DRUGS

[Afibtastic]

Good afternoon.

I take 50mg Flecainide morning and night. 1.25mg Bisoprolol mornings. 4mg Candesartan mornings and 20mg Xeralto at night.

Heart rate is usually on the low side of normal even without Bisoprolol.

Two years ago when I started these drugs the recommended dose of Bisoprolol was 5mg and the Candesartan I think was 20mg (not quite sure).

Being on this dose for just over two years I thought I would try 8mg Candesartan as my system should be used to it.

After three doses I have gone back to the bad reactions I was having two years ago.

I normally walk one hour to one and a half hours per day. Today barely made twenty minutes and really struggled with a very gentle incline. Had to get back to the car.

If I double the Bisoprolol it has the same effect. Before these drugs I was taking a calcium channel blocker. Same thing when I doubled the dose.

Cardiologist told me to take 100mg Flecainide doses but that makes my beat faster and harder.

I think I have a drug problem but not the usual type of problem.

I used to get drunk faster than other blokes my size.

I know a lot of members can have Bisoprolol problems.

Has anybody on here had similar issues? Just taking that little extra dose.

cheers Steve

[Afibtastic]

It was a compromise to be on the lower dose. Didn't offer any other meds. Said these were the best for me. I didn't want to have an ablation so told nothing more can be done so it's a bit difficult to make appointments to change medication. I was trying the higher dose to see if I could cope. My BP is around 135 or so. I was hoping I could drop it into the 120s.

[Ilovedogs12 in reply to Afibtastic]

Why are you taking different doses?Being told nothing more can be done doesn't mean your GP has washed their hands. You should be able to make an appointment with your GP even if it's two or three weeks away, but if you ring the surgery and tell the receptionist your problem they will help.

Alternatively you could paste the bulk of your post into an email and send it to your doctor and they will get in touch although it may not be the same day. You can ring the surgery to get the email address.

[Afibtastic in reply to Ilovedogs12]

I don't have a GP as such. I usually go to local medical centre. GPs don't want to mess with what the cardiologist has advised so I have to make cardiologist appointment. I am doing OK on the lower dose but wanted to see if I still react the same as I did at the start of these meds. I was just asking others if they have similar reactions. The cardiologist seemed surprised that I was reacting this way. That was early in my adventure and hadn't read how many people do have different reactions to various drugs complicated

[Ilovedogs12 in reply to Afibtastic]

Ah right, I understand.

My GP usually asks the cardiologist for advice and will only alter my medication on the cardiologist instructions.

Last time though I emailed the cardiologist myself with details of how I was feeling and he wrote to me to tell me my medication needed to change.

You could do that. The phone number for the secretaries is at the top of a letter from cardiology and they will give you the email address.

He also sent a copy of the letter to my GP, but as you don't have one you could take your letter into the walk in centre and get the prescription.

Do you get your prescriptions from the walk in centre?

[Afibtastic]

Been thinking about changing

[opal11uk]

You mess with your drugs at your peril! I did, I thought I knew best but it turns out I did not....reduced Bisoporal by half, the same with Disopyramide, I'd lost almost 5 stone, I didnt need such a heavy drug regime..........I ended up going from P/A/F to permanent and in heart failure, really did my self a favour. So, now I do as I am told in the hopes that I live a long and happy albeit drugged life, it took the cardio team several months to sort me out lol and I can no longer do the things I enjoyed, table tennis, keep fit to music, long walks etc. so, as I say, mess at your peril.

[secondtry]

Suggest you get a second opinion from another cardiologist and ask about increasing the Flecainide to 200mgs/day & try without the BB or CB; this is not a common approach and your physiology has to fit but it worked fine for me for many years. However I did couple the drugs with a magnesium compound and COq10 supplements as well as numerous other lifestyle changes.

[Afibtastic]

Originally this was about asking if anybody had similar reactions to me with drug dosing. I guess I worded it incorrectly. I know I shouldn't mess with the drugs but I was only increasing the dose to less than I was originally prescribed. Because of my reactions we eventually settled on the minimum dose. Cardiologist told me to try 100mg Flec x 2daily but it didn't go well. I do larger dose in the morning and smaller in the evening. Thanks for all the replies

[pusillanimous in reply to Afibtastic]

My personal belief , and I stress personal, is when doctors prescribe medication it is trial and error, there is a set formula i.e. PAV, Beta Blocker (usually Biso either 2.5mg or 1.25mg. and an anti coagulant) and it seems to me that in the UK it is not easy to go back and forth to your GP to have changes made, hence the temptation to tinker yourself (I live in South Africa and could go to my GP every day without a problem as long as I pay my share of the consultation)Given that doctors have a relatively short period of their training devoted to pharmacology (perfectly understandable as their field is so huge), I often feel that the doctors should restrict themselves to a diagnosis, and the prescribing for the condition (each patient should have a book issued on their first visit to a doctor, in which each subsequent visit and diagnosis is recorded) left to a pharmacist, who has spent 3 years studying pharmacology, I've got a bag full of half finished drugs that did not suit me, and I have no idea how to dispose of them.

