Taking Eliquis and Metoprolol for A-fib: Concerned about side effects

Posted by damari @damari, May 25 7:27am

Just diagnosed. Doctor prescribed Eliquis and Metoprolol. I was wondering what side effects common. I read there is a rare side effect of hair thinning for metoprolol. (take 25 mg 2x day) Also read that Eliquis can sometimes cause some stomach discomfort. (5 mg 2x day) Can either medications be taken in lesser amounts?

Liked by damari, lucky1038

Hi @damari. Glad to see you back with us, especially since the two of us are A-fib victims. Your reliance on Metoprolol and Eliquis is not uncommon. The first of these and its side-effects are discussed on Mayoclinic.org. Check out https://mayocl.in/2LTLhoP as well as https://mayocl.in/3d0JLx7 for starters. Search separately there for Eliquis or its generic name apixaban with a focus on the "oral route" (as opposed to the intravenous route). On your question about lesser amounts, be advised that changing the dosages on both drugs is possible, but only in direct coordination with your specialist or primary care physician. A lot of patients cut their dosages without consultation, causing side effects that are hard to tolerate. In my case, my similar drugs are Carvedilol (25mg morning and evening) and Coumadin (5.0 and 7.5 mg on alternating days).

The side effects you mentioned are on public lists for your drugs. Can you raise your questions about them with your doctor(s) or your pharmacist before any changes are made in dosage? Martin

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I have A-fib 5 years. Eliquis is doing the trick. To me Warfarin is too much maintenance. Was on Pradaxa for a while but it is so expensive. Ask your Cardiologist.

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I have a history of A-fib, started 11 yrs ago. I joined a study group and had a Cryo Ablation in Victoria BC. first , but that dod not work, A year later I had a regular Ablation, (they burnt the triggerpoints in my heart ) and since than for 5 years no A-vib. Am on Xeralto 20 mgr a day. (Eloquist ? ) last year I had a big surgery for Cancer treatment and had an a-fib during recovery. 6 month after surgery I started Chemo. Had 7 doses and than got very sick, side effects of the chemo. Had also a STV (afib + tachycardia ) one time, they paddled me with no result than they gave me via intravenous Amiodarone and that fixed it. Now I am still on Xarelto and Metropolol 25 mgr a day have to take one half (12.5 mgr ) in the morning and the other half in the evening . I am in remission of cancer right now have regular check ups with CTScans. Have no side effects so far and feel great. Am 81 and live alone and don’t need any help so far. Am happy. Still having regular check ups, bloodwork and CT scans for a while . My heart behaves at the moment.

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I have been on both meds for 5 years, also for AFIB, no side effects at all.

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I , Margreet have had no side effects from the Metropolol and xarelto ever in the 8 years I have taken it for Afib.

Liked by lucky1038

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@thecrawf3

I have been on both meds for 5 years, also for AFIB, no side effects at all.

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Same for me. I am on Eliquis with great success.

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HI… am new to AFib and meds. Concerns and questions!?
Bradycardia noted 2014. Holtor monitors rates in 40's/ at night while asleep in 30's. Dr. "no need for pacemaker… as it would cause a scar". More concerned about scar than low heart rate. I had always had low BP. I seldom see a systolic at 100.On a stressful day 100-110. More common 70 to 90 over 40 to 60
Second opinion…followed closely, found pretty steady in 40's to low 50's so we continued monitoring. She had me increase salt and fluid intake as I had dizziness, weakness, tiredness. Did help me keep more hydrated. Keeps BP up better. Less dizziness but that never really goes away.
2017 Cardio transferred to Colorado. Started w. new cardio here in DE.
2018 started falling frequently. Saw Neuro, Cardio, ENT, ortho. No one could find cause. Sept 2018 had a TIA. Continued to be monitored. Placed on low dose bayer aspirin.
August 2019 I started telling my PCP, Cardio my heart rate was irregular. Multiple studies- echo, stress test, monitor, EKGs, sleep study. NSR, brady, occas. PVC. Irregular irregularity kept me thinking i was in AFib – going in and out. Would wake me out of dead sleep, Started putting together this may have been happening for a while and ??cause of some symptoms as listed above??
Jan 2020 back to cardio to say I wanted more help… there is something wrong. He inserted LINQ/LOOP Jan 20th. Was supposed to be advised as soon as they got a reading that could define diagnosis. WELL
March 25 .. call from cardio to say AFib. Asked when they knew. Said – with fist report in Jan!!! It was now the end of March. I expected this tool would provide timely answers & care. Cardiologist referred me to electrophysiologist. Met (telehealth) 2 days later and we discussed options. He is pro ablation but due to covid and ban on elective surgery this is delayed. Meantime electro phys doc put me on Eliquist BID and added a PILL IN A POCKET APPROACH Using one Metroprolol 25 mg and two Flecainide 150mg tabs (300mg) if I am in AFib that I don't come out of in 20-30 min.
Concerns:
He admitted my concerns for:
– side effects of these drugs are valid
– dose of drug is high….I am at home – cannot always tell when I am in Afib. Said do the best I can.
I spoke to pharmacist and he indicated concern for dosing of Flecainide as well and suggested I speak to dr again. I did so. He said follow his direction.

