaloc 25 twice a day in the morning&night, Clopitab A 150 once a day after lunch and Crestor 5 mg after dinner. During this phase his BP used to be around 120/80 and his resting pulse was around 68-70 bpm.
Recently he was diagnosed of chronic prostatitis and the urologist put him in FLOTRAL D 10 mg once in the night. Two weeks into this new medicine along with his old medication, the physician found out that his BP dropped to 110/70 and so the dosage of betaloc was reduced to 25 mg once a day in the morning from twice a day. Now his BP is back to normal and reads 120/80 most of the time, but his resting pulse has dropped to 52-56 bmp. The lowest pulse value recorded was 48 bpm while in deep sleep and the same value was also recorded 3 hours after taking betaloc 25 in the morning.

General patient info: Age:59/M, Moderately fit, exercises about 30 mins daily. Underwent a bypass + stent grafting surgery last year due to a major road accident that ruptured his aorta. Before the accident his did not have any BP/pulse issues. He was taking only cholesterol lowering drugs bk then.

I would like to know the following:
1) Why did his heart rate drop when the dosage of betaloc 25 was reduced to once a day? Ideally the opposite should have happened.
2) Is his present heart rate alarming and should we do something about it?
Posted Fri, 15 Aug 2014 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 37 minutes later
Brief Answer:
Yes even I find it surprising but doesnt seem dang

Detailed Answer:
Yes you are right that after having reduced betaloc, heart rate should have increased. With addition of FLOTEROL we expect BP to fall but not heart rate. But occasionally in these combinations patients can have exaggerated response to other meds.

If he doesn't have any giddiness or breathing difficulty, it's ok to have heart rates you have described. Sleeping rate of 48 bpm is quite acceptable. Generally it will back to baseline rate in few days time.

Hope this helped. Let me know if you need clarifications.


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