Imbruvica plus alcohol or amitryptiline yields... - CLL Support

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Imbruvica plus alcohol or amitryptiline yields Afib?

profrich
profrich
23 Replies

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?

23 Replies
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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?

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profrich
profrich
in reply to Lola69

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

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Lola69
Lola69
in reply to profrich

How long did it last?

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profrich
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.

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Lola69
Lola69
in reply to profrich

Have you tried changing the brand of alcohol?

Was it beer? Wine?

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profrich
profrich
in reply to Lola69

whiskey with sweet vermouth.

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Lola69
Lola69
in reply to profrich

Hard liquor

What did the doctor say?

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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!*

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profrich
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

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TimHB
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.

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profrich
profrich
in reply to TimHB

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

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TimHB
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.

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profrich
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?

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profrich
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?

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TimHB
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.

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profrich
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.

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profrich
profrich
in reply to TimHB

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

Thanks,

Rich

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TimHB
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.

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profrich
profrich
in reply to TimHB

Thanks for the information.

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Jm954
Jm954Administrator

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

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profrich
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.

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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.

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Newdawn
NewdawnAdministrator

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

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