I am about start 2.5mg of bisoprolol fumarate one daily, and flecainide acetate 50mg twice daily. Is anyone else taking these two together?

[Jomack]

[CDreamer]

Hi Jo and welcome, I am on exactly those dosages. Do you have a question?

[Jomack]

Yes. I am very worried about starting them. I've been on other drugs two different types and they have not slowed down or stopped my AF attacks and the side effects have been horrific! How's these two together and why do we have to take them together? As doc just left me to try these without being about to talk to him! Like a guinea pig!

[Kiwi2]

I have taken these together since the beginning of October 2013 with no side effects. I was very worried and left it for 6 months before taking the plunge. I wish I had started sooner as it controls the AF attacks and I have only had 3 since starting. If I do get an attack I was advised it was OK to take an extra Flecanide which flips me out of AF again. I hope this helps.

[RobertELee]

You're not a guinea pig Jo. These are well established and much used drugs, each of which addresses AF in two different ways - bisoprolol encourages rate control which is about slowing down the heart rate and flecainide is a rhythm control drug which is intended to maintain a regular heart beat. But yes, like many drugs, they can have side effects - not necessarily because they are being taken together - but only you can be the judge of those. Give them a try. If side effects are particularly unpleasant then go back to your GP/cardiologist. You never know though, they might just do the trick!

[shirljo]

I'm taking the same as you plus Rivaroxaban 20mg and I am so tired all the time, I don't get to see my consultant until June and all my GP does is repeat the prescription so there is no-one to talk to about this constant lethargy. My AF is mainly under control but have the occasional fibrillation which I deal with by stopping, sitting and giving myself some down time (I work in a busy school so taking it easy is a myth!)

How are you doing?

[Polldoll in reply to shirljo]

I hope by now you have seen your consultant and talked about this

I'm on exactly the same meds and I'm constantly tired . Although To be fair I had felt constantly tired before that due to the AF . 220bpm for up to six hours a day usually in the evening . I am fortunate to have a great cardiologist ep and have private health insurance which meant I only suffered for a few months Having only had two or three episodes in the two years previous then suddenly one every day !

I had laser ballon ablation four days ago and am still on the meds . I am prepared to continue as advised in the hope that the ablation has been a success and eventually I can me med and AF free

I think we are all fortunate to be able to benefit from the new therapies available to us . My mother suffered with af fir years and died of a stroke . I'm sure she would have lived longer had she had the benefits we do .

I was horrified to be diagnosed but am determined to stay positive after all lots of people have much worse

Good luck

[Beancounter Volunteer]

Hi Jomack

This is a common prescription, and yes they are powerful drugs but they also are effective, just take them for a few weeks, it will take your body at least that long to get used to them, and then after that initial period then worry about any side effects and if necessary go back to your cardio (I am assuming cardio as GPs seem to seldom prescribe flec)

How about anti-coagulation?, have you had your CHADS23VACS score? that's the real risks with A Fib, you can self test here

mdcalc.com/cha2ds2-vasc-sco...

If you are 2 or above you MUST be anti-coagulated, and many of us would argue with a lower score than that

Be well

Ian

[Rellim296 in reply to Beancounter]

Beancounter, i followed your useful link, and just because I am female and over 65, I already score 2 before my medical history adds further to the score

[Beancounter Volunteer in reply to Rellim296]

Hi Rellim

Then you need to be on an anti-coagulant such as warfarin or similar urgently, ring your doctor or Cardio and tell them you have self tested for CHADS2VACS and have a score of over 2, the real risk for us A Fibbers is stroke and an anti coagulant mitigates that a lot.

If you have any problems with your medical advisors then ring the AFA helpline on 01789 451837 and they will help you get the message across.

Good luck and let us know what happens

Ian

[Rellim296 in reply to Beancounter]

It's OK,I'm on warfarin, and within therapeutic range, if not above, checking tomorrow.

My point is that the indications are that all women over 65 should be anticoagulated.

[CDreamer]

Hi Jomack, I was very resistant to taking any drugs so I understand your concerns. I came round to thinking that you need to look at from the view of what is worse, AFib attacks which will eventually permanently damage your heart and high risk of stroke which will have devastating effects for you OR take the meds which are quite effective at stopping them, or take them, see If they work and if they give you intolerable side effects of back to you GP.

I find that the Biso, the heart rate drug, causes breathlessness on exercise. That's because it slows your heart rate so you get less oxygen to the muscles, which means you just have to slow down a bit. That's annoying but the only side effect I have had.

The Flec is the rythm control drug and that has no side effects for me, except when I take it within an hour of food, before or after. I then feel nauseous for a couple of hours, but the 50mg dose is very low I have never had nausea at that low dosage. It hasn't always prevented episodes, I think I have had 4 in the time I have been on them but 2 of them was because I stopped taking them and ended up in hospital. The other 2 were very mild and only lasted 1hour tops.

The difficulty for the doctors is they have no way of knowing which drugs will work on which person so it is sometimes trial and error but they will work with you, especially if you are well informed.

Take note of what Beancounter says, my CHADS score was 0 so the cardiologist prescribed aspirin which is not an anticoagulant but an antiplatelet. On referral to an EP he said no! I needed anticoagulant as just having AFib means you are much more likely to have a stroke, the anticoagulation massively decreases your risk.

Do hope that you find your answers soon, very best wishes and let us know how you get on...

[Jomack]

Hi Ian thank you for your message.. I took the test and my score was a 1. What's your suggestions my GP is a cardiac specialist so I'm lucky I can call him when I'm feeling unwell. He has ref me to a surgeon now for an ablation as I'm only 37 and having up to 6 attacks a day and had a two day attack which was soooo scary! This is the third lot of meds now and started last night so fingers crossed? However I don't want to take drugs the rest of my like I want it gone!!! Jo :0)

[BobD Volunteer]

hi Jomack. One of the problems with AF is that it is a very mongrel condition and no two of us experience it in the same way. It often takes several different drug regimes to find one suitable for the individual but as Ian says these are commonly used.. I am so glad you have been offered ablation as at your age it would be my best option. Good luck and do read as much on the subject as you can as knowledge is power.

Bob

[dedeottie]

Yes me only in slightly different amounts.initially stopped my A.F. completely but had a few mild breakthrough episodes so suspect dose needs increasing. I initially had a few side effects but these soon stopped. I am however a little less motivated than before. Good luck. Hope this helps.x

[Lcpatrol]

I'm taking these two for my AF, but double those doses. 10 years ago my AF had built up to 12 hours AF overnight every 9 days or so. I was on single therapy but when I was put on dual therapy (Bi & Flec) the AF stopped. I haven't had an AF since. Side effects are tiredness and that's about it. I'm 63 and cycle about 60 miles a week so I'm still fit taking the tabs. If I overdo the exercise (ie cycling hard uphill) I get really tired and weak and it takes hours to recover. It's as if I'm in AF without the flutters. You learn from your mistakes; don't overdo it!