Imbruvica plus alcohol or amitryptiline yields Afib?

[profrich]

After a few weeks on imbruvica, I had very bad arrhythmia attacks a few nights in a row, and had to quit. I am now switching to calquence.

I have two drinks every night. I googled and learned that alcohol can trigger Afib. So, I wonder if drinking plus imbruvica triggered the arrhythmia. I have never had a heart problem, and an echocardium and cat scan shows everything is in good shape.

I would be interested in hearing from other who continued to drink. Did you experience new onset Afib with no prior Afib?

I think the other thing that might have been a problem is the .25 mg of amitryptiline I take every evening for sleep. Some research of mine indicates amtitryptiline can trigger Afib.

Anyone using nightly amitryptiline or something similar? If so did you get new onset Afib?

[Lola69]

Hi Pro!

I drink about 2 glasses of white wine 3 times a week with my evening meal.

No A/F noted.

does it feel like a flutter?

[profrich in reply to Lola69]

Mine was actually diagnose as PVC. It was a flutter every minute or so.

[Lola69 in reply to profrich]

How long did it last?

[profrich in reply to Lola69]

An hour or so. Then it would go away for a few hours, and come back again. It only happened at night. that is why I suspect it was something I took/drank in the evening.

[Lola69 in reply to profrich]

Have you tried changing the brand of alcohol?

Was it beer? Wine?

[profrich in reply to Lola69]

whiskey with sweet vermouth.

[Lola69 in reply to profrich]

Hard liquor

What did the doctor say?

[TimHB]

My doctors always remind me that it's best NOT to drink with CLL and especially while in treatment - especially ibrutinib. But I do enjoy a cocktail most nights and wine with dinner - with their knowledge and tacit approval. When I got hit with AFib, it was after 10 days of NOT drinking, so I don't believe alcohol contributed to my particular episode. (I had pre-existing hypertension so was pre-disposed.) Since moderating my AFib with metoprolol, I've resumed my moderate drinking habits without any consequence. So far. Fingers crossed. *Cheers!*

[profrich in reply to TimHB]

Hi Tim,

My usual morning blood pressure is around 60 and it goes up to mid to high 60s in the afternoon. I took 50 mg of metoprolol last night and it was only 52 this morning and 57 in the afternoon. Did you experience a big drop in blood pressure on metoprolol?

Thanks,

Rich

[TimHB in reply to profrich]

It sounds like you mean heart rate, not blood pressure? Yes - my normal heart rate usually ran in 50's-60's. During AFib it was as high as 180 which is the verge of stroke. On metoprolole, I now run in the 40's so yes, I experienced an immediate and drastic drop after starting metoprolole.

[profrich in reply to TimHB]

Isn't a pulse that low a concern? I find I have little energy today.

[TimHB in reply to profrich]

40's are on the low side, but I'm active and fit, walk several miles a day and work out with a trainer so the docs say it's due to that and is OK. For most people 60s are normal.

[profrich in reply to TimHB]

I guess I am similar. I exercise a lot and my normal pulse is 58 to 66. Today it was 52 to 58. Is that the same drop amount you experienced?

[profrich in reply to TimHB]

I am supposed to start calquence next week. I am really apprehensive about taking a medicine similar to imbruvica after my experience. Weren't you nervous about going back on impruvica?

[TimHB in reply to profrich]

I can't be nervous about this stuff. I'm being treated by one of the best CLL teams in the world and I have full confidence in them, so nothing they ask me to do makes me nervous.

[profrich in reply to TimHB]

Wow. I wish I could be like that. I worked out for the first time since my incident today (cardiologist told me Wednesday I could work out), and I only had the nerve to bench with 105 on the smith machine (which I think is equivalent to 70 pounds). I used to go up to 175 on Smith machine even weakened by anemia.

[profrich in reply to TimHB]

How long did you wait after the incident before resuming ibrutinin?

Thanks,

Rich

[TimHB in reply to profrich]

Once I was stabilized, they had me wait 3 days before re-starting ibrutinib, and just 1 pill and ramp up slowly to the full dose of 3 pills over a week.

[profrich in reply to TimHB]

Thanks for the information.

[Jm954 Administrator]

Hi, you could be right. Did you discuss your alcohol and amitryptiline with your Dr when you reported the AF? Might be worth it if you didn't

best wishes

Jackie

[profrich in reply to Jm954]

I did now with a cardiologist. He said amitryptiline is a no, but 1 to 2 drinks is okay. My hematologist did not see amitryptiline as a problem.

[Shaheenji]

Yes, amitryptalines and all other of this groups do interact with ibrutinib,Red wine in moderate amount can be OK but about others please consult with your oncologist thanks n good luck.

[Newdawn Administrator]

My Haematologist has prescribed 30mg of amitriptyline for me and I’m on Ibrutinib & Venetoclax. It is know however that the metabolism of Amitriptyline can be decreased when combined with Ibrutinib. It’s a considered risk with clinical approval and oversight.

However, amitriptyline should never be taken with alcohol.

I think everyone on Ibrutinib should ensure they have regular cardiac/b/p checks.

Newdawn