A question about diltiazem.

[Rubyray]

It is 4 am here in the US. I went into AFIB about 3am. Pulse ranges from 60 bpm to 126bpm. I took 50 mg flecainide at 3 am. Cardiologist said to take that if my heart rate was over 100 bpm. I take 120 mg of diltiazem every morning at 8 am. Do you know if 120 mg is as much as you should take in a day?

[TracyAdmin Partner]

Good Morning Rubyray, it is important to take medical advice if considering changing any medication dosage. Take care

[Rubyray in reply to TracyAdmin]

Thanks Tracy

[Bertiedette]

I take 300mgs but I am in permanent AF. So not the same as you. Just to let you know that higher dosages do get prescribed.

[Rubyray in reply to Bertiedette]

Thanks Bertiedette.

[Kmm96]

120 mg is the smallest dose

[Rubyray in reply to Kmm96]

Thanks Kmm96

[Bambi65 in reply to Kmm96]

no, its not the lowest. I take 30mg as a PIP. (pill in the pocket) I usually dont take it unless my HR is over 140 and lasting over 2 hrs.

[Kmm96 in reply to Bambi65]

Sorry. I meant the lowest of the 24 hour slow release dose.

[Bambi65 in reply to Kmm96]

AHHHHH. yep, that would make a difference for sure

[Jancam1 in reply to Kmm96]

I take 60 in the ,24 hour slow release

[Kmm96 in reply to Jancam1]

Interesting, I’ve never seen a 60mg 24 hour slow release capsule. I’ve seen a 60 mg quick release white tablet. Thanks!

[Rubyray in reply to Bambi65]

Thank you, Bambi65. That was very helpful.

[Kmm96]

One thing to check. Your Apple watch heart monitor won’t always read your pulse right in AFIB as you you have two different beats going on. However, if you use the EKG on the Apple Watch it will tell you the correct rate. Example: my watch showed 71BPM on the heart app, but when I used EKG app it measured my rate at 160BPM, which is the top part of heart heart beating very fast. When I have that type of rate I take a fast release metoprolol or Diltiazam on top of my morning slow release dose. Maybe something to ask your doctor about as mine wants my heart rate under 110 while I’m in AFIB, hence the small dose fast release metoprolol. Hope this makes sense.

[Rubyray in reply to Kmm96]

Thank you. I didn't know about any of that information.

[Kmm96 in reply to Rubyray]

Doctor can also prescribe a rhythm control med such as Flecinide to take as pill in pocket if your episodes are infrequent, daily dosage if frequent. This med reduces the chaotic electrical signals and converts you, but doesn’t control heart rate or blood pressure. Doesn’t work for me, but it does for a lot of people. It’s been around for a long time with many studies about its safeness and effectiveness. Once you start it, the Dr has you get an EKG a week or two later to ensure it didn’t cause a some type of weird or new arythmia.

[Bambi65]

I take 30 mg. as a PIP. pill in a pocket. Only take them if my HR is over 140 and has lasted over 2 hrs or I dont feel its gonna go back down anytime soon.

[Singwell]

I take 50mg X 2 Flecainide for rhythm control and 200mg slow release Diltiazem once a day for rate control and BP. You'll have to contact your medics because sodium.channel blockers (Flecainide) and calcium channel blockers (Diltiazem) are not really to be messed with. Something you might find helpful is to go into the internet and read about how these drugs work. I find this helps me although it doesn't make the AF better. Hope you're now back in sinus rhythm.

[Rubyray in reply to Singwell]

I am back in sinus rhythm. Thank you. I appreciate the responses I am receiving.

[KMRobbo]

I used to take 200mg diltiazem slow release daily.HOWEVER, as a question for your cardiologist (I am not medically trained) why are you only on 50mg of Flecainide if its a PIP? Post ablation I was advised PIP for AFIB was 200Mg but DO NOT exceed 300mg In a day. ( I never used such a level as a PIP as I never had to but before my ablation I did take ( in a& e) 200 mg in two 100 mg doses in 12 hours in addition to The 50Mg maintenance dose I had already taken in order to cardiovert me.

[Rubyray in reply to KMRobbo]

Thank you.

