Stopping Diltiazem

Ironically, just on the way home from the cardiologist last week I went into afib which set me back a bit. When I was at my appointment it had been 6 months since my last afib episode. I have been on 120 sr diltiazem for 3 yrs now. Lately I have started having some side effects from it, such as increased PACS and dizziness. The Dr told me that I could go off of it and that it didn't keep me from going into afib anyway. (Not sure why they prescribed it to me? ) He said that I could just stop the drug without tapering it off. I have been looking online for discontinuing it and find conflicting information . Does anyone know what the withdrawal can be from this drug?

You should do at least a modest taper Amyorca,

The rebound is not as much of an issue for most folks, as it can be with some folks with stopping a Beta Blocker cold turkey, but calcium channel blocker like Diltiazem can have some rebound like side effects when stopping abrupting. Best to be kind to your body and to a gradual reduction over 5 days to a week ... no hurry. You said you had Diltiazem SR and thus I assume it is a capsule form which makes tapering a challenge. See if you can get an immediate release form of Dilitazem and preferably in a tablet that is easier to score and split to allow a finer titration downward during taper.

And was this an EP who told you that it wasn't doing you any good anyway since it did not 'prevent' your AFIB from recurring?? Neither a calcium channel blocker ( such as diltiazem or Verapamil) or a Beta Blocker (such as Metoprolol, Bystolic, Bysoprolol, Atenolol etc) will ever stop or prevent a paroxysmal AFIB from triggers, nor will it terminate and already active AFIB episode. The prime reason for using Diltiazem (or a B in AFIB treatment is as an effective rate control agent. a CB tend to work better as a rate control agent for Vagal paroxysmal afibbers, while a Beta Blocker tends to work better for Adrenergic paroxysmal afibbers.

There are exceptions to this rule of thumb, and for those who are mixed vagal and adrenergic and for full blown persistent afibbers for whom the distinction between vagal and adrenergic party much lose their practical meaning.

It is true that there is no reason at all to be on Dilitazem full time if you are (or were until the last) only having an AFIB episode one every 6 months!! That is total overkill when you should have had the drug handy to start if and when you triggered.

Let me repeat again, neither a CCB nor a BB are anti-arrhythmic drugs and will not convert you directly with a causal effect back to NSR! If you are paroxysmal you will convert to NSR and whenever you do, something the patient or doctor even, while immediately credit whatever the person happened to have been doing/taking ... or not doing/taking ... at the time when NSR is restored naturally., But these drugs are primarily useful in AFIB to keep your rate comfortable and safely under 100bpm when your or in AFIB. If you are prone to more frequent bought of AFIB or have other Cardio issues like hypertension and sometimes general anxiety disorder along with AFIB, a doc will have you take the drugs daily for constant therapy.

Whenever I hear a Doc say that: "you might as well stop a CCB or BB since it isn't stopping or preventing your AFIB, it tends to raise a bit of a red flag for me. More often a regular cardio or more likely a GP might say such a thing.

In any event, do keep the Dilitazem handy and do take one if, and when, you trigger again if you are prone to high speed AFIB or Flutter during your episodes. I think some docs just automatically prescribe these drugs with a new patient and tell then to take them daily, even if they only still have very infrequent paroxysmal episodes. My hunch in such cases, is they do so mainly to make the patient (or themselves) feel like that 'did' something for the patient and that the new client is thus now officially under their treatment.

Shannon

I talked to my pharmacist today and he told me that I can just stop the diltiazem. He said that you don't need to wean off of it. I am wondering if my afib snd PACs will increase once I stop it. What keeps me out of afib? I take daily magnesium supplements amongst other supplements. I do get PACS fairly regularly these days. Sometimes I can go months without having them. My afib episodes are usually about 6 months apart. They seem to come out of the blue. When I get one they are very intense, my heart rate goes over 200 bpm and I feel like I am going to pass out. I either end up in the ER or I deal with it at home if I can, with metropolol and or more diltiazem. I usually convert in about 12 hrs. I wish that I could predict them ahead of time so that I could be prepared for them. These boards are very helpful and have been a morale boost for me. The information here is something that I was looking for and I knew that I wouldn't get it from my Dr.

I did not take the diltiazem yesterday first the 1st time in 3 yrs. I didn't notice anything different. I have not taken it today either. So far, so good. My next goal is to get off xeralto and take aspirin instead. The cardiologist said that I would have to take Plavix for a while before completely switching over to aspirin.

amyorca, Sorry you are having these problems. Next time you see your Doctor, ask him if you can use Diltiazem as a pill in the pocket when you have those 200bpm episodes. That is what I did before my second Natale ablation. It sure is an attention getter when the HR gets that high, isn't it. I got the OK to take 120mg at one time as 60mg just didn't do much. The Diltezem got my heart down to the 120 to 130 range which I could live with, for awhile anyway.