Also my concern that he wrote script for Flecainide at 1 tablet every 12 hours.
Now if I should take two tablets according to the PILL IN A POCKET APPROACH and have an adverse event they would say I didn't take prescription that is on my bottle. Not good for me, my insurance company.
So much to try to work through.

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What a scary story of your history. Can you get to a better cardio doc? Have you checked on line for information about your doctors?

Liked by lucky1038

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@katydid77

What a scary story of your history. Can you get to a better cardio doc? Have you checked on line for information about your doctors?

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Does anybody know how to treat peripheral artery disease? I cannot walk any more and am in a wheel chair and getting worse. The pain is constant. Think I have a cardiologist that is not to informed.

Liked by lucky1038

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@jlcswell

HI… am new to AFib and meds. Concerns and questions!?
Bradycardia noted 2014. Holtor monitors rates in 40's/ at night while asleep in 30's. Dr. "no need for pacemaker… as it would cause a scar". More concerned about scar than low heart rate. I had always had low BP. I seldom see a systolic at 100.On a stressful day 100-110. More common 70 to 90 over 40 to 60
Second opinion…followed closely, found pretty steady in 40's to low 50's so we continued monitoring. She had me increase salt and fluid intake as I had dizziness, weakness, tiredness. Did help me keep more hydrated. Keeps BP up better. Less dizziness but that never really goes away.
2017 Cardio transferred to Colorado. Started w. new cardio here in DE.
2018 started falling frequently. Saw Neuro, Cardio, ENT, ortho. No one could find cause. Sept 2018 had a TIA. Continued to be monitored. Placed on low dose bayer aspirin.
August 2019 I started telling my PCP, Cardio my heart rate was irregular. Multiple studies- echo, stress test, monitor, EKGs, sleep study. NSR, brady, occas. PVC. Irregular irregularity kept me thinking i was in AFib – going in and out. Would wake me out of dead sleep, Started putting together this may have been happening for a while and ??cause of some symptoms as listed above??
Jan 2020 back to cardio to say I wanted more help… there is something wrong. He inserted LINQ/LOOP Jan 20th. Was supposed to be advised as soon as they got a reading that could define diagnosis. WELL
March 25 .. call from cardio to say AFib. Asked when they knew. Said – with fist report in Jan!!! It was now the end of March. I expected this tool would provide timely answers & care. Cardiologist referred me to electrophysiologist. Met (telehealth) 2 days later and we discussed options. He is pro ablation but due to covid and ban on elective surgery this is delayed. Meantime electro phys doc put me on Eliquist BID and added a PILL IN A POCKET APPROACH Using one Metroprolol 25 mg and two Flecainide 150mg tabs (300mg) if I am in AFib that I don't come out of in 20-30 min.
Concerns:
He admitted my concerns for:
– side effects of these drugs are valid
– dose of drug is high….I am at home – cannot always tell when I am in Afib. Said do the best I can.
I spoke to pharmacist and he indicated concern for dosing of Flecainide as well and suggested I speak to dr again. I did so. He said follow his direction.

Also my concern that he wrote script for Flecainide at 1 tablet every 12 hours.
Now if I should take two tablets according to the PILL IN A POCKET APPROACH and have an adverse event they would say I didn't take prescription that is on my bottle. Not good for me, my insurance company.
So much to try to work through.

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Dr. "no need for pacemaker… as it would cause a scar". THAT is a red flag if I ever saw one. I'd get a second opinion fast.

