AF Association
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Do Flecainide and Bisoprolol make you feel worse?

I have PAF and Aflutter. On waiting list for ablation (possibly Novemberish). I've had quite a few changes to my medication and following a run of hospital admissions through A&E with the AF in March, I'm now on Flecainide 100mgm twice a day (also can use as a PIP), Bisoprolol 7.5mgm at night (it was increased to 10mgm but I couldn't tolerate it & Apixaban 5mgm twice a day. At first I could hardly move - side effects totally floored me but I know you're supposed to give your body a chance to get used to the meds. Anyway I feel hellish!!! No energy, not sleeping, sore bones & muscles, headaches, forgetful, brain fog, sudden sweats (not 'tropical moments'), feel as if an elephant's sitting on my chest - not chest pain just a heavy feeling, intermittent sore throat. I could go on but I'm boring myself!! I feel that the meds are poisoning me. I'm not a regular at my Dr's surgery but did make an appointment - I was told that if I was worried about it then I should rock up to A&E!!!! (Obviously they hadn't a clue). Occasionally in the midst of the misery I'll have a day when I feel like me. I'm not sure if the Flecainide works for me anyway but I think the Bisoprolol is probably the biggest culprit. I feel that if the meds are making me feel this bad they can't be doing me much good. Sorry for droning on. Has anyone else had similar experiences? Thanks

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Any and All treatment for AF is only ever about improving quality of life (QOL ) so it is usually a case of trying different drugs till you find what works for you. I never had beta blockers but bisoprolol is known to cause all the things you mention. If I were you speak to your EP again about trying something different.

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I think you are right in identifying Bisoprolol as the culprit

Bisoprolol is the heart rate controlling drug whereas Flecainide controls the rhythm.

We are all different but I was only on 1.25Mg once a day and yet my EP took me off it altogether as it was causing Bradycardia (slow heart rate). I know that often doctors favour the combination of the two.

If the side effects are too severe see if you can get guidance to reduce the dose.

Pete

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I too had to stop taking the 1.25 mg Biso after just a few days as it brought my heart rate down too low- now just take flecainide when I have the occasional episode which is about once every ten or more days. It never lasts more than a few hours so I don't bother with the anticoagulants as they just give me bruises that I don't need!

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Hello Petrified... I’m on 100mgs of flecainide twice a day and 5mgs of Apixaban twice a day at the moment... I had an ablation 5 weeks ago. Heart is stable ... overnight it can drop to 48 or thereabouts and otherwise low to mid 50s.

Before the ablation I was on Bisoprolol which didn’t regulate me ... nor did digoxin. Bisoprolol made me feel exhausted, foggy, confused, permanently tired... all the things you’re experiencing...

now I’m just quite dizzy and my bones ache and feel as though I’ve lost quite a bit of strength ... I push through it and am using coping strategy to get through it...

I feel for you ... I’m very lucky as my EP is so accessible ... I hope you get further help with the meds - they sound like a real struggle for you...

🌻

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Hi Alpacca, I am interested in the bones aching thing. I have been droning on and on about this problem. I think mine started when I was put on rivaraxaban . Is it similar to apixaban ? I keep asking my consultant and my GP if my pain is related to the anti coagulant but , no one will even think about it.

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Hello Luludean... it looks like it’s more likely to be the flecainide ... I’ve copied an article:

ehealthme.com/ds/flecainide...

It’s hard to tell what’s causing the problems...

🌻

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Bisoprolol definately made me feel worse. I didn’t notice much difference when taking only Flecainide but take it no longer and am much happier and healthier as a result. I would not even contemplate not giving up anti-coagulation though.

As Bob says - all treatment is symptom relief - if meds make you feel worse my opinion - speaking only for myself - is why on earth am I taking them?

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Hi petrified, Bisoprolol made me so ill . I stuck it for months thinking that was what my life would be like . I and "they" found out I can't take beta blockers, I stopped and was fine but it was a battle getting changed .

Now I am on Digoxin and though in persistent AF feel normal! Digoxin does not suit everybody.

Flecanaide gave me horrendous nightmares.

Hope you get the right cocktail.

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It’s clear to me from comments regularly posted here that some people can’t tolerate Bisoprolol. It appears to be a preferred choice of the medical fraternity. I consider myself fortunate that my side effects from 7.5mg are quite minimal and manageable. I was tried on 10mg but my BP went lower than was considered prudent.

If I were you I would ask if you can try an alternative beta blocker.

