I was wondering why I was put on 40mg pantoprazole after I was started on apixaban. Apparently pantoprazole inhibits the absorption of magnesium among other things. Magnesium Apparently is one of the markers for a fib which I now have. I used my health tracker to look back. It was taking sleep readings up to the time I was put on pantoprazole but after that it just gave me basic readings. One of the reasons for this Apparently is that it can't get a consistent heartbeat reading. Has anybody had this experience and would it be safe to drop the pantoprazole? My doctor has dropped it to 20mg but no sleep readings yet. Thanks.
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TillyBoss
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Anticoagulants (thinners) like pantoprazole can increase bleeding in the upper gastrointestinal tract and therefore co-administration with a PPI like pantoprazole is sometimes started.
This is no doubt the concern of your doctor, so I do not think it would be safe to stop the pantoprazole without speaking to your doctor first to thoroughly discuss the issue.
Based on previous discussions here, someone(s) may tell you not to take PPI's, but remember they do not know your complete medical history, nor have they gone to medical school.
I'm not sure what kind of sleep readings you are talking about, but I use the Apple Watch for my Sleep readings, and they have not been affected at all by taking PPI's.
Jim
Thanks for that. I had a stroke last July. Thankfully fully recovered now. So put on apexiban and pantaprozole 40mg by stroke doc. When going over my meds with my own doctor recently he asked me had I got GERD (a gastro reflux disease) when he saw the pantoprazole and when I told him no, he reduced the pantoprozole to 20mg (he's a very careful doctor). I had stroke on 17th July and up to that I was getting indepth sleep readings, i.e rem, light sleep, deep sleep and awake most of the time. I think this was the period the a fib was creeping in. But after 17th July the watch only gave me basic sleep readings ALL of the time and the reason it gave was 'tracker couldn't get consistent heart-rate readings'. Its a Fitbit watch. So if the pantoprazole is blocking magnesium from being absorbed (according to literature) does that not mess my heart rhythm up? It seems very coincidental. Anyway I'll stick on the 20mg maybe that doesn't block too much magnesium. To make things more complicated I used to use Nexium (pantoprazole) otc on and off for years so I suspect that on the occasions the Fitbit wasn't reading properly it was because of this.
PS. nobody advised me to go off PPIs Jim I was just curious about the link. I saw some studies and apexiban apparently is the best anticoagulant for avoiding internal bleeding when compared to the rest which soothed my mind somewhat. I just don't like the idea of building up my meds. First hospital I was in they put me on apexiban and pantoprazole. Then during rehab stage they increased my dosage of statins. Then in another hospital they put Bisop down on the list. It goes on and on.
I think you meant "go on " not "go off"?
Again, it's a risk/ reward thing and one size does not fit all. If you take a look at the literature, you will see that thinners still have an increased chance of upper GI bleeds. That doesn't mean everyone should take them, it's really case by case, and in the end should be a shared decision between you and your doctor.
Jim
Hi
I did read that certain meds can give you abnormal levels towards toxicity.
I was given some constipation meds. My potassium is just under 5 which is the 'keep an eye on level'. I checked with my usual but Locum Dr who said "NO".
Because there is Magnesium in the medication.
I take Colofac instead only when necessary. But up to 6 weeks after surgery and G.Anaesthetic.
cheri JOY
Also Statins can take you down a road towards becoming Diabetic.
I am on the same meds but apixaban is for stroke protection and pantoprazole is for GERD. Bisoprolol controls the heart rate. I take a magnesium malate supplement also.
I am curious why you are on pantoprazole and your GP may take you off it.
Pls consult your GP to review your concerns and let him/her know you want to be on minimum meds.
I'm not sure why I'm on pantoprazole. I presumed it was for the apixaban as that can cause bleeding (in the upper digestive tract I think) in rare cases according to leaflet. I used to take Nexium (20mg pantoprazole) for a nervous stomach but I had stopped that. I've a meeting with doc. in March and I'll ask him again. They seem to be loath to change prescriptions that other doctors have written. Also they seemed to be loathed to lift up the phone or send an email.
