Rash From AFIB Medications

[NYCgal22]

Hi, everyone this is my first time post. I thank you all for being so informative and helpful on this site, as I have learned a great deal. I was diagnosed with paroxysmal AFIB 1 1/2 yrs. ago. Other than that I am 68 yrs. old and very healthy, no other health issues and never took any drugs before except for an very occasional antibiotic. I developed a rash on my back while on Propafenone. That was the only drug I was on for 2 months. I then started Xarelto 4 days before I went to see a dermatologist who did a biopsy and it turns out the rash is drug related. My Dr. wanted me to stay off Propafenone for 2 weeks or until the rash cleared up but my AFIB started acting up badly so I went on Flecainide. I have been on it for 3 weeks (plus Xarelto) and I still have the same rash. Has anyone had an issue with switching drugs and still having a rash. I am seeing the electrophysiolgist in less than 2 weeks and will discuss this with him. He has said I should have an ablation as he gives me an 85% chance of getting off all meds. I have been fearful of the procedure but this is making me reconsider it.

[BobD Volunteer]

Never had such a problem with either drug to be honest. Go for the ablation and see if you can come off propafanone but don't expect to stop antcoagulation ( Xarelto) as this will likely be for life now. Far better than having a stroke.

[NYCgal22 in reply to BobD]

Thanks Bob for your reply. Yes, this has made me seriously consider ablation. My CHADS score is only 2 - 1 for female (not fair!) and 1 for being over 65. Since I have never taken Xarelto alone, hopefully I will not have a reaction to it. And being that it is only once a day and such a small pill makes me feel better.

[CDreamer]

I had difficulty with drugs but in a different way so after ablation I stopped all drugs and felt SO much better.

Some people find that they are more sensitive than others to drugs so I think you are certainly not alone.

You have to weigh up what is worse - the AF or the rash. Did the rash disappear when you stopped Propafenone? You could try a different anticoagulant and just see if that makes a difference?

Treatments are given more to improve quality of life for those with very symptomatic AF so it’s always a question of weighing up the benefits against the treatment affects.

You might also look at the brands you were given because I’ve had allergic reactions with the fillers used rather than the active ingredient and some manufacturers use different fillers so worth doing a bit is sleuthing.

[NYCgal22 in reply to CDreamer]

Thanks for the info about the fillers, never thought of that before. I will look into it. No I have been off Propafenone now for 3 weeks but now on Flecainide and still have a rash.

[NYCgal22 in reply to CDreamer]

Meant to add nice to hear you are off all meds after ablation!

[Desanthony in reply to CDreamer]

Always annoys me when Docs poo poo the idea that differences in fillers can make a difference to the delivery of and side effects from a medication. My wife's hospital consultant wanted her on a specific make of a drug because it was one that he used for everyone he treats and has no problems with it - or minimal problems - this is over 35 years of research with people on this as a long term medication for up to 25 years now, whereas the medication is usually used short term as it is actually a different way of treating the condition she has - her GP grudgingly got it for her then it was hard to get it and she had to battle with the health board and go back to the hospital a few times to get it - 300 miles away. Even the specialist here refused to get it for her as he said it would make no difference. 4 years later unfortunately the company making this medication has stopped and now she is having problems on the different makes she gets and has had to cut down on the medication as the different fillers are letting too much of the medication into her system - which could be a problem. Though all the tablets have 200mg of the active ingredient in them. Anyway thankfully the hospital keep tabs on her - full blood tests twice or more times a year and she is fine and may be able to come off the medication. Previous treatment would have been a long and involved operation with a very long recovery time - probably never recovering to her usual fitness. So thankful we were able to access this treatment and it looks as if it has cured her without the operation.

[NYCgal22 in reply to Desanthony]

Sorry to hear that your wife has had so many problems getting her meds. Yes sometimes I think doctors just don't want to deal with reactions to meds, if they ignore it is less work for them and they may downplay the side affects. However, when you are the person experiencing unpleasant side affects it is a big deal to you,.

[Desanthony in reply to NYCgal22]

Absolutely

[HailMary-USA]

Hi NYC. My husband is the one with Afib and he had a prolonged drug rash several years so.

First the cardiologist stopped his Cardizem as known to be a likely cause of rash.

When the rash persisted, the cardiologist replaced his Xarelto with Eliquis, and the rash resolved.

There had also been a complication of overusing topical steroid creams which exacerbated the rash.

Best wishes to you.

Mary

[NYCgal22 in reply to HailMary-USA]

I guess some of us are just more sensitive to drugs than others, I also was prescribed a steroid cream and told to use it for 2 weeks then stop for 2 weeks then use it again. The first 2 weeks it seemed to help with the rash but when I started again after waiting 2 weeks it just aggravated it more, so I can't apply it anymore.

[Ppiman]

I think some kinds of rashes can take an age to go. You do sound like an ideal candidate for an ablation. It should succeed to keep you AF free for many years.

Keep in mind that AF is a progressive condition and that it's likely to find its way back eventually. With luck that will be years away! The first six or so months after the ablation might see it pop its head up now and again, too, so give it time if you go down that route.

