Diltiazem: Last Friday i| started... - Atrial Fibrillati...

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Diltiazem

Qualipop profile image
19 Replies

Last Friday i| started having a very low pulse which would suddenly rise quickly then drop again. It went down to 42 then up to 102 instantly with very erratic heart beats. I won't go into the 5 hour delay for an ambulance or the 7 hour wait in A&E but I ended up being admitted for 4 days; diagnosed with extrasystolic arrhythmia and unstable angina. ( I have never had any symptoms of angina) and on TUesday was started on diltiazem and sent home. The first day I started shaking with utter exhaustion. It could have been lack of sleep and stress from the hospital as they never g ave me my painkiller for my chronic spinal disease until an hour after it w as due or it could have been the tablet. I missed yesterday's dose as the previous one was given very late but have taken it today.

I am however concerned because it says it can c ause constipation and shouldn't be taken if you have slow transit. After being on opiates for 20 years, my stomach and bowel are now not working properly and I need daily laxatives and even they don't work well. Over the hospital stay I was unable to "go" for 5 days. I also started getting painful mouth ulcers as soon as I took the first tablet.

Can anyone please tell me how they get on with diltiazem? I'm on the lowest dose. The doctor first suggested bisopralol but I can't tolerate beta blockers. They drop my BP far too low but I can't cope with any worse constipation as a large part of my pain is caused by bowel adhesions.

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Qualipop
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19 Replies
baba profile image
baba

It dropped my heart rate and blood pressure too low, but I seem to be very sensitive to drug effects. Might suit you ok.

Qualipop profile image
Qualipop in reply to baba

I'm also very sensitive; had to be taken off beta blockers because I couldn't even get out of the chair after my heart attack and slept almost 24/7. When i got home from ho spital having had just one diltiazem I was shaking with tiredness but that could have been the results of hospital; a full day and half with no sleep and my pain being through the roof as I never got my painkiller on time.

mav7 profile image
mav7 in reply to Qualipop

Had a similar experience as baba, Quali. Sudden drop in heart rate (40's) and blood pressure. Doesn't mean dilitiazem is a bad drug, just different people, different reactions. May be it is the best drug for you.

Best to discuss with your doctor and also the constipation issues. He may prescribe medications to assist with the consitipation,

Keep in mind most all drugs require a period to adjust to any side effects. May also want to discuss with your doctor about the proper dosage for beta blockers.

Lastly, on this journey we are on have to try to maintain a positive outlook and patience. Easier said than done, I know.

Best to you in managing your health.

Qualipop profile image
Qualipop in reply to mav7

Thanks I've had treatment for the constipation and slow transit for years but it often doesn't work and the pain goes out of control. I was given the lowest dose of beta blockers after my heart attack, changed time of day I| took it, tried everything ; pushed through it for 3 months but simply couldn't function for the low BP and slept almost all da y. It was stopped; ace inhibitor tried which did the same so I was told I didn't need either and taken off them. Up to around a month ago my BP was constantly around 126/72 but has crept up into the 130s. Beta blockers just dropped it far too low.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Qualipop

Hi

For constipation.

Colofac 140mg 1 x big glass on water 1 hour before breakfast or more. You will have success. It relaxes colon and bowel.

Repeat before lunch/dinner and dinner/tea.

I guarantee success.

I need start the day with .... I am constipated always at hospital.

Not sure why even if I drink plenty of my boiled tank water from home.

Extreme I have glycerine suposotories. A nurse put them beyond the block. No way put in by me just inside the bowel.

cheri JOY. 74. (NZ)

mbhakta profile image
mbhakta

I'm taking dilitiazem for four years and it's okey with me. This medicine has almost managed my intermittent afib and flutter. My HR is 60-90 more or less NSR.

Qualipop profile image
Qualipop in reply to mbhakta

Well it's apparently not A Fib and I know this bout was called by severe stress last week. All calmed down now with pulse between 66 and 80 but I itch evrywhere. Waiting in a queue for a call back from doctor.

mav7 profile image
mav7 in reply to mbhakta

mbhakta May I ask if you were in paroxysmal or persistent afib prior to dilitiazem ? And dilitiazem permits you to remain in NSR ?

Thanks !

mbhakta profile image
mbhakta in reply to mav7

Mav7 In my case it was paroxysmal afib. Yea, I remain in nsr except sometimes, after a week or two, ectopic beats for several minutes. Now ectopic beats have become rare. I have felt no ectopic beats for four months after I'm taking Tide E 10 mg continuing dilitiazem 60 two times according to my doctor's suggestion

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to mbhakta

Hi

You will be interested in the latest ESC video- a nasal spray of CCB Calcium Channel Blocker as necessary with paro.... AF.