What is the mechanism by which PPIs help with bleeding in the upper gastrointestinal tract? PPIs can help with ulcers but that's because they control acid production. I take an anti coagulant but it's never been suggested to me that I take a PPI with it even though I have acid reflux.
Thanks, I will defo talk to my doctor about it: less meds to worry about. The problem is in the Irish health system the docs work in silos. So the original doc put them on prescription and then the next two in different facilities just ticked the box and on we go. Just read that the spending on Nexium in the usa was about a billlion dollars in 2012 so you can follow the money.
I was never prescribed a PPI. However, have just had a nightmare where a vertigo induced bout of sickness ended up in the emergency room. (Oesophageal tear requiring clips.)
Definitely on PPIs now, and when I resume apixaban - which I think will be a balance of risks half dose*. (With the history of stroke in my family, I can’t ignore that risk.)
Anyway, I get home tomorrow!
ETA - *was delighted to be able to resume normal apixaban dose. With PPIs high for now, then reducing next week.
Happy out
Do you have persistent AF?
it could be that you are having it at night and that’s why the fitbit doesn’t work. I can’t see why the PPI would affect the reading.
As I understand it, proton pump inhibitor ("PPI") drugs, such as pantoprazole, have been shown to prevent bleeding in the gastro-intestinal tract and are given when starting anticoagulant drugs (i.e. so-called "blood thinners") such as apixaban. The drugs are considered to be safe and useful and are widely prescribed. In a few cases, I gather, and only in the long term, they can reduce the uptake of calcium, magnesium and vitamin B12. I think the long term safety of the drugs is, though, under review. I have been taking them for many years for acid reflux and I would choose another option if there were one, but at present, there seems not to be. When a PPI drug does cause problems, it has to be stopped since it completely blocks the uptake channels in the GI tract and, in those unusual cases, taking oral magnesium has no effect.
I have never read that magnesium can be a marker for AF and would be surprised if it were. The cause of AF still isn't fully understood and it hasn't been generally linked to magnesium levels. Magnesium is, along with so many other miracle cures, widely promoted as a wonder drug on the internet, but there is no evidence of any useful effect at all, except as an effective treatment for constipation.
Steve
I started taking a magnesium supplement to help me sleep. I stopped it for a while when trying to ascertain the cause of my frequent diarrhoea. There was no difference to that but I was shocked that my average heart rate increased by about 20 bpm. I quickly started it again. Incidentally, my sleep quality decreased too, while I was off the Mg.
I guess this could have been a withdrawal reaction, but I wasn't going to stay off the Mg to find out.
Just for info I'm on edoxaban, bisoprolol, atorvastatin, amlodipine, omeprazole, calciD and prednisolone (only 1.5mg)
Just out of interest what is your dose of atorvastatin? I just take 5mg daily with no side effects. My cholesterol is 4, and lipids are fine have been for years, and was again on Friday when I had a full blood count done. When I read about people hating the drug, I wonder if they are perhaps taking too high a dose? (please note I'm not a medical doctor - just a fellow A fibber)
Atorvastatin was 10mg but increased to 20mg due to my cholesterol being 5.2 at the last reading. I've been on it for years with no apparent side effects.
My Rosuuvastatin is up to 40mg. Also take 10mg Ezetimibe: belt and braces. It runs in the family.
Hereditary raised cholesterol is common in certain ethnic groups - here in South Africa, among Afrikaans people it can be traced back to a family of early Dutch settlers.
Well I'm irish so in the ballpark
If that were me, I'd try it again to check for coincidence as that kind of dramatic effect - if sustained - seems unlikely to be caused by magnesium. Even a strong beta blocker such as bisoprolol has a relatively modest effect.
Steve
I had to get my dose of bisoprolol reduced at my request as it made me feel too sluggish. I was on 2.5mg, now on 1.25.
