What to do?

[ElizabethBee]

I recently had the strength of my Adizem meditation increased from 120mg to 180mg daily as my BP was increasingly higher than usual. This medication was prescribed to control my blood pressure and help my heart rhythm. I have noticed I have mild swelling round my ankles and slight puffiness of my feet at the end of the day since the dosage was increased. I am also constipated and require medication to control this which I buy from the pharmacy. My weight is increasing slowly too which I am putting down to a culmination of both water retention and constipation. I also take Edoxaban 60mg daily. The increase in weight and constipation are a nuisance but I am unsure whether I need to see my GP or put up with the situation. I see numerous post with a variety of medications that work for other people and wonder if there may be something better suited for me that hasn’t been tried so far. As a post script. I have tried a Beta Blocker (Bisoprolol) which made me lethargic and constantly looking for a bathroom nearby as I suffered with IBS symptoms which, after about 3 months of not taking Bisoprolol disappeared. What would you do in my position? I have not spoken to a cardiologist for 9 months after first being diagnosed with AF.

[BobD Volunteer]

Adizem is a calcium channel blocker and many people find they can't take this family of drugs for that very reason. I was put on amlodopine (a CCB)but had to come off if I wanted to wear shoes! Speak to your doctor as there are always other treatments.

[Buffafly]

That’s the dose I take and those are pretty usual side effects for a higher dose. When my BP went up (temporarily as it turned out) my GP prescribed a separate BP med which gave me a very annoying cough then changed to Candesartan which was OK for a while until my BP dropped for some reason and I began having dizziness, headaches, blurred vision, confusion, loss of appetite - nearly collapsed in the shower…. The advantage was that I could reduce the BP med while keeping an eye on my BP with my GP’s consent. If you haven’t got a good quality BP machine I would get one because you might find it’s not as bad as your doctor thinks. As for constipation etc it’s better to adjust your diet if you can. I have a rest with my feet up for at least half an hour every afternoon if I can - at 79 I think I’m entitled - and that helps with the swelling. Anyway, to sum up, I’d stick with the devil you know but be prepared for some problems if you don’t ❤️‍🩹

[ElizabethBee in reply to Buffafly]

Thank you Buffafly. That’s why I’m umming and arring about visiting my GP. If I start messing with changes to my meds, I don’t know how that will go because I note there are side effects to all types of medication. These side effects I have at the moment are manageable - for now. I read the messages and comments and think everyone else is managing quite nicely without any side effects (obviously not). Wish there was a magic wand to wave 🐝

[BenHall1]

Hiya,

Just a couple of suggestions you may wish to consider. 1) Based on my experience GP's are the least likely profession I would turn to regard Pharmaceutical issues. I wonder if your surgery has a resident Pharmacist you could get a consultation with .... this profession seems to be more and more of an addition to Surgeries these days when GP's are to busy to bother with face to face consultations. If your surgery doesn't have a Pharmacist then a major Pharmacy ( like Boots ) may be able to offer you a consultation and advice. They also have a better skill set with medications/drugs etc. The 2 ) ..... which will get you a different take on matters of the gut ( you mention IBS ) is a Nutritionist..... again they have a much more meaningful skill set than a GP - they have a real world understanding of the gut, how drugs affect the gut and even how foods affect the gut too.

I find post CoVid GP practices are worthless.

[ElizabethBee in reply to BenHall1]

Ben thank you for responding. I must admit to thinking a pharmacist might know the answer. I may speak to my usual one when I next pick up my meds. 🐝

[mav7]

I have not spoken to a cardiologist for 9 months after first being diagnosed with AF

Is it difficult for the GP to refer you to a cardiologist or EP ? Or can you contact by telecon ?

There are other medications to control blood pressure, e.g., lisinopril to perhaps reduce your dosage of Adizem.

Do confer with your GP about a referral and choices for a different medication to insure your afib and BP are controlled with minimum side effects.

[ElizabethBee in reply to mav7]

Thank you Mav7 for your reply. It all comes back to getting advice. Thank you 🐝

[Maglynne007]

Hi, I take 200mg Adziem SR along with 8mg Perindopril and until about 3 weeks ago 90mg Adziem in the evening but upon seeing my cardiologist about 3 weeks ago he advised me to stop taking the 90mg as he said the dosage was way too high. 3 weeks on I suspect my BP has increased again as I’m experiencing muzzy headaches again. I have a 24hr holter monitor appointment at the beginning of April so am lasting it out until then. Yes I’ve gained weight slowly over the months, yes my ankles and feet swell a bit too. I have tried a low dose of bisoporol (2.5 I think) but it made me very lethargic, my heart rate dropped to mid 40s during the day and 30s whilst asleep and I felt like I was wearing lead shoes. I know this is not helpful but just sharing my similar experience with you. Hope everything goes well for you.

[ElizabethBee in reply to Maglynne007]

Oh Maglynne I feel your pain. I envy those whose meds are doing the job 100%. I have tried so many BP tabs and have had side effects from swelling, coughing, dizziness which I cannot tolerate. I felt a lot better without the medication although I had a high BP count. I do wish you all the luck in the world with your BP and hope it’s controlled soon. 🐝

[Cat04]

I was changed to diltiazem (Tildiem 300) when I became intolerant to beta blockers. I too suffer from constipation as a side effect and my GP prescribes lactulose and senna tablets to deal with this. Saves buying them yourself and also lets the GP know that it is causing a problem rather than just dealing it yourself, especially if you have previously had IBS.I also get mildly swollen ankles later in the day but not excessively.

Also taking apixaban, candersartan, omeprazole, diogoxin and atorvastatin.

Unfortunately 9 months is not an unusual wait to see a cardiologist, I've just waited 14 months for a telephone appointment with my cardiologist/EP, who now has put me on the list for an echocardiogram and a 5 day Holter monitor - another 3 month wait!

[ElizabethBee in reply to Cat04]

Good luck on your journey Cat. Thanks for taking the time to reply. 🐝

[Adiepie]

welcome to my world! My Adizem dose went up to 360, but that gave me tremors, so now down to 200. Flecainide 2x50 for stability and bisoprolol for pill in the pocket - taking it continuously zombified me! Constipation is an issue, but manageable by diet. Major advice would be to talk to your consultant!!

[ElizabethBee in reply to Adiepie]

Thank you Adiepie. 360mg seems an awful big dose! Best wishes for the future 🐝