[Vonnegut]

Why take Bisoprolol if your heart rate is “on the low side”? It is known to reduce heart rate and I had to stop taking the lowest dose of 1.25 mg daily after only 3 day! Flecainide deals with the irregularity pretty well for me most of the time!

[Afibtastic in reply to Vonnegut]

49 when in NSR. Usually 10 to 15 higher in afib. Resting numbers

[Leechg]

Hi, I only know about the Bisoprolol. Consultant said I could take up to 10mg a day if I have a fast AF event. It keeps you firing on only three cylinders as we used to say. My daily dose is 2.5mg and that stops me going up steep hills. Good luck.

[Tapanac]

like others on here I’m a bit confused as to why you’re experimenting with your pills

As you most probably know bisoprolol is a rate control drug and flecainide is a rhythm control.

If your heart rate is slightly below normal and you are on 1.25 bisoprolol why try a larger dose which would slow your heart rate and you’re BP even more?? That definitely would make you feel awful

Recommended blood pressure (if you are a young fit person) I am told by my EP would be 120/70 but often when older it varies but then the medics ideally wouldn’t want it to go above 145/80 ish

Heart rate is acceptable anything between 60-90 or 100

I was approx 45 heart rate and felt ok but when it dropped to under 40 snd during the night was once 24 I couldn’t do anything. Felt ill. Now have a pacemaker snd steady 70 but I’m still on 1.25 bisoprolol snd 50 x 2 flecainide. As I’m now in permanent afib I was told I could come off flecainide which I did for a month but felt worse so back on it now plus of course my apixaban and low dose diuretic

Do please do not self medicate it could do you more harm than good. See a cardiologist

All the best

[Garaidh]

Hi Steve

I see no problem with you "listening to your body" and being a little varied with your Flec and Bisoprolol doses, within the max limits set by the cardiologist / EP.

I absolutely got the all clear and indeed encouragement to do this.

I don't take the other two drugs (no doubt I'll be on a blood thinner one day though!).

I'm similar to you in regard to being sensitive to drugs, and indeed most stimulating things from stress and excitement to the wrong food. Very frustrating but there's no alternative! Also in that I have a very low resting pulse, regardless of meds.

I feel the Flec and Bisoprolol are very active drugs and (speaking for myself) I have a baseline dose (and, importantly, schedule reminder on my mobile) - but check my stressors and risks. That's as low as 75mg + 1.25 in 24hrs. But if my heart is sensitised, or going through an unstable phase, or I'm under pressure, I'll take more. As I will if I get a breakthrough episode.

So with these meds I take a responsive approach and that's fine.

And I feel best / most active after a while on the lower dose of Flec and Bisoprolol. A higher dose (and I mean under 5mg) of Bisoprolol leaves me absolutely dragging - but it stops a higher Flec dose causing issues.

I feel that the blood thinner and pressure pills you mention are perhaps a bit more like statins in that it's low as possible effective background steady dose that works best...?

I live in Edinburgh and my doc (can see her anytime needed) will email my cardiologist / EP any questions there & then and I'll get an answer very fast.

Just as a footnote, I also take an anti anxiety med called Loprazolam. It's marvellous. Short acting and has helped me avoid or get through many a crisis!

Best wishes

Garry

[Afibtastic in reply to Garaidh]

Thanks Garry. I wonder sometimes if I do get anxious. I am in Straya. I am old and when I go surfing I do feel a bit anxious. Beaches are full of younger fitter folks I struggle with jumping up to stand up and lack of paddle strength trying to compete against the young folks. I can have afib later in the evening after a day surfing. Anxiety might be an issue I have not looked at. Cheers

[Vonnegut]

I hope your pacemaker is fitted correctly so that it works properly and is beneficial.

[Been]

Why have you increased your bisoprolol? 1.25 to 8mg is a huge leap and it's bound to slow you down a lot. If your BP and HR are stable on 1.25 I would leave well alone. Or at least increase a little at a time.

[Afibtastic in reply to Been]

No it was Candesartan. 4mg to 8mg. 3 days only and have gone back to 4. See how I feel in a couple of days