Extreme itching revisted: I posted on here... - AF Association

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Extreme itching revisted

Twitchen
Twitchen

I posted on here about a month ago regarding my OH's itching problem as a result of being prescribed Apixaban and Bisoprolol following his first episode of AF.

He has now been off all AF meds for just over two weeks and there is still no improvement with the itching - it is driving him crazy, he just can't get any relief from it day and night (when it is actually even worse). He has tried three different OTC antihistamines and various creams, but nothing is helping.

In desperation I contacted a GP, but she did seem rather dismissive and asked about changes in washing powder and another medication that my OH has taken as and when required for the past 10 years and never had the slightest side effect from. Anyway she did say he should have some blood tests and prescribed another antihistamine called Fexofenadine, which he was hopeful would help but so far it hasn't made any difference.

It is just so frustrating. We thought that once these drugs were stopped, as it obvious one of these was the cause, the itching would go away.

Thanks to everyone who replied to my first post on this, any new ideas would be really appreciated.

41 Replies
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BobD
BobDVolunteer

Knowing the half life of these drugs I would have thought they were well out of the system by now so maybe your GP has a point.

Twitchen
Twitchen in reply to BobD

One of replies on my previous post said that he still suffers from the itching 3 years down the line, so no she is wrong.

This could be way off, but has he had any lab work done? Could there be a liver problem?

Hi I got a very itchy rash with a reaction to the calcium channel blocker Tildiem, it took a couple of weeks to develop and just under three to go away.

I did a bit of research and it may be that the itch is to skin surface cells with the drug residue in them , not the drug in you OH’s blood system.

Because skin cells can take month or so to go from forming to being shed this may take longer than you would hope.

My strategy was to have a warm bath ( not hot ) every early evening and gently rub my whole skin with a facecloth to accelerate skin surface replacement. It did go away but it felt a long time after stopping the drug.

Good luck

I suffer an allergic reaction to the sticker pads put on my skin for ECGs or ablations.

Urticaria is awful and like you antihistamines are ineffective for me.

I now use Double Base Gel to shower and we clean with “Method” products.

After my worst episodes 3 + years ago. I found that only time helped me, but in the end it did abate.

Pete

Emgee
Emgee in reply to pottypete1

I too suffer terrible skin rashes after having a holter monitor on for a few days. I have had to refuse further holter tests, because of this as I did not want my skin to be permanently disfigured. I also react to tapes being on my skin for more than an house or so. Even the ones I am told that are non-allergic.So I avoid tape or gel based items if at all possible. I also changed my laundry detergent to Tide for sensitive skin to see if that would fix it, but so far, nothing eliminated the itching completely. If I am bitten by a mosquito or flea, I have a terrible itching reaction for weeks, I since have discovered Polysporim Anti-Itch to give relief from itching, whereas nothing previous worked to control itching.

Unless it's a liver problem as already mentioned it doesn't sound like it was Apixaban then. When I went onto the correct lesser dosage it was like turning off a switch on the itching. It sounds like the GP doesn't understand how awful itching can be. I've had sensitive skin all my life and it really can be hell trying to live with it. She is right about washing powder though, I had a period when biological washing powder came out when I became really itchy and it was only when my wife went back to the old non biological we realised that was the cause.

I had this when I was given citalopram for anxiety many years ago so can sympathise with your husband's plight. The itching continued for a very long time indeed even after I stopped the tablets. What a dreadful drug that turned out to be for me. The itching was truly awful. I found a cream called Eurax and it was a godsend. I have some dry skin patches now on my back and they also itch terribly and the cream, once again, has done its trick.

Steve

Auriculaire
Auriculaire in reply to Ppiman

I use Eurax for my hives and it works well. I prefer ghis to a systemic antihistamind though I have been thinking of trying quercetin .

Ppiman
Ppiman in reply to Auriculaire

I never found ant histamines worked but I think some find them useful. Eurax works well for me but E45 Itch cream did nothing at all despite many good reviews.