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People talk about adverse side effects but do they really try? It takes a while, possibly a month or so, for your system to become accustomed to any medication. Perhaps we have simply become a nation of moaning minnies. Speaking of which did Lewis cheat?

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Been on this regime for best part of four months, so I reckon I've given it a fair shot. I worked in the NHS & know a lot of people almost actively look for problems so I'm possibly over cautious in case I become a Moaning Minnie!!! Thanks for the advice

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Hi Petrified :-) you only have to read the number of posts on here from members who have had a bad experience when taking Bisoprolol to know you are far from alone in not tolerating it well . I am surprised that it is so widely prescribed when there are alternatives. It is bad enough having to cope with AF in the first place without meds that are supposed to improve quality of life making it worse.

Do not be afraid to go back to your doctor and ask to try something else.

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Agree if your body is telling you something is not right go back to your Dr I changed my doctor to one who would listen came of Bisoprolol have not looked back.

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I find that remark somewhat offensive as you have absolutely no basis to know how others experience medications. Bisoprolol and Flecainide made me very ill and I now have a red alert on my medical file that I must not be given - in any circumstances.

We all respond very differently - one man’s meat is another’s poison.

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Very true!! It's easy to be dismissive if you've not had a bad experience. I think I might possibly be the same as yourself CDreamer. Flecainide & Bisoprolol don't seem to be a winning combination for me. I really do feel now that I'm taking poison!!! I do like reading your posts

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I think if you should know that anxiety effects people even regarding their medication and so tend to associate any unusually symptoms they may have with them It is no fun having reaction to medication it took me several years to get myself back to normal life I was not a moaning Minnie I was scared and felt not understood Compassion is what is sometimes missing in our world today Moaning Minnie's are people who feel alone unsupported and desperate With help from places like this it can help the understand and become stronger to deal with what is ahead of them Sorry for going on

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Well said Vonnie

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Thank you

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Thanks for your understanding

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I take the smallest dose of solatol possible. In the very beginning it make me feel strange ... mood swings. Now nothing. Perhaps you should give it more time? I was diagnosed with PAF two years ago. I have had two episodes. I “feel” cured but l know that l am not. Hence, l live a very healthy and disciplined lifestyle. It works!! Good luck.

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I have taken Bisoprolol twice, two years ago after my original diagnosis, and again after a recent stay in hospital with what they described as heart failure. Both times the dose was lowered after side effects to 1.25, but heart rate dropped to mid 30’s, I had eye problems, and felt really ill. No good for me, as I have a really busy life.

I am sure that if I had continued taking the tablets my quality of life would be non existent! My GP wasn’t too happy with me stopping the tablets, but it’s my life, my body, and my decision! I do however take my Rivaroxaban as prescribed. 😊

Trust your own feelings, you know what effect tablets are having far better than anyone else!

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i have been on Flecainide and Bisoprolol and had some similar side effects until the Bisoprolol was changed to Atenolol and then I felt absolutely brilliant. Bisoprolol does not agree with everybody, go to your cardiologist or electrophysiologist and ask to have it changed. You don't have to feel this way. Good luck.

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Can I ask how often do you get episodes of atrial flutter? X

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Only told I had atrial flutter when I saw EP about 6 weeks ago. Prior to that only the AF had been mentioned. Now it's bubbling away every other day.

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I was put on Bisoprolol and Flecainide and felt terrible. I think Flecainide was the culprit as I had been on Bisoprolol before with no side effects. I felt as if I was going to pass out and my heart rate was dangerously low so came off these drugs and now take Sotalol.

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I am on the same combination as you drug wise. I had my ablation about 8 weeks ago and now suffer from the same symptoms as you. I have spoken to my GP , not much use, called the Arrhythmia Nurses numerous times and left messages and no one gets back to me. I’m seeing the EP at St Thomas in September so have decided to wait until then to sort things out. Feeling very pissed off tbh.

My advice to you is to try and get your medication changed so at least you can get your life back!

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Good luck!!! I hope your ablation is a great success. It's very difficult when you know that things are just not right but no-one's listening. I'm very aware that medics don't like to be questioned and if you do then there's a good chance you'll be labelled as a pest or worse yet the much used medical abbreviation a PITA (pain in the ass). I'm going to try and contact one of the Consultant Cardiologists I've seen. As I've not been attending a clinic & was admitted to CCU through A&E, I've actually been seen by 4 Consultants - all very helpful. I was referred on to an EP (I saw him 6 weeks ago & I'm not going to see him until I have ablation). One Cardiologists is a great fan of ablation. Two of the others are very much against it and the other one is very good but associates AF with a very small run of palpitations he had after drinking a bottle and a half of red wine!!!!!!! True!!!