Unfortunately mine is persistent.

cheri JOY. 74. (NZ)

Qualipop profile image
Qualipop in reply to mav7

I wasn't diagnosed with AF. This time the diagnosis was extrasystolic arrhythmia. The dilitiazem has been stopped today. I'm allergic to it

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Qualipop

Hi

Interestingly ESC (I watched latest video) they have developed a nasal spray a CCB to take if you feel you are in tach......

Any anrythmia is an irregular heart beat isn't it???

Not sure what is happening to you qualipop.

Wouldn't be great to take a nasal spray!

Are you sure that you are 'allergic' to Diltiazem or the dose is too high for you. It reacts within 2 hours but wears off about 12 hours. Why not take it am not pm. There were 30mg as well. But NZ lowest is 120mg. Taken away 18 mths ago. Were changed to ACCORD but now back to Medsafe MYER I think.

Even a change in manufacturer can change things.

No B12 available in NZ. I had to get SOLGAR 1000ug Sublingual nuggets from Naturalius NZ to Switzerland. I'm taking 1 nugget daily until I catch up. 500-600 ideal for a 74 year old. I have B12 deficiency.

cheri JOY 74. (NZ)

Qualipop profile image
Qualipop in reply to JOY2THEWORLD49

I was on the lowest possible dose 60mg. GP has confirmed an allergy and that the ectopics are not AF. He just needs confirmation that the numerous ECGs didn't show anything else. The last and only time it happened, last October, right after my booster was also diagnosed as simple ectopics if there is such a thing

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Qualipop

Hi

Not understanding 'booster'????

COVID BOOSTER???

Then you are allery to Covid booster.

Diltiazem in 30mg, 60mg, .... 120, 180mg. ..... 360mg the most dosage in 1 day.

120mg comes in SLOW RELEASE but mine works until 12 hours which is great.

It could be too much for you.

THERE ARE OTHER CCBs.

cheri JOY

Qualipop profile image
Qualipop in reply to JOY2THEWORLD49

Sorry I'm also on another forum where you are not allowed to mention covid. Yes my 4th covid booster caused 3 weeks or extremely bad ectopics. I had a holter monitor that showed 5000 ectopics in 8 hours; both a trial and ventricular last October/NOvember. It slowed down in week 3 and by week 4 had stopped completely so I was never treated for it. It is now known that covid and the vaccine can cause it and one of the triggers is stress. NOthing since until last week which was far more stressful than usual. . I had a definite allergic reaction to diltiazem 60mg; confirmed by GP and by the B HF nurse helpline.

Qualipop profile image
Qualipop in reply to mav7

No nothing like that ever

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to mbhakta

Hi

After a year on Diltiazem 120mg my Heart Rate Day further dropped to 62-69!

At night my H/R average is 47

BB Bisoprolol for controlling BP

but I continue to have persistent AF but controlled lesser exertion symptoms.

cheri JOY. 74. (NZ)

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Diltiazem AM introduced 18 months was a godsend.

Last November still on same dose of 120mg AM my H/Rate dropped to 62-69 Day so I'll be keeping an eye on it. In NZ 120mg lowest.

CCB with me doesn't keep BP controlled so I take Bisoprolol 2.5mg at PM.

These need to be separated and Diltiazem lasts until 7pm.

But mine doesn't change like yours. Something is causing the up and down thing. Are you having pauses. Have you had an ablation that has upset your heart. Some folks after ablation need a pacemaker.

Have your Diltiazem early AM. Any BB at night. Metoprolol gave me pauses, breathless, fatigue. Losartan is in that group.

I hope you find out Qualipop

cheers JOY. 74. (NZ)

Qualipop profile image
Qualipop in reply to JOY2THEWORLD49

Only 60 mg first thing on a morning. I don't have AF. It was just called extrasystolic arrhythmia. First episode was October 10 last year immediately after my covid booster. Nothing at all since then until last week. BP usually 120s/70s but for about a month has rept into low 130s. Pulse rate has been in 80s for at least 20 years. JUst two tablets so far dropped u lse to 66. Can't cope with it any lower. Heart attack 5 years ago cause no damage at all. Physically heart is in perfect condition. I'm certain last week was triggered by extreme stress. We had at least 3 things went badly wrong plus extreme worry about my dog going in for an operation. My last one died unexpectedly when she went for an op before they even got her on the table. I'm wondering whether I could just take it if an when I got an episode because there's been absolutely nothing at all since October and I 'm itching like mad since taking them. Cardio has also said unstable angina b ut I've never ever had a single sign of angina. My GTN tablets that they give to everyone after a HA were stopped very quickly as unnecessary. The cardio had no idea of my digestive problems or the level of pain for 30 years. They also started me on clopidogrel for just two days this week before deciding I shouldn't have them. I Just feel he's jumped into prescribing too qu ickly when it may never happen again. I'd rather wait and see but nothing was explained to me and he seemed very put out when I tried to ask questions.

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