Steve

Auriculaire
Auriculaire in reply to Ppiman

Cetirizine worked like a charm on my hives but it gave me awful backache. Because I am so sensitive to meds a quarter tablet would last 3 days but after I stopped I got rebound itching in places like the scalp , palms and soles so I stopped it. The hives disappear in Spring and come back late autumn. It is a mystery . Obviously my body is producing more histamine but why?

Ppiman
Ppiman in reply to Auriculaire

You’re lucky it works so well. Itching is an odd thing and doctors don’t seem very sympathetic. Histamine is the result of some kind of allergy or sensitivity, I believe.

Steve

Auriculaire
Auriculaire in reply to Ppiman

Apparently there are low histamine diets you can go on but I am averse to wholesale diet changes. Some gut bacteria produce histamine so taking probiotics of ones that don't is supposed to help too but probiotics tend to make me burpy! I'll just have to keep smearing on the Eurax and wait till spring. If it wasn't for ghe afib I'd up my thyroid meds. My GP said we need more in winter but my afib attacks have been more frequent this year so I am wary of taking more. The first time I had this problem was before I was diagnosed with hypothyroidism and after treatment it went away for years. I do suspect that that is at the root if it.

Ppiman
Ppiman in reply to Auriculaire

I once worked for a pharmaceutical company that made a very successful child's asthma medication called "Intal", which was based on a drug called sodium cromoglycate (or "cromolyn sodium"). They then made a form of this for more general food or similar allergies like yours, as a capsule called "Nalcrom"; this released the drug in the intestine and colon where it protected the mastocyte cells there from releasing histamine (these are the immunoglobulin cells that release histamine when challenged by an allergen, or something which the body sees as a "foreign" protein but which isn't really foreign at all; this leads to a reaction intended to protect the body but which, instead, harms it by creating an "allergic response").

Sadly, it never really took off as a product, and I suspect this was because such allergies are so hard to diagnose and thus the success rate for the product seemed rather poor. I did, however, meet quite a few patients who were really helped by it, one especially, I recall, a policeman in Malta who thought it was a godsend. It was an exceptionally safe drug, too, with no side effects and virtually no toxicity. I've often felt it would be worth people with unspecified "allergies" trying it.

Steve

Auriculaire
Auriculaire in reply to Ppiman

Thanks for this. I have looked it up and see that Sanofi make it under the name of Intercron . It is prescribed for food allergies according to the Vidal so I will ask my GP about trying it.

Ppiman
Ppiman in reply to Auriculaire

It’s a very unusual medicine as it’s so very safe. The active ingredient was derived from plants originally but it is now made synthetically. If it works, then you will know that your problem is an allergic reaction to something as that’s all it does - protects the mastocyte cells from releasing histamine.

Auriculaire
Auriculaire in reply to Ppiman

I don't really think I am more allergic than when I don't have the hives! I have basically the same diet all year round . I know I am allergic to moulds as my asthma and runny nose is a bit worse in autumn but this year I haven't had much problem. I have had this problem of hives in winter for about 3 years now. The problem is that mast cell activation can be a floxing symptom . These come and go in cycles . At five years + since my last exposure to Cipro I think I am starting to recover except for my cartilage problems. Generally I feel better and the cycles are more widely spaced and last for a shorter time. This is typical for recovering floxies. But I have had a flare up of PN as well. It turns out that 2 brands of this sodium chromoglycate have been taken off the market here in August but there is still one left made by Mylan who have a lot of generics here. It's certainly worth a try. I read it was extracted originally from an Egyptian plant that had been used for centuries.

