Bradycardia & Arrhythmia - please advise what LHRH & 2 generation drugs

[Christopherg]

I have just been diagnosed with both Bradycardia and Arrhythmia.

I would be grateful if anyone can advise which LHRH and 2nd generation drugs are safest

I cannot get Regilux due to insurance reasons

Thank you so much

Chris

[114411]

Everybody is eligible for a two month free trial Of regulux from the manufacturer. After that you can get what they call a bridge prescription free of charge which should bring you to a point where your insurance should cover it.

[Christopherg in reply to 114411]

I will contact. Thank you so much

[LearnAll]

Unfortunately...all Lupron like meds are cardiotoxic. Antagonists are slightly less cardiotoxic than agonists.Among Lutamides, Bicalutamide is least toxic to heart....Out of all, Abiraterone (Zytiga) is most toxic to heart.

[depotdoug in reply to LearnAll]

That’s exactly what i thought. Abiraterone. And thats why i’m on 250mg Abi so far. Thxs LesrnAll.

[Christopherg in reply to depotdoug]

Do you have heart electrical problems also?

[depotdoug in reply to Christopherg]

Yes absolutelyMay 17th five days post sudden cardiac arrest i got my 1st ICD/pacemaker implanted.

On my second ICD/Pacemaker since Jan 2019.

Two cardiac ablations: 2015 Cryoablation

May 2020 Rf cath ablation, successful so far.

At least 5 cardiversions.

Dx'd with AFIB back in May of 2013 with a variety of anti-arhythmia meds.

Had an RA lead revision this Mar to replace an aging and noisy fractured pacing lead.

I could add more.

I've talked considerably with my most two MO's since 2019-present about my cardiac rhythm issues and AFIB. That is why I'm one:

only 1 - 250mg of Abiraterone meds so far.

And keep both my EP and cardiologists updated all the time.

I could add mores.

Doug

[Hidden in reply to depotdoug]

🤙🏽

[Christopherg in reply to depotdoug]

So glad all is well with you

Keep on trucking

[Christopherg in reply to LearnAll]

I read that too. Doesn’t give me too many choices though. Thank you for sharing

[tango65]

If you do not have coronary artery disease, or a previous heart attack or stroke, I believe bradycardia (an arrhythmia) is not a condition which will be made worse by Lupron or similar.

Personally I will consider an LHRH antagonist such as Firmagon because they may have less cardiovascular complications and act more quickly than Lupron or similar.

en.wikipedia.org/wiki/Arrhy....

healthunlocked.com/advanced...

Abiraterone may cause cardiovascular complications (mainly hypertension, edema and hypokalemia which could cause arrhythmias other than bradycardia), if the increase in aldosterone is not controlled correctly with prednisone, dexamethasone or eplerenone.

Enzalutamide and apalutamide may cause hypertension.

accessdata.fda.gov/drugsatf...

accessdata.fda.gov/drugsatf...

[Christopherg in reply to tango65]

Thank you so much Tango

I have been on Lupron

My MO and cardiologist say the drugs are much of the same including firmigon

Doesn’t give me much confidence or hope hearing this

I will read the literature you kindly sent

Thank you so much for this

[tango65 in reply to Christopherg]

You are welcome. I wish you the best of luck.

[Christopherg in reply to tango65]

🙏🙏. You keep well

[Hidden in reply to Christopherg]

Much the same , sure kinda , firmagon is better and more costly . The drs think in a box. Many don’t like to be questioned much . I did the orch to drop the shots . Glad I did. 4 yrs no shots . No t is a bitch however with its own sets of little pleasures.

[Christopherg in reply to Hidden]

I agree my MO definitely doesn’t like to be questioned

[Hidden in reply to Christopherg]

More Typical than not .

[TylexGP]

Just an insight on my experience. I had a cardiac ablation for Atrial Fibrillation January and I just started ADT (firmagon 1st, lupron 2nd month, with abiraterone). In May. So far so good regarding cardiac toxicity (though I know it is only been two months).

[Christopherg in reply to TylexGP]

Was the abi suggested by your MO?

[TylexGP in reply to Christopherg]

Yes the Abi was suggested by my MO. I have inteaductal Gleason 9 locally advanced.

[winkoliu]

Regular exercise may help. Walking every morning is the best.

[Christopherg in reply to winkoliu]

I’m all in with walking twice a day 8000 steps

[winkoliu in reply to Christopherg]

Great, deep breathing every day is also helpful.

[timotur]

Something to be aware of, ADT is associated with an increase of the QTc interval-- a risk factor for ventricular arrhythmia's.

uspharmacist.com/article/ad...

academic.oup.com/jes/articl...

[Christopherg in reply to timotur]

Thank you TImotur I wasn’t aware but now am and will investigate

[timotur in reply to Christopherg]

Sure Chris, I have had occasional arrhythmia events, related mostly to caffeine intake, and when I was on abiraterone, had a moderately severe episode that persisted longer, and stronger than my usual 5-10 minute fluttering event. After that happened, and due to elevated BP— going from 110/70 to 165/100, I dropped it after five months. Something to discuss with your cardio if needed.

[Christopherg in reply to timotur]

I most definitely will

Thank you for the alert

I trust you are keeping well?

[Christopherg]

Lupron only but MO wants me on a 2nd generation

He said xtandi but it’s causes fatigue and all others have heart related issues

I do take a BP medication and one for arrhythmia

Apart from these nothing else

Fitness ok for being on ADT

I walk twice a day, workout in small home gym and golf twice a week walking the course

Not as much energy as I would like hence xtandi puts me off

[Christopherg]

Hi nalakrats

biscopal fumarate 7.50 mg daily

Candestartan 20 mg for BP

Best regards

Chris

[Hidden]

I know the candesartan is for BP because that's what I take but 16mg. The other med must be for the Arrhythmia.

My cardiologist originally prescribed the candesartan 25+ years ago.

[Christopherg in reply to Hidden]

That’s a long run

[Hidden in reply to Christopherg]

Yeah tell me about it..but I'm in pretty good shape otherwise. Still play ice hockey 2x week at the young age of 55...and up until very recent, exercise 5+ days a week.

[Hidden in reply to Hidden]

55 dam Tom ! 55 is too freakin young . I started at 53 . Ice hockey ? Fantastic 💪✌️

[Christopherg]

By my cardiologist

Presently as on Lupron PSA is .08

Gleeson score 7 (4 plus 3)

[GeorgeGlass]

Orgovyx is less toxic for 1st line ADT, Nubeqa is probably the least toxic on the heart for the more recent 2nd line AR drugs.

[Christopherg in reply to GeorgeGlass]

Hi George

I am meeting my MO this week

Can you let me know where I can get scientific evidence about Nubequa to discuss with him

Thanks so much

Chris