[SuziElley]

Definitely seek medical advice before changing any medication. You are on a low dose of diltiazem but still seek advice first

[Rubyray in reply to SuziElley]

Thanks for the advise.

[Slidingdoors99]

Hi Ruby. You should phone your doctor to check, but I take 180mg twice a day!!😳😳

[Rubyray in reply to Slidingdoors99]

Does that keep your AFIB in check?

[Slidingdoors99 in reply to Rubyray]

Not really Ruby!😘 It does calm my heart down though! It was the amiodarone that has eventually got me back into sinus rhythm. Had to come off it though... bad side effects...😳😳

[Cookie24]

I take 240 mg SR once a day.

[Chrissy7]

I was taking 120 mg slow release once a day same as you but I felt awful on it and had bad joint pain etc.Do I asked my doctor I could wean off starting last Friday one week ago… I only have PAF so it comes and goes… But has been coming more frequently before I started the 120 mg per day. Before that I had 30 mg fast acting as a PIP

Immediately when I cut back to 30 mg twice per day I felt much better because the side effects from medication lessened.

I was Also starting to feel depressed and I did blame that on medication but I’m not sure if it’s correct.

My doctor said it’s to try to get off the medication because I had asked to but at 2 I do feel some breakthrough what I think is flutter or Afib

I just feel sick feeling all over and not sure if it’s even afib sincebi can’t catch it on my watch-

But this is about you - sorry- !

I agree with everyone here that you should not double up on those 120 mg pills - if you had a 30 mg fast acting to take with it that’s what my doctor suggested to do if I felt symptoms coming back. Your fictitious may have another suggestion however ....

[Respondicus]

Hi Rubyray, bearing in mind you are supposed to listen to your cardiologist, Im on 240mg a day of diltiazem and a minimum of 200mg of flecainide day day. To see off my Afib I usually need to take a further 200mg in one dose...that usually shifts it but my cardiologist has ok'd only 100mg as pill in pocket, Ive just had a letter through today to say I need both a pacemaker and ablation, cant wait, ive been suffering Afib for a while now and at worst it takes me off my feet totally so I cannot even walk, I would suggest as others have said seek medical advice first, flecainide is a powerful drug as is diltiazem (which I think can be taken up to 360mg max dose daily) ive spoken to some people that have been prescribed 450mg of flecainide which is 50mg above the maximum dose...stay safe

[Rubyray in reply to Respondicus]

Thanks for that information. I have a pacemaker for 2 years that appears to work well. I have never had ablation.

[Respondicus in reply to Rubyray]

It never ceases to amaze me how varied the symptoms can be even at an individual level, Ive had cold sweat, dizzyness, nausea, palipitation, tight chest, unable to breathe and so on and sometimes just one or two of the symptoms, or all at the same time..I had no idea what was going on, I spoke to my brother and he recognised the sypmtoms straight away, I went to see the Dr..he said I was just stressed, even though I told him my heart was running irregularly, he kept arguing over it and in the end tested it the a fingerpulse monitor, then stesthscope, then fingers on my wrist...finally stating...Oh you have an irregular heartbeat..I went back to him and he did the same again saying it was just stress and refusing to listen only to find out when he tested me that I did have an irregular heartbeat, I dont asee him anymore...hes a clown as far as Im concerned..(that was a general practitioner) it took 6 months of me then ignoring it to get an actual diagnosis by the time I did I was in a bad way, it can be extremely frustrating until you start getting the right care from the right Dr's, keep getting on to your cardiologist, once they get the balance right im sure you will feel a lot better, at least I know I did, it is a difficult job for them to get the right balance of chemicals into you and of course there can be reactions that are unwanted too...I had to come off bisoprolol because it made me a whole lot worse..diltiazem was a better drug for me...good to hear your pacemaker has made a positive difference, I cant wait to get mine x

[cuore in reply to Respondicus]

I am saddened to read cases like yours where the GP is so ill-informed about AF, yet does not refer to an EP with the bottom result of lack of treatment causing the AF to get worse. It is hoped that the current graduating family doctors will be trained to refer their patients in a timely manner. I have also been a victim of a general practitioner that inadequately treated me. One can only spread the word to get early treatment because in this day and age it is available.

[KevJenn]

I take 180 mg a day extended release. No issues.