Any advice on how to deal with nausea

[Nickybhf]

Hi everyone,

I’ve joined this forum as my mum was diagnosed with atrial fibrillation in May this year. She has been given Bisoprolol , Apixaban and water tablets. Since taking these medications, she has hardly any appetite and feels nauseous everyday. Has anyone else experienced this side effect?

Also, we cannot work out which of these tablets is causing the nausea. I’ve spoken to a few doctors, some say it’s the Bisoprolol, others say it’s the Apixaban. She’s now been given anti sickness tablets too and still feels nauseous most of the time.

Any advice would be helpful.

Thank you

[Hidden]

Hello

I can only imagine how your Mum must feel side effects are not great but having nausea all the time must be horrible to try and cope with

I know someone that had nausea such a lot and they did suffer , they thought also the tablets they were on were causing it and after long time the cause was anxiety

I am not sure if your Mum is an anxious person ?

When you are on a few meds it can be hard to work out what is causing what

I think the only thing your Mum can do is whichever the Doctors feel could be causing the nausea ask for an alternative and see one by one if changing the combination of meds makes a difference

I am sorry I cannot be of much help and maybe someone will come along with some better ideas but I think that is what I would ask my Doctor if we could do

Let us know how she gets on x

[Nickybhf in reply to Hidden]

Thank you so much for your reply, myMum isn’t really an anxious person but before being diagnosed with AF, she was given anxiety tablets, but after diagnosis, we found she didn’t need the anxiety tablets as it was the rapid heartbeat from AF that was making her feel anxious. The doctor has said they’ll do a CT scan to see what’s going on in her tummy. I just hope the nausea settles as she’s not even eating 1 meal a day- and she’s diabetic!

[Hidden in reply to Nickybhf]

Hello

They need to find what is causing it when she has had that scan and doubtful there will be anything wrong they need to look at the meds

If you are really worried though before them phone them back and let them know just how bad it is and how much this is a worry

If you could just get some toast or something in her little and often it would be better than nothing

I really hope this gets sorted soon I am sure it will x

[Nickybhf in reply to Hidden]

Thank you, to be honest we’ve tried everything, like toast etc. I’ve bought the weetabix breakfast drinks and she’s sometimes has bits of that throughout the day. I did get in touch with consultant, he was unavailable so I left a voicemail. Didn’t get a response though. I think I’ll have to keep trying.

We have the scan tomorrow so hopefully they can rule out any other problems.

[Hidden in reply to Nickybhf]

Hello

Thank goodness the scan is tomorrow and hopefully they can rule anything else out so they will have to look at the meds then

They usually will get back to your voicemail messages you leave but can sometimes take a week even longer with some but I would keep leaving one every week till someone got back to me as this needs sorting

Let me know how the scan goes x

[Nickybhf in reply to Hidden]

Thank you so much for your support, will get back to you about scan ❤️

[Hidden in reply to Nickybhf]

x

[Heyjude31 in reply to Nickybhf]

Hi Nickybhf, I had a 4 x bypass nearly a year ago and really struggled with all the meds. Each medication I was on had a side effect of nausea. I also have a very sensitive digestive system so that doesn’t help. One of the meds I was on was bisoprolol, so I was taken off that. I am not on the other meds you mentioned. After six months, losing a lot of weight it was put down to anxiety, I have been on meds for that and thankfully am a lot better. I still get bad days but thankfully I am now eating more. I am also diabetic so you are right, we cannot afford not to eat. I lost over 2 stone in weight, I needed to lose weight but not in that way. I really hope you get the right help for your mum and take good care, I am thinking of you. Judi

[Pollypuss in reply to Nickybhf]

Well that is something if she has a scan. I hope it means they can identify what is going on . Really wish she will find a resolution and have no more discomfort

[Silvertail]

Maybe ginger would help with the nausea. I find ginger ale very good if I have reflux indigestion.

[Nickybhf in reply to Silvertail]

Thank you. I’ve tried ginger, even bought some ginger sweets from Holland & Barrett that are especially for nausea, still got nauseous after trying them.

[Silvertail in reply to Nickybhf]

That’s a shame. I hope you can find an answer soon.

[Norfolk_spaniel]

Hello. I do feel for your Mum, I'm in just the same position. I'm unable to take quite a lot of medication because of the nausea. My guess is that it's the Bisoprolol which is causing it. I have been into AF three times in the last 18 months. The only medication I can tolerate is the blood thinners. Flecainide and beta blockers cause nausea and vomiting. My cardiologist now recognises this.

[Nickybhf in reply to Norfolk_spaniel]

Have they said they could offer an alternative to bisoprolol?

[Norfolk_spaniel in reply to Nickybhf]

Tried several medications including calcium channel blockers(verapamil). They all gave me nausea. Cardiologist has said just stick with the Edoxaban (blood thinner) as I'm obviously very sensitive to medication. My Mum died from a reaction to arthritis drugs and my twin sister died from chemotherapy poisoning so I'm really careful to stop a drug as soon as I know that it doesn't agree with me.

[richard_jw]

Firstly I'm not a doctor. That said, Bisoprolol is a beta blocker, it slows the heart by reducing the uptake of adrenalin/noradrenalin by the heart in particular. So it's often prescribed in preference to other BBs. One side effect can be nausea.Apixaban is an anti coagulant.

