Apixaban and alcohol.

[ryang101]

Hi, I'm a relatively fit 54 year old male, None smoker and not overweight, Before being furloughed i walked to work at a good pace 3.5 miles each way 5 days a week and at weekends usually a 4 mile walk without issue. I had very minor palpitations and irregular heartbeat now and again which the dr. wasn't concerned with (from 20 + years ago). It was usually put down to stress then in May early one morning had my first big AFib attack (which lasted several hours). It was that bad i called an ambulance and went to hospital. The Dr. there asked me many questions , Took bloods etc. I'm due a heart scan, 24hr. monitor and maybe cardioversion but all this has been delayed. I was put on 2.5mg bisoprolol and 5mg apixaban twice a day. A I felt really sluggish in the morning after a few weeks and my HR was around 40 BPM at night. I phoned the Cardio number and told me to reduce the 2.5mg to 1.25 which i did. This was much better. I also never stopped walking daily (minimum 5 miles a day at a good pace without issue). I do still like a drink or two but usually don't drink midweek , just either Fri or Sat with friends. I know the limit is meant to be around 2 pints in one night on Apixaban , Just want to know what others think about this ? Thanks.

[Finvola]

Some lucky people can continue with the odd drink whilst being treated for AF but I’m one of the losers who cannot tolerate alcohol any more.

Bisoprolol is notorious for causing massive fatigue and sluggishness so it’s great that you are able to do some good healthy walking.

Your heart will tell you if a couple of drinks are a no-no for you - binge drinking, on the other hand actually causes AF.

[ryang101 in reply to Finvola]

After a month on meds i began to feel really sluggish ,Especially in the morning. I suspected it would be the Bisoprolol. Since reducing to 1.25mg it's been better. I'm going to have a chat with my Dr. as at night time in bed my resting heart can still be in the 40's ,even now at 8.30pm it's 53bpm. My blood pressure is 111/66 this is just before i take the 1.25mg bis. at 9pm. I'm wondering if i should actually be taking any beta blockers.

[BigDunc in reply to ryang101]

I workout most days and my BPM was always in the low 50’s since take Bisoprolol my BPM is now in the 40’s in the evening and into the 30s sleeping which seemed to trigger episodes of AF every 4-5 days that lasted around 40 hours when I would flip back into Sinus

My last episode lasted 3 weeks that has seemed to have broken the cycle. Although because I tolerated it so well I’m less bothered about going into AF which maybe the reason

I take Bisoprolol 1.25 in the morning now and with my breakfast and was advised to give it 6 weeks to get used to it

[BobD Volunteer]

I think many of us here stopped alcohol when diagnosed because it is a known trigger. Obviously only you can make the decision but for me it just wasn't worth it.

[ryang101 in reply to BobD]

To be honest i've never really had any alcohol midweek unless a special occasion and for the last decade or so either a Friday or Saturday night. I can't really remember it being a trigger, Certainly in May when i had the big one it was a Friday morning about 1.30 am. I hadn't touched any since the previous Saturday (about 2/3rds bottle of wine). If i were going out with friends then limit would be equivalent of 6 pints but now reading into it wouldn't want to risk that amount. Alcohol isn't a must for me but would be nice to know what a sensible limit would be even if just 2 or 3.

[Morzine in reply to ryang101]

I am ok with a couple if glasses if red if we go out to eat. If we go to our local bar for open mike on a Thursday I have half of beer.

I thinkwe All have to make our own judgements in what’s best eh,

Sue

[Dodie117 in reply to ryang101]

As long as I don’t overdo it I too seem to be ok with a couple of glasses of wine and for me it is worth it. You need to monitor it and make your own decision. I had ablation in 2013 and free of af since. No meds except apixaban.

[wilsond]

Hi

I can tolerate two pints of good quality local brewed ale over 4/5 hours or so..on half pint measures.. not often though. Never more ,similarly I can have ONE Proper Coffee but no more.

It's kinda suck it n see!

But if you have any reservations dont risk it. I'm 7 years into the Crazy Heart Club and suppose I've got used to the nonsense a bit..lol!

Best wishes xx

[HiloHairy]

One cardiologist warned me about drinking on the weekends only calling it "Holiday Heart"syndrome.

I drink usually two drinks, occasionally three nearly every night and it doesn't trigger a fib events. However, too much sodium in a meal will trigger an event during the night. I wish I could find my way around that as it precludes virtually all Asian cuisines and I live nearly halfway between the continental US and Japan where most of our local restaurants are Asian.

