Q. Do I need to stay on Metocard and Pradaxa lifelong?

Answered by
Dr. Prashant Valecha
and medically reviewed by iCliniq medical review team.
Published on Mar 19, 2016 and last reviewed on: Mar 28, 2019

Hi doctor,

I am a non-diabetic 52 years old male. I was diagnosed with Afib one year ago and since then I have been taking Metocard-XL 100 mg od, Pradaxa 150 mg twice daily, Valzaar SM for hypertension. I have been taking various medicines for BP over the last 10 years. After taking Metocard for about a month my symptoms vanished, but still I am continuing with the medicines over 11 months now. Please see my Holter reports both old and recent and give your opinion if I need to be on Metoprolol and Pradaxa lifelong. I think my heart has returned sinus rhythm on its own and may be the drugs can we weaned off.

Dr. Prashant Valecha

Cardiology General Practitioner


Welcome to icliniq.com.

I have read your query and seen the reports (attachment removed to protect patient identity).

  • According to Holter there is no atrial fibrillation. Your echo is normal with few hypertensive changes and TSH (thyroid stimulating hormone) is normal.
  • Metocard - Metoprolol not only control heart rate but also blood pressure. So, no point of stopping that.
  • Pradaxa - Dabigatran is to prevent blood clot formation. As there is no atrial fibrillation at present, we can think to stop this after six months. But, you have to do regular 12 lead ECG (not holter) monthly or whenever you feel palpitations.
  • As without Pradaxa risk of clot formation in Afib which can lead to brain stroke. By seeing six more months we can think on stopping Pradaxa.
  • Metocard will be continued and the dose can be tapered according to heart rate and BP.

For further information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

Hi doctor,

For BP I am already taking Valzaar SM (a combination of 80 mg Valsartan and 2.5 mg Amlodipine). So, can Metocard be tapered off?

Dr. Prashant Valecha

Cardiology General Practitioner


Welcome back to icliniq.com.

  • I have already considered that before as you have written that. Metocard can be tapered down but should not be stopped.
  • You can check your radial pulse daily two to three times and make record while continuing Metocard and same time BP readings or do a 12 lead ECG and post to me.
  • Anticoagulation can be stopped because it is quite expensive too. On top of that if we stop Metocard then surely heart rate will go up and you will be at risk.
  • If heart rate is 60 or less then we can decrease dose. Kindly send your ECG.

Revert back with the ECG report to a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

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