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To be sure. I left that dr. the day that comment was made. I am with another provider. Actually the third provider. The one I first switched to was awesome but she left the state thus requiring a change again. So am on my third cardiologist. Thanks for caring adn responding.

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@predictable

Hi @damari. Glad to see you back with us, especially since the two of us are A-fib victims. Your reliance on Metoprolol and Eliquis is not uncommon. The first of these and its side-effects are discussed on Mayoclinic.org. Check out https://mayocl.in/2LTLhoP as well as https://mayocl.in/3d0JLx7 for starters. Search separately there for Eliquis or its generic name apixaban with a focus on the "oral route" (as opposed to the intravenous route). On your question about lesser amounts, be advised that changing the dosages on both drugs is possible, but only in direct coordination with your specialist or primary care physician. A lot of patients cut their dosages without consultation, causing side effects that are hard to tolerate. In my case, my similar drugs are Carvedilol (25mg morning and evening) and Coumadin (5.0 and 7.5 mg on alternating days).

The side effects you mentioned are on public lists for your drugs. Can you raise your questions about them with your doctor(s) or your pharmacist before any changes are made in dosage? Martin

Jump to this post

Martin – just curious why you are on Warfin? The old gold standard but high maintenance. Xarelto and Eliquis so much easier to maintain – no dietary restrictions. Both now with meds to neutralize if needed. Sure you have good reasons. Would you share your thinking ?

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@elwood

Martin – just curious why you are on Warfin? The old gold standard but high maintenance. Xarelto and Eliquis so much easier to maintain – no dietary restrictions. Both now with meds to neutralize if needed. Sure you have good reasons. Would you share your thinking ?

Jump to this post

Hi @elwood. I get your question frequently — why do I stick with Warfarin as my anticoagulant? My answer is simple and to the point. There is a readily available antidote for Warfarin, but not for most other anticoagulants. Almost all hospitals (but with a few stupid exceptions) have the Warfarin antidote (a Vitamin K solution) on hand for use when it's needed. I have two personal experiences that drive my choice of Warfarin.

Three years ago, a neighbor on Warfarin fell off a ladder in his garage. I called 911 and the EMTs came and hauled him off to a hospital emergency room a mile away. An hour later, a medical helicopter picked him up and flew him to another hospital 20 miles away. Within another hour, he was pronounced dead from a hemorhaggic stroke — an uncontrolled brain bleed. The first hospital had no Warfarin antidote on hand. It's sister hospital 10 miles away could not rush it over either. So they called for the helicopter. The second hospital administered the proper antidote, but by that time, it was too late. I sang at his funeral a week later.

Another episode just last week involved a friend with A-fib who also takes an anticoagulant, but not Warfarin. I reminded him about my neighbor's fate. He called the doctor, asked about his medication, and was told it is a lot less trouble than Warfarin — lab tests, some diet restrictions, etc. In our pandemic environment, that's a bigger problem than before, risking the coronavirus to go to a medical laboratory for a periodic blood test required to remain safe under Warfarin. Even so, he is now looking for a doctor who will include Warfarin in his range of therapies for A-fib.

I remain upset about the death of my neighbor as a result of his treatment in a hospital that had no antidote for Warfarin on hand. As a result, my first question of doctors when I was rushed to the emergency room last Fall was "Do you have an antidote for Warfarin on hand?" They did. I resolved that I'll always ask that question when under treatment at any clinic or hospital, regardless of which anticoagulant I am taking at that time. I hope this gives you some options to consider and discuss with your doctors, hospital, and EMT services. Martin

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Afib raises risk of stroke, Eliquis the latest and considered most effective in prevention. Metoprotol slows heart rate in afib, does not correct afib. Makes people feel more comfortable with lower heart rate. I take both and metoprotol seems to be lowering my blood pressure too much. Taking a little less, though very careful to lower just alittle. I think Eliquis inflames my joints including my jaw though my cardiology person says inflammation of joints is not listed. There is alot not know about meds and the med people do not admit to much. In all fairness, those med heros are overwhelmed with covid19

Liked by lucky1038

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I have been on Metoprolol for about 13 years with no detectable side affects. My daughter had major side affects on it. I just went on Eliquis a week ago (A-Fib) so I don't know how they interact. My Metoprolol morning dosage doubled at the same time I was diagnoses with A-Fib. I was losing my hair before Metoprolol so I cannot address that. Good Luck !

Liked by lucky1038

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