[Jmc43 in reply to HiloHairy]

My experience matches HiloHairy’s...I have paroxysmal Afib and have 2 or 3 glasses of wine a day, or maybe one small mixed drink and a glass of wine. I have not had this be a trigger. I take apixiban and a BB. As I have relatively few episodes, I am not sure what the trigger is, although I think dehydration was a problem a couple of times. I had an ablation about 6 weeks ago, and am recovering, have had no problems.

[HiloHairy in reply to Jmc43]

Dehydration seems to be part of my problem too. When I do have an event I usually realize too late that I didn't have as much water as I usually do that day. I know that sodium and water retention are related but I don't really understand how they're related to AFib.

[Peddling]

Me too - a couple of glasses of wine with my meal. I’m in persistent AF and it’s a matter of debate whether alcohol put me there. However, I’m much more comfortable in persistent rather than the chaos of random attacks.

Many of us on this site have switched from bisoprolol to Nebivolol which is a less energy slapping drug. I too take Apixaban. If you are still having the same difficulties with it at the end of your trial period you may want to give it a try.

[bigolbears]

I’m on Apixaban and asked Dr about having a beer. His opinion was in moderation if on the very rare occasion it’s a celebration and I drink a bit. Don’t take the one at night. As for Alcohol and my A Flutter doesn’t make any difference seems we’re all different

[Auriculaire]

I drink one small glass of wine with my principal meal -mostly in the evening. If we go out for lunch we share half a bottle so that's nearer 2 small glasses. It does not seem to have much connexion to my infrequent afib episodes. Eating too much in the evening or being very tired or stressed is more of a trigger for me. The former is easier to avoid !

[Maggimunro]

Hi Ryang

I think I must be one of the lucky ones since I still enjoy a Gand T every evening. I take Apixiban 5.0mg bd after my 3 ablations.

But it seems we all react differently.

[Daver112]

I drink 2 to 3 drinks a night before dinner, take eliquis and have no problem. Been doing it for 3 months now, every night. I had one episode which 1 100 mg flaccanide solved but I was stressed that day and tired from lack of sleep with our new puppy.

I rose too quickly at 2:30 AM as puppy bark to go out to poop and this sudden heart rate increased from a relaxed sleep was all that was needed it seems to cause my afib. That was 6 weeks ago and I still continue to drink between 7 - 8:30 before dinner and watch that I don't get too tired and "be especially careful to drink plenty of water before and after a few drinks" and I believe this will keep me out of Afib; we'll see.

[Limoncello]

I have persistent AFib and a mitral valve defect (tests/ treatment deferred because of - yes, you’ve guessed it, Covid). I’m on Apixaban and am about to switch from Bisoprolol to Nevibolol because of problems with walking that came on as the dosage was increased from 1.25 to 2.5 to 5 (slowness, breathlessness on hills). I don’t drink beer, but do have a large glass of wine, never more, with my evening meal on Saturdays and Sundays. The cardiologist asked how much I drank and didn’t react when I told him, although I’ve read that you should avoid alcohol if you have AFib. I’ve noticed red wines in particular make my heart race at night. If you feel ok, don’t notice any change in your heart pace or rhythm, I would imagine it’s ok. Just monitor yourself.

[lovetogarden]

Everyone is so different when it comes to alcohol. I have had a few short events that might have bee wine related, hard to tell. Could be other things too, a big meal, dehydrated, etc. Since my last ablation, 2 weeks ago, wine just hasn’t appealed to me. Which is very surprising! And a good thing too. Saves money, calories and my liver! 😂

[Madscientist16]

The bisoprolol will reduce heart rate and blood pressure even more when consuming alcohol, so be careful.

[Ianc2]

try low alcohol 0.5% or no alcohol beer. Adnams Ghost ship is 0.5% and is quite palatable. Peroni and Stella also offer low alcohol products.

[ianbut]

I think it is generally accepted that high on the list of triggers for AF are alcohol, caffeine, stress and exercise. All of these are probably triggers for me. I have decided that I like being free of the nasty sensations of an AF episode more than I like alcohol and caffeine so, reluctantly I have eliminated these. Often there is a delay between the intake of alcohol or caffeine and onset of AF - sometimes it can be the next day. There are now enough alcohol or caffeine free beers and coffees with a decent enough taste to satisfy me.

[ianbut]

Re beta blockers : probably true to say that most people suffer side effects from these and I was no exception. Even nebivolol caused unacceptable tiredness/fatigue. It is worth discussing with cardiologist whether a change to, for example, a calcium antagonist might be considered. I was a new person following such a change