Flecainide and Diltiazam

[Debjimmay]

Is anyone taking these two medication‘s together? When I did some research on taking these two medications together it looks like it can cause several side effects that can be dangerous.

[Buffafly]

Most people taking Flecainide take it with either bisoprolol or diltiazem or some other medication in the same categories. Taking Flecainide on its own can be dangerous. I wonder where you got that information from?

[Debjimmay in reply to Buffafly]

I got this information from my Drugs.com app. Here is what it says….

Flecainide interacts with Diltiazem Hydrochloride XR (diltiazem).

Using dilTIAZem together with flecainide can increase the effects of either medication. This can cause dizziness, weakness, chest pain, shortness of breath, fainting, an unusually fast or slow heartbeat, coma, slurred speech, and confusion. You may need a dose adjustment or need your blood pressure checked more often if you take both medications.

[Buffafly in reply to Debjimmay]

I had a bet with myself it was drugs.com, it always comes up with a worst case scenario. That might happen on high doses of both which I doubt applies to you.

[Debjimmay in reply to Buffafly]

I have heard this complaint more than once about the drug.com website. I have to learn to be a little less serious about everything I read. Thanks I appreciate your response.

[mjames1]

Yes, I have. It's a very common combination. But because of their properties, they should be monitored carefully, preferably by an ep.

Jim

[TracyAdmin Partner]

Have you visited the AF Association US resources tab, whereby you will find information regarding both medications: heartrhythmalliance.org/afa...

For the most accurate information regarding medications on a personal basis, please discuss with your doctor.

Kind regards

Tracy Admin

[Debjimmay in reply to TracyAdmin]

Hi Tracy. No I was not aware of the website you are referring to, but I will definitely check it out. Thank you so much.

[Ppiman]

I have been told that flecainide is potentially dangerous and needs either a beta-blocker or similar (such as dlitiazem) to reduce the rare chance of its "pro-arrhythmic"ventricular effects from occurring. Balancing the two is likely difficult at times and may be what the Drugs.com website is referring to.

Steve

[Murphy10]

I have been taking Flec and Dilitiazem for over a year and no issues. I am on a low dose of Flec 50mg a day and 180mg Dilitiazem. I had an abalation 3 months ago and now reducing and aiming to be medication free by July this year. There is a lot of warnings with Flec. but it has been around for a long time and just about every medication has risk but best to discuss with your doctor.

[Debjimmay in reply to Murphy10]

Hi Murphy10. I have been taking 180 mg of Diltiazam once a day for few years and I take it at night because my blood pressure is very high in the morning. I’m getting ready to start Flecainide and I wanted to ask you if you take both Flec and Diltiazam at the same time or do you wait and take them at separate times? Thanks

[Murphy10 in reply to Debjimmay]

Hi,

I take them both together. That was what my Cardiologist required. Perhaps also check with your cardiologist.

[lizzieloo2]

Hi. I was on Diltiazem 300mg daily plus 100mg Flecainide as a PIP. After my ablation last August, my EP took me off both and said he would decide what BP medicine I would need at the 3 month review. However, I went into AF the day after the ablation so he put me back on Diltiazem only and said he doesn't want me to go back on Flecainide. I took both medications for about 5 years without any problems before

[Debjimmay in reply to lizzieloo2]

Hi Lizzieloo2. Thank you for sharing your medication info with me. I read a lot about ablations on here and it seems that sometimes the ablation doesn’t do much to help? I’ve never had an ablation and I’m concerned that if they can’t get my heart to return to normal rhythm after trying the Flecainide I will need an ablation. I’m terrified to have anything like that done but my irregular heart rate is causing me constant anxiety and worry.

[lizzieloo2 in reply to Debjimmay]

I was diagnosed with PAF about 10-11 years ago and I was offered an ablation straight away. However, the thought of it terrified me so I steered clear for years but eventually decided to go for it when my AF episodes became more frequent. To begin with, they occurred every 9 months or a year once I was put on 300mg Diltiazem but they gradually occurred more often until about 2 years ago, I was having an episode once a week. I was very scared to have the ablation after reading all the bumpf they sent me but as AF is a progressive disease, I decided it was better to have the procedure while I was still relatively fit (I am 69 at the moment) rather than wait until I was older and maybe not as fit. Also, I was told that ablation has a better chance of success whilst the AF is paroxysmal rather than when it becomes permanent. Since the ablation last August, I have had 3 or 4 AF episodes but they are few and far between and only last a couple of hours and then I'm back in sinus rhythm without having to take the Flecainide. So all in all, I'm glad I took the plunge. The procedure was done under GA and the EP and anaesthetist were great, letting me ask all sorts of questions. They and the nurses were so reassuring and attentive, I wondered why I had left it so long.

