Weight loss and medication

[Mrspat]

Has anyone experience of losing weight and then needing their medication adjusted?

I have recently lost about 20 lb, quite deliberately, over a 6 month period. My heart rate is sometimes now below 60 bpm when resting although I can still feel that I have an irregular beat. I am classed as being in permanent AF.

I will shortly have an annual medication review with my GP which will involve blood tests for thyroid, liver and kidney function plus Digoxin levels. Currently on Bisoprolol 10mg, Digoxin 125 mg, Levothyroxin 75 mg (as a side effect of previously being on Amiodarone) and Rivaroxaban 20 mg. Just wondering whether any of these doses needs to be reduced in view of a lower body weight.

[BobD Volunteer]

Interesting question Mrspat and well done on the weight loss by the way.

We know that weight loss can ave a beneficial effect on AF so it may be that you could reduce some of those but of course we are not the experts. Rivaroxaban is not dependent on body mass I don.t think. Why not pop in and see your local pharmacist and discuss before you see your doctor. They are the experts on drugs after all and if you are on regular monthly medication will no doubt know your pharmacist quiet well by now. Mine always says good morning/afternoon Mr D when I walk in!

[Mrspat in reply to BobD]

Good idea Bob. Our village pharmacist is very knowledgeable.

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When I was on Digoxin 250mcg I lost weight quite rapidly . I am also on bisoporol 10mg twice a day and 5 mg ramipril. The digoxin is now used as a pip when I experience AF .

[Rellim296]

Congratulations, Mrspat. An excuse to acquire something new for the wardrobe perhaps?

There can be a sort of threshold at about 60kg (about 133 pounds or nine and a half stone) for some drugs, NOACs included, under certain conditions. I wonder how much difference it makes if one is a tall, skinny and underweight person or a short, nicely rounded one.

[Mrspat]

The nine and a half stone threshold is interesting as I have indeed gone below this weight. Where did you get this information, please?

And yes - I dropped a clothes size, so several new items have been acquired. The trigger for the weight loss was actually my husband being advised to shed a few pounds, so I kept him company.

[Rellim296 in reply to Mrspat]

It was an on line guide for Rivaroxaban doses but I think it applies to Apixaban also as this was touched on in a recent post.

More to follow!

[Rellim296 in reply to Rellim296]

I've not seen what I looked at before but there's one that suggests a different dose for 'patients with any 2 of the following:

--Age 80 years or older

--Body weight 60 kg or less

--Serum creatinine 1.5 mg/dL or higher'

I've remembered it because I'm usually about 60kg. I take the standard 20mg Rivaroxaban.

[Mrspat in reply to Rellim296]

Thanks. I am well short of 80 but no doubt forthcoming blood tests will show my creatinine levels.

[Rellim296 in reply to Mrspat]

I don't think I've ever had my creatinine levels tested but I'm well under 80 too. I've had no problems with Rivaroxaban - quite the reverse!

[dedeottie]

Well done. X