Diltiazem purpose???

[kizzie105]

Hi everyone, hope someone out there can answer my question. I don’t have AFib but I notice a lot of AFib sufferers take Diltiazem. I’ve been prescribed it to use alongside bisoprolol to help me wean off it as I’m struggling. Not sure how it will help as I don’t have high blood pressure, and from what I’ve read it doesn’t keep heart rate down ( or does it? ) and today I can’t get off the sofa for palpitations and apparently Diltiazem can cause palpitations. Really reluctant to take another med so can any one enlighten me please. Many thanks

[BobD Volunteer]

Obviouis question is why are you on bisoprolol, if you do not have high blood pressure , AF or other arrhythmia?

Diltiazem is a calcium channel blocker , another way to lower blood pressure for some people. Some of us can't take calcum channel blockers as we suffer swollen ankles and feet. Amlodopine (another calcium channel blockers) did it for me!

[Elephantlydia in reply to BobD]

If a doctor is treating Afib ,as you are aware he will use mainly a beta- blocker for rate control and if the side effects affect the quality of life of the patient,he will probably change to diltiazem or verapamil,depending on the patient as an alternative rate control .The use of Amlodopine or other dihydroprinidine calcium channel blockers such as nifedipine are not used for rate control in Afib.Amlodopine which is a dihydroprinidine calcium channel tends to be used for angina and hypertension.

[BobD Volunteer in reply to Elephantlydia]

Sorry not sure what your point it. I never said I was on amlodopine for AF. It was a general comment regarding the effects of these drugs.

[sleeksheep]

I take Diltiazem , it was prescribed by my Cardiologist to lower the heart rate.

Thats all I take plus Xeralto for AFIB.

Dont know where your seeing that it doesnt lower heart rate as Dr Google has this as one of its important functions.

[kizzie105 in reply to sleeksheep]

Hi, BobD and Sleeksheep, I was diagnosed 18 months ago with left bundle branch block and short runs of non sustained VT.had echocardiogram and angiogram and all fine. Given bidoprolol as precaution. All fine til April when started to feel unwell, weakness generally. GP decided that as I was on low dose he would take me off it to see if that was causing problems. Had horrible withdrawal symptoms. High HR and BP, shakes, sweats, anxiety etc so old dose reinstated but I never stabilised. It’s a long story but now have to wean off. Latest 24 hour tape also shows occasional ventricular ectopics. One of the worst withdrawal symptoms is high heart rate so if the Diltiazem will help with that and the ectopics then great but everything I’ve read points to mainly lowering BP and one side effect is arrhythmia! So confused, thanks so much for your reply, sorry long post

[Ppiman in reply to kizzie105]

I have broadly similar to you. I thought these drugs (B and Ca blockers) reduced the rate and only had a small effect on blood pressure. I think for patients with LBBB the cardiologist will be looking to the future and try to prevent cardiomyopathies developing by "protecting" the heart muscle. In my case, I've been told to start on losartan for this purpose, even though my BP is normal.

Steve

[beach_bum in reply to sleeksheep]

Ditto... Diltiazem and Xeralto here. Spec sheet clearly says to control HR and BP.

[Elephantlydia]

I understand you do not have AF or other arrhythmia?If you do not have high blood pressure and you are coming off the beta blocker to go onto diltiazem ,I would assume you have angina.Is that so ? If the answer is yes,then diltiazem is an excellent choice if you cannot tolerate a beta blocker.

[Singwell]

I'm on it together with an antiarrhythmic, Flecainide. As others have said Diltiazem is a calcium channel blocker and considered a rate controller as well as helping to keep the BP low by widening the arteries. I'm really surprised you're on both the BB and the Diltiazem at the same time, whatever the rationale. They're both rate controllers and I'm not surprised you feel bad. Obviously this s is a lay person's point of view but personally, with what I know about my own drug regime I'd be questioning the logic of this approach. Here's my experience:I

used the be on bisoprolol and an Ace Inhibitor for the BP. I inadvertently switched to the Diltiazem whilst still taking the bisoprolol because I was waiting for my Flecainide to arrive at the pharmacist. I had no idea what I was doing! This was right at the beginning of the pandemic and I couldn't get any advice. I felt awful for days and never understood why till I read about how these drugs work and what they're for. As soon as the Flecainide arrived and I came off the bisoprolol I started to feel better. Long response - hope it helps. Don't be afraid to question things if you don't feel right.