There are alternatives in both cases. I take rivaroxaban and bisoprolol and have no problems with nausea.

Because bisoprolol affects the heart in particular, it may be better to change the anticoagulan (apixaban) t first to see if it helps. Talk to your doctor, or even a good pharmacist. The pharmacist may not be able to prescribe, but may point you in the right direction.

[Nickybhf in reply to richard_jw]

Thanks, I have spoken to our GP and asked if the Apixaban can be changed, they gave Doxiban first, after one dose mum was sick immediately so they changed it to Apixaban. I will speak to our pharmacist as he’s pretty good with advice etc.

[Hidden]

I take a similar cocktail after a bout of AF in 2017. Perhaps it the time of day she takes them? I used to take the Biso in the morning, but as it is a beta blocker, I felt worn out doing anything. I now take it at bedtime and have no issues. Likewise the blood thinner. The diuretic is best taken in the morning, or she will end up getting up in the night to visit the loo! The main ting is the problem has been diagnosed, and is being managed, it is common too, make sure she is getting enough of the minerals to help prevent it- potassium, magnesium, chloride, sodium. Look up good sources of these, -dried apricots, for potassium etc. it's easy to not get the right tiny amounts to keep the balance right.

[Nickybhf in reply to Hidden]

Thanks, I think that’s not a bad idea to try the bisoprolol at night, the Apixaban she has to take twice a day. The GP has prescribed a meal replacement drink as she’s struggling to eat, but she’s not too keen on them. Dried apricots seem a good idea, mum actually likes them!

[Pollypuss]

Hi. Really sorry about your mother. Firstly you should not be the one who should be worried about which drug is making her feel so awful. After my bypass I went through hell and lost nearly a stone in weight. I had shocking diarrhea and sickness and had to take anti sickness pills and medication for diarrhea . They took me back into hospital and made tests on the medication I was taking and decided it was Statins. They even isolated me because they thought I had Norovirus. at one stage. It was only at my 6 week post op with the cardiologist I started to live again. I cannot reveal why because your mother ‘s condition is different to mine and she may need different treatment .You shouldn’t be fobbed off with assumptions as to which drug is causing the problem . She should be tested properly. I hate the thought of anyone feeling like I did and going through it. The bypass itself was not nearly as bad as what I went through after.

[Nickybhf in reply to Pollypuss]

Thanks for your reply, gosh, you’ve been through a lot, hope your doing okay now. Your right, they do need to find out which medication is causing the side effects, I’ve been told that mum needs these tablets for her condition, I understand that but surely they should do a follow up to see how she’s getting on. We were seen in May by cardiology, then nothing! I’ve asked our GP to get in touch with consultant so that we can hopefully get an appointment and raise all of our concerns.

[Engineer46]

I take Bisoprolol and Apixaban for AF. I recently stopped taking the Apixaban when I had a bleed in my retina as it is an anticoagulant and could make the eye condition worse. My GP agreed with my action as my risk of stroke is low. We will review the matter when my eye has been treated.

Ask your GP if your mother is in a low risk stroke category and, if she is, tell the GP that you would like to stop the Apixaban for a few weeks to see if that is causing the nausea.

Assuming that the CT scan shows no other cause of the problem, then rather than adding an anti-nausea tablet to the cocktail I’d try stopping the Apixaban first, then if that doesn’t work, try a different beta blocker or alternative heart rate control drug.

As always, consult your GP before changing your drug regime but don’t be afraid to ask why each specific drug is being prescribed and what risks it is meant to protect against.

Hope the scan goes well.

Paul

[Nickybhf in reply to Engineer46]

Thanks, I did ask our GP about trying this, she said only if the consultant agrees, they haven’t got back in touch with her yet. She said in the meantime, take anti-sickness tablets which don’t seem to stop the nausea.

[Engineer46]

Have you tried working out your mother’s stroke risk? GPs use this calculator:

mdcalc.com/calc/801/cha2ds2...

Mine is 2.2% per year (I’m a 76 year old male with no other risk factors) and my GP was OK with a pause in the Apixaban.

If your mother’s risk is similarly low, perhaps you could speak to your GP again armed with the risk figure.

I hope that you get some answers soon.

Paul

[Nickybhf in reply to Engineer46]

I never realised they could check a percentage for stroke risk, thank you. Will question GP next time I speak to them, I did ask if mum could take aspirin but was told these blood thinners are a lot stronger than aspirin.

[qp3usavk]

So sorry for your mum in this situation. I have suffered with nausea, on and off, most of my life, and it was eventually linked to IBS and then a hiatal hernia. I was diagnosed with AF in2020 and had a successful cardioversion soon after. But I was put on 10 mgs of Bisoprolol and now, 2 years later, my dose has been halved and I feel so much better. Less nauseous, more energy and the weight gain has dropped. So don't know which drug could be causing it, but it needs to be eliminated, once it is identified. Noone should feel like that as there are always alternatives.

[Nickybhf in reply to qp3usavk]

Thanks, that’s good your feeling better, I honestly hope the doctor figures out what’s causing the nausea.