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Hi there, I am on the same combination( flecainide 50x 2, bisop 1.25 daily)- same horrible symptoms☹️. I was even questioning myself if I was going mad altogether. Going to see my cardiologist on Friday week and hopefully will get off this nightmare combination. Hopefully you will get sorted soon ! Best wishes- kat

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Have been ok with Flecainide but Bisopropol was awful and was eventually changed onto Atenolol (which I understand is the ne of the 'old' drugs and am coping with it although even though the low dose of 25mg makes my HR very low. You could try taking the Bisopropol in the morning rather than at night - might help.

Netty

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I can echo some of what you say NooNoo. Atenolol (which I've taken since 2002) has been around for a long time and doesn't seem to be used very much now. I'm OK with it. Although my heart rate is slow, I don't find it a problem at all. The cold feet have to be cosseted in the winter though. I'm very happy that Bisoprolol has never been suggested to me!

Flecainide did not made me feel bad and I used to take 300mgs per day. All the same, I do feel that the less one takes of it, the better and I'm delighted to have stopped taking it, except very occasionally.

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Yes, I agree, one Paracetamol is one too many as far as I am concerned. I only take 150mg a day of Flecainide 50gm in the morning, 100gm in the evening. I am just careful to take it with the right gap between and after food as I believe it can cause problems if you take it with food. On my next visit to my EP in August I am going to see if I can maybe take it as a PIP.

Netty

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Yes, food and flecainide don't get on.

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Thanks NooNoo. I was taking the Bisoprolol in the morning and it was even worse!!! Could hardly move as I was so breathless & tired. Cardiologist suggested taking it at night.

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Sounds to me like you just cannot tolerate Bisopropol, I think you should definitely go back to your Cardiologist to request a change of meds.

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1.25mg of bisoprolol put me to sleep in 40 mins and when I woke up 4 hours later I was groggy, felt drugged, pain in Arms and upper chest, more than an ache but not agony but enough to feel bad and irritated . No exercise tolerance. Did 7 days and was enough.. went to GP and she put me on Atenolol. Better but still bad, tired and irritated , no pain and i kept awake for 4 hours before succumbing to sleep. Did this for two weeks went back to gp who decided I did not tolerate beta blockers and put me onto verapamil 120mg a calcium channel blocker which was so much better with only a little bit of exercise intolerance. So i did this for 2 years until my AF developed and I was put on to Flecainide 2 x50mg and diltiazem 200mg. as rate control, This was crap, brain fog, Exercise intolerance , tiredness, definitely the diltiazem. I think the flec was not to bad . The diltiazem dose was too big. I tried120mg which was not great but Much better, however I missed a flec one night and ended back in a&e at 160bpm so the medics put me back on 200's. I put up with it as I had an ablation planned. I wish i had argued more as it was several months I wish I had not done on those meds at that strength. When I came off all drugs 3 months post ablation, ( flec first) I felt no better then, even when I stopped diltiazem it was probably 4 to 6 weeks before I lost most of the side effects and started to feel sharp and good. I think the side effects were cumulative so you do not realise how bad you are. But I don't think the flecainide was the problem.

Your GP could help you more. I do not think GPS like, or are not allowed to play with rhythm control drugs. But she/he could contact the EP..

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Try changing bisoprolol to nebivolol and keep flec as a PiP

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I know exactly how you feel. Similar experience with Flec and betablocker. I would ring the hospital who diagnosed you and ask for the arrhythmia nurse, they are so helpful and have all your notes available to see if they can make any adjustments. If not they can arrange for you to see the consultant. I have done this at the Liverpool Heart and Chest Hospital, my beta blocker, Nebivalol, was reduced in dosage and it helps but I reckon with me its the Flecainide that makes me so fatigued in the afternoons. But for now I cope, mostly, not ready for an ablation just yet.

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I am on those same three drugs flecainide 50 mg twice a day, bisoprolol 2.5 mg twice a day and the 5 mg apixaban twice a day. The drugs do make me tired but I sleep better with them than without. I do have breathlessness and a pressure pain over my sternum quite frequently but being in AF is worse. I have PAF and flutter, have just had an ablation but not sure whether it has worked yet as stlll having AF. You do seem to be on higher doses than I am but I am not completely controlled on the amount I am on.

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I do wonder if it's a trade off between feeling awful on the meds or feeling awful and terrified in AF. I suppose when you boil it down to this it's a no brainer!!!

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