Ciplar (propranolol) is a beta-blocker, and stopping it suddenly or skipping doses can cause a temporary, rapid spike in your heart rate. To safely discontinue this medication and help your heart rate stabilize, it must be tapered off gradually under your doctor's supervision. I highly recommend consulting your physician to create a safe, step-by-step tapering plan and to evaluate your post-COVID symptoms so you can recover fully and safely.

These 'internal tremors' are often linked to heightened anxiety or your nervous system adapting to medications like clonazepam and Ciplar (propranolol). At 0.25 mg, your clonazepam dose is very low, and sometimes these sensations persist as your body adjusts or if anxiety isn't fully managed. It is very important not to change your dosage on your own. Please discuss this with your doctor, who can safely evaluate your progress and adjust your treatment plan to help you find relief.

Especially when medications like Elipran, Nafroxsen, Ciplar, and Sarotena haven't brought relief. Since temperature, noise, and stress are key triggers, we can explore other paths. Medically, newer preventive options like CGRP inhibitors or botulinum toxin injections might be highly effective for you. Additionally, non-drug therapies like biofeedback, cognitive behavioral therapy for stress management, and acupuncture can make a wonderful difference. Please discuss these alternatives with your neurologist so you can safely find a plan that brings you the comfort you deserve.

Ciplar-LA 40 contains propranolol, which is a beta-blocker. For individuals with lung conditions like COPD, propranolol can sometimes cause the airways to tighten, making breathing more difficult. Because of this, it is generally not recommended. Safer alternatives for managing your blood pressure include generic calcium channel blockers or ACE inhibitors, which effectively lower blood pressure without affecting your lungs. Please consult your doctor to safely transition to an alternative that keeps both your heart and your breathing strong and healthy.

While a heart rate of 90 beats per minute is technically within the normal range, the sensation of palpitations can be very uncomfortable. For quick relief, try slow, deep belly breathing or splashing cold water on your face to help calm your nervous system. Please do not stop your medication suddenly. I recommend consulting your prescribing doctor soon so they can safely adjust your propranolol dosage or explore other options to help you feel better.

It is highly recommended that you do not combine these two treatment plans. Both sertraline from your first plan and Pari (paroxetine) from the second are SSRIs. Taking them together can lead to an unsafe build-up of serotonin. To keep you safe and ensure you get the best care, please do not mix these medications. I gently advise you to consult one of your doctors, show them both lists, and decide on a single, unified treatment plan.