[kizzie105 in reply to Singwell]

Hi, thanks for your reply. LEft bundle branch block is a form of arrhythmia I also have some ventricular ectopics, trying to come off bisoprolol. Haven’t yet started the diltiazem, too worried! Cardiologist seems to think I’ll find weaning off biso easier if I take something else to help heart rate and rhythm. I’m dubious

[Singwell in reply to kizzie105]

Well I can see the logic in that case. Your situation different from mine with the heart issues. Ask for some handholding during the process? Don't make the switch at a weekend for instance.

[kizzie105 in reply to Singwell]

Hi Singwell, was just re reading your post. Can you tell me please what dose biso and diltiazem you were taking together for that period of time so I can compare to what I will be taking. Many thanks .K

[Singwell in reply to kizzie105]

Yes. 2.5mg bisoprolol a day - morning dose. And I'd always taken my BP meds in the evening because ace inhibitors typically make you cough (as a voice trainer I didn't want that), so when I switched to Diltiazem I took that with my evening meal. Dose is 200mg slow release.

[kizzie105 in reply to Singwell]

You took those doses together for a short time? I’m on 1.25 biso and cardiologist wants me to take 120 diltiazem as well

[Singwell in reply to kizzie105]

Yes I did. About 5-6 days I think. I did not feel good have to say. BUT could've been coincidence as I suspect I had an asymptotic dose of COVID around that time. Hard to remember because I got very stressed and anxious - March 2020 - but I've thought about it since - that I took two rate lowerers together and if that might be dangerous.

[kizzie105 in reply to Singwell]

Thank you so much, that’s how I feel about it too. Glad you’re all sorted now x

[SuziElley]

I’m on Diltiazem to lower my heart rate as I have atrial tachycardia and can’t tolerate beta blockers. The two main side effects I’ve had from Diltiazem are shortness of breath and fluid retention. I’m now on very low dose of Diltiazem and a diuretic (as and when I need it) for the fluid retention. Today is the first day for a long time I can see my ankles! But yes, Diltiazem should lower your heart rate. Often taken with Flecainide to help with arrhythmia, which I also take. Hope this helps

[kizzie105 in reply to SuziElley]

Thanks all!!

[Moonriver in reply to SuziElley]

I was interested to see your experience of diltiazem. I take 200 mg slow release but find it makes me wheeze and breathless. I have been on it for a while but feel my symptoms have worsened. I wondered what dose you were on now.

[SuziElley in reply to Moonriver]

I started on 240mg slow release, then gradually lowered the dose, with doctor’s advice, and now take 60mg slow release. Still get breathless but apparently that might be caused by the blood clot I had on my lung. Talk to your doctor about it. The fluid retention is much better than it was but I do take a diuretic when needed.

[Moonriver in reply to Moonriver]

Thanks for your reply. I wondered how you coped with the breathlessness. I find I get shallow breathing for some hours. It is disconcerting. Do you find it lowers your mood? I wish you better.

[Ducky2003]

I have been put on Diltiazem at a low dose to keep my heart rate in check. I had oedema and breathlessness prior to being put back on Diltiazem so had the fluid offloaded first. I now take a diuretic with it as well as Apixaban and Amiodarone.

[HiloHairy in reply to Ducky2003]

Those of you who say that you're on Diltiazem at a low dose, how low a dose are you taking and are you taking the time release? I ask because after being unable to tolerate beta blockers I've been put on the time release Dilt 120 mg recently and found it to be just too much for me. At least in the US the time release is made up of discs, each 60 mg. I've started to take them apart and easily and accurately take 60 mg per day and feel quite a bit less bad than taking the full 120.

[Ducky2003 in reply to HiloHairy]

I take 60mg twice daily so 120mg total. We only have the modified release tablets in the UK...... apparently there is an instant action liquid version but it costs about £350 for a 28 day supply so would probably be a hospital administered thing. I have been on the maximum dose a few years ago for a few months but I had an ablation in April and this smaller dose seems to be doing the job at the moment.

[sleeksheep]

I take Diltiazem 240mg SR ( slow release ) without any problems.

I would also check what brand your taking as I will only accept Vasocardol CD made by Winthrop Labs.

I had a bad reaction with a BP medication when changing brands and after requesting the previous brand had no further problems. Sometimes its the composition of the ingredients that creates the side effect.

[kizzie105 in reply to sleeksheep]

Thanks, I’ve read that about diltiazem