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What Causes Slow Heart Rate While On Propranolol?
Question: 31 year old male.
For the last 2 weeks have been taking Propranolol 10mg x 2 for recently diagnosed Vestibular Migraine prevention. Am supposed to go up to 20mg now.
My concern is even at the 10mg, my resting heart rate when calm and relaxed can go down to low 40s. Now of course itâs not low all the time, just sometimes when resting and super calm. Sometimes it can be more towards 50, its just occasionally it slips down to the lower 40âs. If I get up, move, ect, of course it goes up.
Before taking the medication, I always has a low resting heart rate, usually around 50bpm or so.
I donât want to bump up to a higher dose or take this medication if slow heart rate could be an issue, I donât want my heart to stop or something.
On an unrelated note, I did have an echocardiogram this spring for unrelated issues along with a 48 hour holter that both were normal. (I have attached the echo report). Also, for the last several months (before taking this medication) I have been running about 3 miles a day, 5 times a week with no issues, so my overall point is I think I have a healthy heart besides the fact the itâs a low resting heart rate.
My question is, with someone like me with a low heart rate to begin with, is it OK to take a low 10/20mg dose of Propranolol? And is it ok that my resting heart rate had dropped more because of this medication and OK to be in the low 40s? I just donât want it to stop or something, I am probably just being anxious about it. Should I try something else like verapamil that wonât slow the heart as much, or not worry about the Propranolol?
Thanks much
For the last 2 weeks have been taking Propranolol 10mg x 2 for recently diagnosed Vestibular Migraine prevention. Am supposed to go up to 20mg now.
My concern is even at the 10mg, my resting heart rate when calm and relaxed can go down to low 40s. Now of course itâs not low all the time, just sometimes when resting and super calm. Sometimes it can be more towards 50, its just occasionally it slips down to the lower 40âs. If I get up, move, ect, of course it goes up.
Before taking the medication, I always has a low resting heart rate, usually around 50bpm or so.
I donât want to bump up to a higher dose or take this medication if slow heart rate could be an issue, I donât want my heart to stop or something.
On an unrelated note, I did have an echocardiogram this spring for unrelated issues along with a 48 hour holter that both were normal. (I have attached the echo report). Also, for the last several months (before taking this medication) I have been running about 3 miles a day, 5 times a week with no issues, so my overall point is I think I have a healthy heart besides the fact the itâs a low resting heart rate.
My question is, with someone like me with a low heart rate to begin with, is it OK to take a low 10/20mg dose of Propranolol? And is it ok that my resting heart rate had dropped more because of this medication and OK to be in the low 40s? I just donât want it to stop or something, I am probably just being anxious about it. Should I try something else like verapamil that wonât slow the heart as much, or not worry about the Propranolol?
Thanks much
Brief Answer:
No you should not take Propanolol
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Propanolol causes drop in Blood pressure and pulse rate.
Now in your case pulse rate is dropping down to 40 beats per minute and that is low.
There is no point in increasing the dose further. In fact you have to stop taking Propanolol.
Verapamil is a calcium channel blocker and it's not a good choice for Vestibular Migraine.
Since your ECHO, Holter are normal so, the probable cause of reduction in your pulse rate is Propanolol that should hence be stopped.
I would recommend in your case a wonderful drug known as Flunarizine which has no effect on BP or pulse rate and controls the Migraine very well.
Share my opinion with your doctor.
I hope it helps you.
If you have any further query, please ask me.
Stay Healthy.
No you should not take Propanolol
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney. I understand your concern.
Propanolol causes drop in Blood pressure and pulse rate.
Now in your case pulse rate is dropping down to 40 beats per minute and that is low.
There is no point in increasing the dose further. In fact you have to stop taking Propanolol.
Verapamil is a calcium channel blocker and it's not a good choice for Vestibular Migraine.
Since your ECHO, Holter are normal so, the probable cause of reduction in your pulse rate is Propanolol that should hence be stopped.
I would recommend in your case a wonderful drug known as Flunarizine which has no effect on BP or pulse rate and controls the Migraine very well.
Share my opinion with your doctor.
I hope it helps you.
If you have any further query, please ask me.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
I will see it he will let me try the flunarizine, thank you.
But if he insists on the verapmil should this be ok with my normally slow heart rate? I have read that the verapmil barely slows the heart in comparison to the inderal. a couple articles had good studies on it for vestibular migraine he said apparantley, who knows?
my bp is not an issue, it never gets super low, just the heart rate.
and any other suggestions on beta blockers/calcium channel blockers for migraine that won't slow the heart too much? thank you.
But if he insists on the verapmil should this be ok with my normally slow heart rate? I have read that the verapmil barely slows the heart in comparison to the inderal. a couple articles had good studies on it for vestibular migraine he said apparantley, who knows?
my bp is not an issue, it never gets super low, just the heart rate.
and any other suggestions on beta blockers/calcium channel blockers for migraine that won't slow the heart too much? thank you.
Brief Answer:
I recommend Flunarizine
Detailed Answer:
Hello. Every doctor has his personal experience with various drugs for a single disease.
My experience with Verapamil is not so good. It's well tolerated and seldom affects the heart rare but I have never got satisfactory results in Migraine.
Flunarizine is also a calcium channel blocker with very good results in Migraine.
No other beta blocker or calcium channel blocker I would advice in your case.
If you have any further query, please ask me.
I recommend Flunarizine
Detailed Answer:
Hello. Every doctor has his personal experience with various drugs for a single disease.
My experience with Verapamil is not so good. It's well tolerated and seldom affects the heart rare but I have never got satisfactory results in Migraine.
Flunarizine is also a calcium channel blocker with very good results in Migraine.
No other beta blocker or calcium channel blocker I would advice in your case.
If you have any further query, please ask me.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Yogesh D
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