Diltiazem and Metoprolol

[Debjimmay]

I am on 180mg of Diltiazem once a day and my doctor just added 25mg of Metoprolol once a day to help with my increasing arrhythmias and Afib. My Afib and arrhythmias are worse now. Just wondering if anyone is taking this combination of drugs and if so are you having any issues taking the two together?

[FraserB]

It could be a number of things, but one of them is that both these meds work to lower your heart rate, and possibly the heart rate may be slowed too much , which may trigger arrhythmias in some. Is your heart rate going too low? I would mention this to your doctor who knows more about your medical history and possibly why.

[Izzle]

I take both these meds for a fast HR. I'm in persistent AF and when exercising I can keep my -HR within a 70-80% of my age related max rate (at 80yo this equates to 99-113 bpm).

My doses are 120mg Diltiazem (morning) and 95mg Metoprolol (taken as half dose after evening meal and the other half at bedtime.

My pharmasist says Met.... is best taken before sleeping. If I takethe full dose at other times of the day, I generally will feel very sleepy within an hour or so.

My BP tends to be about 110-120 over 70-75.

The Diltiazem can have the side effect of giving the face a red hue.

Hope that helps.

[JOY2THEWORLD49 in reply to Izzle]

Hi

Heck lots alot of doses.

BBs like Metapolol and Bisoprolol with my rapid only brought H/Rate to 186 with pauses 2 secs x ? at night and 156 without pauses separately.

Come in CCB Diltiazem 180mg down to 51 but 120mg down to 60s rising later but with 2.5mg Bisoprolol at night.

As my H/Rate drops to 47avg bpm at Night I take Diltiazem 120mg CD early morning and BB Bisoprolol 2.5mg at Night.

Later last year my BP went low so decreased and stopped Bisoprolol.

Stopping it my H/Rate day moved up to 80s Day. Same at Night.

BP rose 145/69 Day.

Not sure whether to take 180 Diltiazem CD or add back 1.25mg Bisopolol.

No Metopolol for me. In 2008 it was doubled from 49.75 I WAS ALMOST RUSHED TO HOSPITAL. I couldn't breath normally.

cheri JOY. 76. (NZ)

[FibChick]

The combo of Diltiazem and Metoprolol did not work for me, prescribed post- PF ablation for AFIB. No AFIB after ablation but intermittent Tachycardia and PVCS were bad. I cycled through 9 different drugs ( not counting the various combos of them.) Finally Acebutolol and flecainide seem to work the best. Talk to your doctor about other options. 🙂 I have found that when I am up and about more and out of my low resting rate in the 50's I also seem to do better now.

[Debjimmay in reply to FibChick]

You sound like me. I’ve tried so many different drugs and combination of drugs without much luck. I’m probably driving my cardiologist crazy! I know I’m going to have to get an ablation. I’m just trying to do everything I can to see if there is something that will help me before I have it done. I’m 73 and I hate waiting because I’ve heard the longer you wait to have the ablation the harder it is to treat Afib.

[FibChick]

I will be 70 this month, my ablation was in September 2024. So far 🤞 the AFIB was quieted, but PVCs surfaced. I have an appointment later in the month to decide on a second ablation for the PVCs, which I am leaning toward doing as these meds help but still symptomatic. Hoping for the best for you!

[JOY2THEWORLD49]

Hi

NZ Heart Foundation Nurse said.

Take CCB Diltiazem early morning.

Take BB - Bisoprolol is better for AFers. Was on Metoprolol which did not control my rapid AF. 186bpm and changed to bisoprolol 156bpm both during day levels. My normal night is 47bpm.

Metoprolol made me breathless and couldn't exert sweating profusely. But also 2 sec pauses at night.

Along came private specialist who introduced CCB Diltiazem 180 CD mg but reduced to 120 CD mg. In 2 hours and on 5mg BB Bisoprolol the 156 went down to 51 IN 2 HOURS. Yes 51.

So be careful. BB was for control of BP. Although it does a little reduction of H/Rate too.

Diltiazem is a perfect anti-arrrhymnic SAFE med.

See how you go. 12 hours apart GUIDANCE.

cheri JOY. 76. (NZ)