Hi, I just want to throw in my own experience here - nothing to do with meds, but the function of trackers. I use the iwatch, and some of the data I used to get on the Sleepwatch App is now in the 'premium' ie payable section (but not the basic data of hours slept, type of sleep, interruptions etc, admittedly). More significantly, my watch is a few years old now, and its charge capacity is reduced, also I use it far more, so it needs charging after only a few hours. I keep forgetting to charge it in the evenings specifically for sleep monitoring, and end up most nights not wearing it, or it's dead during the night. So, I've gotten out of the habit of checking the app, and looking back, I haven't had any recordings for about 4 months now, even for the nights I would have been wearing it charged. Trying to reboot to find the missing nights' data, I went into all my settings, and read that I needed to wear it more consistently, otherwise it stopped recording altogether, also because I hadn't been bothering to enter my sleep hours manually either. If you neglect that, it starts to stop producing any data. Bear in mind that the apps have limited available notifications, so yours about not being able to get a consistent reading may be a generic notification relating to your tracker operation/app. On Apple you'd get no reading at all on the sleep app if you wear your watch too slack on your wrist, but it would just tell you 'no sleep tracked', not 'your strap us too loose'. Try rebooting your App, your tracker, your sleep App, check all your individual settings are set to 'on', reboot your phone, check its settings, check you are using the most up to date versions of your phone, the fitbit app and the sleep app if it's separate. See if you can borrow for a night or two someone else's tracker you know is working consistently, and see what your results are with that, and if it happens with their equipment. That way you'll know that it's not a tech issue/faulty tracker, and can be more in confident in deducing it's a meds issue. Just a thought.
I have had the same issue with my Fitbit. Consistent wearing, keeping it charged, and make sure its tight enough on your wrist. Occasionally mine loses its functions and I have to uninstall then reinstall the app to get it working again.
They are all good points. It's a fitbit 5, fairly new, and is usually good. I will try all that you mentioned.
I’m an 80 yr old woman living in the US and this is my first post here. I had a Fitbit watch which identified my AFiB back in July. It stopped giving me the full sleep breakdown the same night and this continued for the duration of the episode. On 7/31 a Zio monitor was applied and it confirmed AFiB/flutter until 8/6 at which time I converted to sinus rhythm spontaneously. My Fitbit resumed recording sleep stages at that time. I purchased an IWatch shortly after diagnosis. I started on Xarelto and metoprolol and had about 3 months of sinus rhythm before AFiB returned in mid November. A cardioversion that month lasted about a week and I’ve been in AFiB since. In the process of deciding on antiarrhythmic med. Kind of long story there which I’ll post later. Also on ablation wait list. Only symptom is increased breathlessness, but my left ventricular ejection fraction action is mildly reduced as compared to earlier measure.
I have no idea why pantoprazole is prescribed along with anticoagulants. It seems counter productive unless you have a SEVERE GI problem. I only know that PPIs like pantoprazole have been linked to AFib due to the deficiency that PPIs can cause for magnesium, calcium and B vitamins. I am convinced my AFib was caused by 40 mg pantoprazole given to me for gastritis and GERD for 6 months. So then I was dealing with AFib and trying to wean off of pantoprazole which took almost a year because the acid reflux would return with such a vengeance. I would be asking your doctor WHY the pantoprazole has been prescribed for you.
Top of my list on my next visit or sooner if I get an appointment with on doc
Hi I have been reading your questions & some of the replies.I just thought I would state my situation which relates to a few of the points.As regards Fitbit having used them for many years as an excercise aid I now feel the brand is rubbish.I do still wear one as it syncs with my slimming app and my Huawei doesn't.
I have took Ppis for 15 years after stents & clobidogrel with aspirin.I suffer with GERD and have an hiatus hernia.I had considered stopping them but every time I have a chest x-ray I get comments like you can certainly tell you have a hiatus hernia or you have a very large hernia.
I take edoxaban.Dont think it causes any problems after 7 years.
I take Magnesium supplement .I do have night cramps but my main reason for taking was the AF.
I asked the Arrythmia nurse re taking it.
He said he couldn't recommend one way or another but
they have been known to give large doses intravenously.
I hope some of this helps.
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