I was the person who still has some rashes 3 years after taking Bisoprolol. Whatever the half life of Bisoprolol I believe that drug fundamentally changed the pH of my skin, causing reactions when I eat certain foods. These include oranges, grapes, tomatoes and bananas. I am still taking 10mg of cetirizine hydrochloride daily.Rashes are a known, ' very rare' side effect of beta blockers. It is estimated that between 1 and 9 people in every 10,000 who take beta blockers will have painful rashes

As soon as the GP in my medical practice who has dermatology qualifications saw the photos I'd taken of the rashes she identified them as reaction to a medication. The rashes came for about three hours on one part of my body then disappeared only to appear elsewhere shortly after. All parts of my body apart from my face and feet were affected. It took two months to be weaned off Bisoprolol. Initially I was prescribed 40mg of cetirizine a day. I no longer take any beta blockers, or anything apart from an AntiCoagulant, for my permanent AF.

I think it's a bit early to expect the rashes to have ceased after only being off beta blockers for two weeks.

I have far fewer rashes than I had 3 years ago, and they are not anything as painful as they were.

Ppiman
Ppiman in reply to Thomas45

I feel sure a few of the side effects I had from citalopram many years ago are still with me. I hate the drug.

Steve

Emgee
Emgee in reply to Thomas45

You could try Polysporin Itch Relief, - it worked for me when nothing else did.It is a liquid and I find it sooths the itch immediately.

Sorry you are having such bad time with itching and many Dr's don't take it serious. I have the same problem for years, because I use morphine and other strong pain killers. If you use pain relief try something different if you can also stress can bring on itching. I hope you solve your problem and you are not alone. Stay safe

Emgee
Emgee in reply to army1

I think it is the other way around - where itching brings on stress.

army1
army1 in reply to Emgee

I think your correct I got it the wrong way round.

My cousin had the same problem for well over a year. Sometimes it was pure itching and a lot of the time he said it was like ants crawling over his body. Eventually he saw someone privately as his GP and local hospital consultants didn’t help and it turned out to be a post viral problem. He couldn’t think what could have been that he had had as (touch wood) he is very fit and no health problems, although I do think that a few months or a year before he had had pneumonia, but he said it was extremely mild. As I say it went on for a long time, but he is better now, but I don’t remember that there was anything that was given to help, just took time to go.Hope your other half feels better soon.

Auriculaire
Auriculaire in reply to Tapanac

Was he treated with an antibiotic for his pneumonia? Itching and the sensation of insects crawling can be a form of peripheral neuropathy which can be brought on by some antibiotics . It also is quite common in post viral syndromes . Other manifestations of PN are pins and needles , stabbing pains ( like somebody stuck a pin in you or bee stings) and sensations of burning or freezing .

Tapanac
Tapanac in reply to Auriculaire

I'm not sure about the pneumonia. I would have thought he would have had anti-biotics for pneumonia as normally it isn't left to heal itself is it?? I know I had loads of anti-biotics when I had it so guess he did. Steve did see so many doctors and consultants with the itching as it was driving him mad and surely someone would have come up with something. All the things you said about PN is so similar to the things he said and so what you wrote above is a good possibility. Thank goodness it has gradually got better, but it has taken altogether at least 2 years.

Auriculaire
Auriculaire in reply to Tapanac

Fluoroquinolone antibiotics are still prescribed for pneumonis and PN is one of the major adverse effects. When I was given Cipro iv for diverticulitis I started with pins and needles in my arms and legs. They stopped the Cipro as the PN can become permanent (there is a warning about this on the patient info ). Didn't do any good. I have mild PN 6years later including zapping electrical type sensations sometimes and the sensation that somebody has poured icy water over the right side of my scalp.

Tapanac
Tapanac in reply to Auriculaire

Oh goodness. I do hope you feel better soon despite having for such a long time. All the best

Auriculaire
Auriculaire in reply to Tapanac

Thank you. The PN comes and goes. It is not really that bothersome just a bit of a nuisance. I am lucky. Many floxies have a far worse experience.

Thank you all for the very helpful replies, at least it makes me feel that there is light at the end of tunnel and hopefully it will stop eventually.

OH has just reminded me that it is the anti-coagulant he came off two weeks ago, he had been taken off the Bisopropol earlier, so hasn’t had that drug for circa five weeks.

I really thought antihistamines would give some relief, but they haven’t helped at all, even the prescription one.