The key thing to keep in mind, perhaps, is that treating the arrhythmia ("rhythm control") itself is, usually, for comfort, to stop unpleasant symptoms. Stopping the racing heart ("rate control") is more important since persistent tachycardia can, over time, weaken the heart and valves. Some people have AF with no symptoms at all, or hardly any, and live a long and good life, My friend is 88 and is a good example of that. My son's colleague is 74 and still happily teaching - he's had three ablations in his time.

Steve

[NYCgal22 in reply to Ppiman]

I actually feel well while in AFIB but my heart does beat really fast sometimes. I only have an oximeter and it bounces between 120 and 170, so hard to tell what it is. It seems some people have AFIB but their heart rate is not that high. If it wasn't for the fact that I feel my heart racing and it gives me anxiety it would not be that bad. Last episode lasted 10 hrs. and stopped when I decided to suck on a cough drop with the thought "that will make it stop" and it DID! Weird think it was just a coincidence though, if only it would be that easy. You may be right about some drug rashes taking a long time to go away. I didn't mention this but when first diagnosed put on Metroprolol and after a few weeks got a very itchy scalp and went to a dermatologist who said "these things happen after age 60." It finally went away after being off the Metroprolol for about 6 weeks or more so now wondering if that was a skin reaction also.

[Thomas45]

I was found to be allergic to beta blockers and was taken off them. Unfortunately I still get rashes 4 years later, but not as often and not as painful.I take a daily antihistamine, ceterizine hydrochloride usually at a low dose, which I increase for really bad rashes. I have also become intolerant of some appetising foods only since I took the beta blockers. I can no longer eat oranges, tomatoes, grapes or bananas without getting a rash.

[NYCgal22 in reply to Thomas45]

I have also tried a antihistamine but only for one day and do not see an improvement, maybe I should take it for a few days instead and see if it helps.

[Thomas45 in reply to NYCgal22]

Initially my doctor prescribed it and for rashes I am allowed to take 40mg a day. There's another anti-histamine which some people like, called Loratadine, but it did nothing for my rashes. Nowadays I take a maintenance dose of 10mg a day of Ceterizine, increasing it to 40mg if I get bad rashes.

I took Flecainide 150mg x 2 a day for 10 years with no side effects at all.

[HGates in reply to Thomas45]

Did you get tested to establish you were allergic to beta blockers ? I developed a rash about a month after starting Bisoprolol in 2021 & have been taking a daily antihistamine since. Still taking the Bisoprolol as it really helps me forget about AF & I didn’t really think it could cause a rash at 2.5 mg daily. Back then I did report the rash to GP over the phone (with photos sent in) & just got an instant diagnosis of idiopathic urticaria without any tests. Now makes me think I should get tested…

[Thomas45 in reply to HGates]

I saw a GP who specialised in dermatology. As the only thing that had changed in my life to affect my skin was taking Bisoprolol for 11 weeks, she was satisfied that was the cause of my rashes. I was weaned off Bisoprolol, during which time I had a very sudden exacerbation of asthma which required am ambulance and three days in hospital.Originally I took 40mg of Ceterizine a day, as suggested by the GP

About five years since then a still get an odd rash of I eat tomatoes or oranges, both of which I had no problem with before the Bisoprolol.

[HGates in reply to Thomas45]

Thanks - really interesting & so weird about the tomatoes & oranges.

[NYCgal22 in reply to HGates]

Since my post which is 2 yrs old I got an ablation. I have been Afib free for 2 yrs and am not on any meds. I did discover it was the Xarelto that was causing the rash!

[HGates in reply to NYCgal22]

I’m glad to hear you’re doing so well & sorry to have jumped into this thread 2 years late! I had no idea as hadn’t looked at the date!

[NYCgal22 in reply to HGates]

No worries..have a nice holiday!

[buddje]

I can t imagine flec causing a rash...prob something unrelated.Flecainide is what it is....some side effects.....

and weight gain but otherwise manageable.

My new bad back is more of a prob to me......never had one before but its arthiritis......

I keep in contact with my EP...have a SATs machine and blood pressure monitor and mobile phone heart rate monitor....

All good.....

Keep safe

[NYCgal22 in reply to buddje]

It's a mystery to me what exactly is causing the rash. When I went off Propafenone the Dr, wanted me to wait 2 weeks until using Flecainide but my AFIB was worse than before the going on propafenone and he said I could start the Flecainide. I thought the rash would clear up, if I would have known it would not I would have stuck it out with more episodes of AFIB before trying the new med. Maybe my skin is just in an uproar from the Propafenone and doesn't want to settle down yet.

[Jill13]

I had hives very badly for two years on xarelto. Dr didn’t think it was causing it but after six weeks off that drug my hives were gone. Now on Eliquis with no problems.

[NYCgal22 in reply to Jill13]

I am on Xarelto now but I had the rash 7 weeks before I went on it. We are all so different I had initially tried Eliquis but it upset my stomach very badly so I went off it,