Switching From Toprol Xl To Bystolic Tonight

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I have been on Toprol XL 25mb twice a day for almost 6 years. Love the drug, but it appears to be wearing off. I am experiencing withdrawal type adrenaline surges after about 7-9 hours so the pills aren't lasting in my system anymore. I went to my cardio today and he gave me Bystolic 10 mg pill samples. He said to take 10 mg tonight and then start taking 20 mg. I asked him why such a high dose? Last year he gave me 5 mg Bystolic samples but I decided to stick with the Toprol. I am wondering if the once a day 20 mg Bystolic is comparable to two 25 mg Toprol XL pills...or is this too high a starting dose? He is a cardiac surgeon and I questioned him but he just said I need to work up to the 20 mg. My bp has been well maintained around 115/65 until recently where stress has caused it to spike as high as 180/110 last week at the doc office. It's been spiking at home to 165/95. I just started zoloft as well which I am sure I need but I know zoloft alone won't be enough to help. Basically I have two problems, stress and a failing Toprol bp medicine in my system. I am wanting to try Bystolic but worry about the 20 mg dose so soon.

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The reason for the higher dose so soon is likely to try to prevent a rebound effect from occurring. When you stop the Toprol, the rebound effect could cause a dangerous elevation in your heart and blood pressure, thus, when switching to a new medication, a higher dose might be needed faster for a period of time.

Once your body has adjusted, the dose can be lowered again, if necessary. But it is necessary to be careful and not put someone in danger by switching them over to too low of a dose of the new medication.

Learn more Bystolic details here.

Recent research has presented doctors with more warnings about the possibility of this happening and of the fact that they have to try to guard against it.

Is there anything else I can help with?

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Thank you for the response. I always hesitate when doctors prescribe two new meds at the same time. I just started 12.5 mg of Zoloft yesterday along with the new Bystolic. I felt fine until I took the Zoloft a little late today - lunch. I will start taking both of them right before bed. I guess the Zoloft had me feeling 'off' but it could just as well be the new bp medicine. I took the 10mg Bystolic last night and felt fine. Tonight I will take the 20 mg and keep fingers crossed. I know it takes up to a month to get it right in my system. I just worry about side effects. But your reply makes sense. My cardiologist seems so no chalant when he talkes..and said that there is no problem getting off Toprol or any beta blockers. "If you don't want to take it, don't take it." I just sat there puzzled. But then he said I needed this. I think he is so busy trying to make his patients 'not worry' or stress that he comes across as very wishy washy. But apprently he knows what he's doing as a cardiac doc and surgeon. Thank you.

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