As some of you say, I don’t think GP’s appreciate just how debilitating this is. I felt the GP who phoned was talking to us like we were children rather than 65+ adults - of course we know all about how new washing products etc can cause problems, but we haven’t changed anything for years.

Auriculaire
Auriculaire in reply to Twitchen

Could get thyroid levels checked. Also vit D levels. There is a phenomenon called "winter itch" that is much worse if you have low thyroid. I get this itching mainly round ankles and calves and also hives in the winter. My thyroid meds were lowered when afib struck and I think this is part of the problem. Does he moisturise skin? Winter itch is often due to skin being drier in winter. I find moisturising my legs at night helps. I use Eurax too for the hives.

In the old days putting camomile lotion on a rash helped to calm the itching. Also bathing in water with bicarbonate of soda (baking soda) in it can help.I have read that lack of vitamin B12 can give rise to similar symptoms (ants crawling etc). It is not enough to just take a supplement, as some people can no longer absorb it via the stomach, hence the shortage of it in the body. One can buy B12 drops to be absorbed under the tongue which would bypass the stomach. Also it is worth asking the doctor to test your levels as that would show if lack of B12 might be the problem.

I have all these drugs, but have had itching in the same place on my arm for over a year. Pictures were sent off to the dermatologist and he said t was chronic urticaria( hives) and prescribed steroid cream and antihistamine tablets . Over this last year tried everything, with no success it is sometimes a bit better then gets worse. Stopped all the creams then tried just calamine lotion, I wash my arm in clean water, Pat dry then apply a soon as the itching starts up, before I start scratching it! After a few days go on to calamine with glycerin cream because my skin gets dry .

Don’t know if this s what your husband has, but simple remedies can be better than all the expensive potions and. Did not want to be using steroid cream over and over again.

This might be worth a try and is inexpensive.

Again, thank you for all of the information.

I did buy some calamine lotion for him a couple of weeks ago, but unfortunately it didn't help.

Don't think it can be down to low Vit D as we both take a 25mcg Vit D tablet every day and also 1000mcg sublingual methylcobalamin b12 a few times a week.

He has always moisturised his skin after showering, so really doesn't suffer with dry skin.

It will be interesting to see if the blood tests show anything.

I was just hoping that the antihistamines would do the trick.

I think they want him to eventually go back on an anti-coagulant, but there aren't many options left. The Dabigatran seemed to make it worse than the Apixaban, which is why he was switched back to that.

I thought he would be okay not taking anything as his CHAD score is only 1, but they seem to think it is necessary.

Did he try stopping the D3 and B12?

Improving the ability of the liver to detoxify may help eg try taking the supplement 'Milk thistle' (but check this first with your doctor or pharmacist, for any interactions with the drugs you take)

Try some 1% Clotrimazole cream with Cetraben after washing with soap and water. Change clothing daily

Twitchen
Twitchen in reply to Lomcevak

I get a steroid cream on prescription called Locoid, so perhaps it would be worth him giving that a try. Nothing to lose!

Had a similar problem a few months ago which was probably caused by Bisoprolol ? I went to my local pharmacy and they gave me Canesten Hydrocortisone which eases the problem. It comes back every now and again and I just apply this cream which again calmed the problem down. I am still taking Bisoprolol and Amerodian for fast and irregular heart beat. Hoping for 2nd ablation but cant see it happening any time soon as my local Hospital UHNM in Stoke is struggling with the number of Covid 19 cases they now have.

Twitchen
Twitchen in reply to Mike-tyson

Wouldn’t this be pretty much the same as the Locoid cream though, only weaker?

Don’t think it could be the D3 or B12 supplements as we have been using these for years. He has never had any reaction/side effect from a drug before and this whole itching thing has only started since he was admitted to hospital, diagnosed with AF and put on these particular drugs, so it has to have been caused by one of them. It is all very strange that it took about 4-5 weeks for this to kick in; perhaps it just builds up in your body.

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