[Debjimmay in reply to lizzieloo2]

We sound so very much alike! I have had two different EP doctors, and they both wanted me to go on Flec, but because I was terrified after reading all the side effects I still haven’t started taking it. Also, when I asked my EP doctor what the side effects were for Flec he said do you really want to know? I said yes. He then said it could kill me. I can’t believe he said that to me knowing what an anxious person I am. So right now I have a 10% burden of Afib going on. Along with that I am constantly out of NSR which causes me severe anxiety. I don’t think I have any choice but to try the Flec and see if it helps. If not, If not then I may have to consider the ablation. Thank you for explaining your experience with the ablation. This surely helps to make me feel better about it. 😊

[lizzieloo2 in reply to Debjimmay]

Yes we do sound alike. I too was worried about taking Flecainide to begin with and put it off for years but eventually decided to take it. Luckily I had no ill effects but I was loathe to take a second dose of 100mg if the AF didn't resolve within an hour. I did take two on one occasion, again without any ill effects, but it took so long to work that I called an ambulance but cancelled it before it arrived as I then went back into NSR. I used to be able to stop an episode by moving about vigorously or sometimes by drinking a cup of tea but if that didn't work, I took the Flecainide and was in AF for about 4-5 hours sometimes before it took effect. So eventually I started taking Flecainide as soon as I knew I was in AF so it worked sooner but my EP didn't like me taking it (he was my second EP) and told me it could kill me as well! After that, I decided that ablation was the best course of action. Some people are taking it on a daily basis rather than as a PIP so try it and see if it helps you. If you do decide on an ablation, it really isn't anywhere as bad as you imagine and everyone on here will be there for you. Good luck with whatever you decide and keep in touch. Liz

[Debjimmay in reply to lizzieloo2]

Liz, thank you so much for your kind words and sharing your story. It helps to know there are other people that have the same fears and uncertainties that you do and then to learn how they handle those fears and uncertainties and what worked for them. I have pulsitile tinnitus so I hear every beat of my heart so I know every time it’s not beating right. I can easily tell without hearing it in my ear because I always feel the flutter. It’s interesting that you say how if you move vigorously it would stop. I noticed that if I go from a sitting position and then get up and walk around, it will stop also, but only for about a minute or a few seconds. I’m going to take my first dose of Flecainide today. Figuring out what time to take. It is the hardest part because I have to take it twice a day or every 12 hours. I take other medication so I’m afraid to mix it with anything else unless I absolutely have to. I will let you know how it goes. Again, thank you so much for being there. It helps me to not feel so alone. The cardiologist and EP, at least mine, are not very compassionate or understanding sometimes. I always come to this blog for help when I’m having serious issues and there is always someone here ready to help. I’m very appreciative of that.

[lizzieloo2 in reply to Debjimmay]

Glad to share - it really helps talking to other people with similar problems. Everyone is so different so it's even more helpful when you hear from someone with similar symptoms and feelings. Some people don't even know when they're in AF but, like you, I can feel in my chest, throat and stomach directly there is a change in my heartbeat but my AF always happens at night and wakes me up. Take care and let me know how you go on. Liz

[JOY2THEWORLD49]

Hi

I wouldn't.

I take CCB Diltiazem 120mg AM. and BB Bisoprolol 2.5mg PM and was told to separate them.

Flex,,,, is an anti-arrhymic med (it has risks) and Diltiazem acts like an anti-arrhymic med as well as reducing (dramatically) heart rate.

cheri JOY. 75. (NZ)

[JOY2THEWORLD49]

Hi

I took your question as asking "do you take them together?.

I read Diltiazem and Bisoprolol - a CCB and a BB should not be taken together but a Heart Specialist introduced CCB because two BBs one at a time were not bringing down my H/Rate 185 and 156.

Diltiazem brought it down to 51 (180mg) in 2 hours. That was spooky.

Then the NZ Heart foundation nurse said.. reduce Diltiazem to 120mg and reduce Bisoprolol to 2.5mg AND SEPARATE THEM.

She rung my private Heart Specialist whom she had worked under. Result - MARVELLOUS AND APPROPRIATE.

I have been on the same regime for 2.1/2 years.

What is your H/Rate?

cheri JOY