Running out of meds to try

[portmoodyggma]

Another new medication, another set of side effects. I've now been on Metoprolol (4 x 25mg) for six weeks and it's great for weight loss (which is a bit scary). At first it wasn't too bad and I could have a sort of life, but not anymore. Nausea, fatigue, congestion etc. and it doesn't consistently control my afib. I also take digoxin and zarelto, but I've been on those since January. This is my third med, after diltiazem and sotalol. I did not tolerate amioderone or propafenone. I will have my 5 minute consult with my cardio on Wed. Not sure if there are any drugs left to try.

[BobD Volunteer]

Why not ablation if drugs don't work?

[portmoodyggma]

Well, first I have to see the ep doc, which I will in December, then if it is offered, there's a one year (at least) wait time. I can request if it's not offered, but my regular cardio didn't think it was an option. Hopefully he won't suggest another cv as the last 4 were not effective and one had some complications.

[seekerPNW]

I had a difficult time as well,but no weight loss.i had been taking metoprolol in the am and about an hour after taking meds felt horrible.The cardiologist I see switched me to the metoprolol succinate which I take when going to bed,175 mg.That has helped with the fatigue and dizziness,I also take digoxin in the am.I feel like it slows me down also but the morning metoprolol was the worst.Hope you find the right combo that works for you. There doesn't seem to be a magic pill with afib!

[portmoodyggma in reply to seekerPNW]

Thank you, I will mention it to the cardio, you're right, it is the morning dose that's the worst.

[Jill13]

I was on 100mg of metoprolol morning and night and felt like a zombie. I asked to be taken off beta blockers and am now on a combination of Digoxin and Diltiazem as well as xarelto which seems to work for me. I think it is a matter of getting your cardiologists to try different combinations of drugs but unfortunately all that takes time

[portmoodyggma in reply to Jill13]

Thanks for your advice, apparently once I've taken diltiazem I can't go back to it, I will have to check on that again as it worked for me before.

[Jill13 in reply to portmoodyggma]

I am not sure if you have episodes of AF periodically or if like me are in permanent AF. I also have high blood pressure and on these meds my blood pressure stays normal and I don't have any AF symptoms, but what works for one person doesn't always work for another and as others have said you need to discuss with your cardiologist or EP. Good luck for the future.

[CDreamer]

I don’t take any Heart drugs at all other than anti-coagulants and day to day feel much, much better. But obviously have to put up with the episodes or try work out how not to have an episode of tachycardia, which then triggers AF.

If you haven’t seen an EP yet, which is what I understood from your post, I would forget everything else you have been told and start from scratch with the EP. And every EP I have ever seen spend longer than 5 mins with a new patient.

[portmoodyggma in reply to CDreamer]

I have seen an ep - almost 6 months ago - they are apparently rarer than miracles. I will see him again in a month - twice yearly visits if I'm lucky. Last time he changed my meds to beta blockers and another two more cv's that didn't work, so we'll see.

Lucky you, no meds! I would put up with intermittent afib anytime!

[CDreamer in reply to portmoodyggma]

So why not? You have a choice and Heart meds such as rate control drugs are purely QOL - unless your HR exceeds 200 for extensive periods of time. Try asking ‘what happens if I don’t take drugs?’

It must always be a benefit : risk assessment but if the risk is low and there a no or few benefits ???

For me, I can’t take any Heart meds as they exacerbate my other condition, which is far scarier.

[portmoodyggma in reply to CDreamer]

I think I'd be scared to quit my drugs, I've already had 3 hospitalizations from pretty well continuous uncontrolled afib and very low blood pressure. I have cut back on the meds to see what happens. I think you're very brave!

[Mike11]

Try Nebivolol or a calcium channel blocker such as verapamil. Best to get these tried before you see the EP so that you can get straight onto whether an ablation is needed or not

[portmoodyggma in reply to Mike11]

Thanks, another shot for my bow when I go to the cardio, all this is really helpful!

[RichMert]

If Amiodarone fails then has to be ablation. Amiodarone is used when all others fail.

[Spoiler]

What about Flecainide? It worked fabulous for my persistent afib. 50 mg twice a day is what I took until I failed a stress test after 7 months of perfect no afib.

[portmoodyggma in reply to Spoiler]

Thanks, I will mention it to my cardio next week.

[Spiritji]

I am now just taking diltiazen 120 mg once in the morning with pradaxa the blood thinner. Everything seems ok......I wanted to comment however that when I first took the diltiazen I had been on digoxin for a couple years.....then my cardiologist had me go off of it........during those 3 months I was like completely exhausted like I had chronic fatigue and had a hard time functioning.........Eventually it ended but i really felt it had something to do with the drugs .I have always wondered if the digoxin and the diltiazen are a bad mix but I am not sure there is any literature to sustain that theory.

Good luck........my health practioner had me go for rate control over rhythm control as those drugs are not as hard on the body as far as side effects apparently.

I have what they call permanent afib

[portmoodyggma in reply to Spiritji]

Mine appears to be permanent too, controlling it seems to be like grabbing a handful of jelly. I am going to ask why the drug switches. In the hosp you get 30 secs with the cardio which is way too quick. I would like to get off digoxin as it's quite toxic. Another ask when I go to the cardio.