As to getting off the blood thinner, I know of one person that quit Coumadin and had a stroke 3 weeks latter, another that refused the blood thinner and just died 3 weeks ago. Maybe it would have happened any way, but then maybe not. I know what some of the studies have shown, what the advice on this board is, and that most of us just can't wait to ditch that stuff. I am due for my second TEE and have kinda been putting it off as I am not sure what I would do if I get the OK to come off a blood thinner (eliquis for me).

Good luck making the right choice....ronH



Edited 1 time(s). Last edit at 03/03/2017 12:11AM by ron.

Do you take the 120 slow release when you are in afib? I have both 60 MG plus the 120 Sr. I also have 25 MG metropolol. Which do you think works best? The cardiologist did say I could take dilt for afib episodes, but really didn't get into the dosage info. Also with xeralto I am not sure which is scarier, taking it or not. I am 63 yrs old. What is the long term prognosis of taking it for the rest of my life?

I'm a newbie to the forum. 60-year-old male in decent health except for AFIB. Have periodic hospitalizations,all tests within normal ranges, but have needed three conversions. Just started taking Eliquis, Digoxin and Diltiazem. Can now barely stand up without keeling over. Weak and tired. It's as if I need a walker. It appears the Diltiazem is the culprit, 360mg/day. Anyone else in the same boat?

frankibis - Welcome to our group. Sorry you have developed afib.

It well could be the digoxin causing your problem. Here's a search result for past posts on that drug.
[www.afibbers.org]

And specifically, this one from 9 yrs. ago by Hans who originally wrote on that drug and side effects
[www.afibbers.org]

Hopefully, you can enlist the cooperation of the doctor who prescribed that for you and suggest that you try not using it.

Have you begun reading in the reports in the Resources section and also the past Conference Room Sessions? There is a lot of helpful information about evaluating your functional nutritional status and using supplements to help replenish critical electrolytes which may be deficient or out of balance. We are all here to help direct you to helpful resource information so let us know if you would like assistance.

Jackie

It has been 3 weeks since I stopped the diltiazem. I feel so much better! I was taking it in the morning as I take xeralto in the evening and there is a moderate interaction between the 2 drugs so I tried to space them out. Every morning I would get up and take the diltiazem. Within a short time I would get very tired and feel like I wanted to go back to bed. Not to mention that I was having trouble with the different manufacturers and the potency of the drug. I was having dizzy spells and PACS. Since going off of it my heart feels normal. I don't know why, but the diltiazem made me very aware of every heartbeat. Now my heart feels like it has sunk back into my chest and become unnoticeable. I am so happy that I made this decision. I will keep the 60mg diltiazem and metropolol on hand for when I have an afib episode.



Edited 1 time(s). Last edit at 03/20/2017 11:35PM by amyorca.

Glad you are feeling so much better, Amy.

Jackie

I also am new to this forum. I am a 69 year old male that was diagnosed with afib lat August. at that time I had a miserable experience with Metoprolol and Warfarin, weak and bad coughing. My Cardiologist Changed to Diltiazem 360 mg/day and Eliquis. 10 mg/day. The Diltiazem has controled my heart rate but, I have begun to become concerned about possible side effects. In the past eight months I have stopped drinking alcohol eliminated most sugar, have been eating a low carb ,high protein and omeaga 3 fat diet., with plenty of fresh vegetables. At my last check up, in a little over 6 months my fasting blood sugar went from under 100 to 130, my cholesterol went from under 200 to the 230's and was diagnosed with gynecomastia.(breast soreness was present for the last several months) All this while I lost about 40 pounds going from 245 to 205 my height is 6'4" . I would have thought my numbers would have been improving , instead the are going the other way. My thought at this time is that the Diltiazem is involved with these issues and is some how involved with a hormone imbalance. Has anyone else had any similar side effects?

FJG - Welcome. It's great to see you've improved lifestyle habits. Always a good move regardless.

There is always a potential for side effects when using Rx drugs. The antiarrhythmic and anticoagulants are no exception. And, it's also a fact that not everyone has the same side effects.

I've been on a full dose and now, half dose of Eliquis and I've been plagued with numerous new 'ailments' that I blame on that drug since it's the only one I take. I found a website ... Medschat.com that is an informal blog where people can report and share experiences with Rx drugs... both positive and negative. I found it to be very reassuring that I matched my complaints to many reports of the same symptoms. Unfortunately, unless you are able to stop the drug, there doesn't seem to be a remedy and I certainly don't want to take another drug to counteract the effects of the original. Catch 22.

Check here to see if your symptoms match up at this link:
[www.medschat.com]
There are several main topic's with separate links. I read through most of them and found quite a collection that matched my experiences exactly.

I attempted to discuss these with my primary care MD and she waived it off as totally hearsay and not valid information... which is exactly what I expected but thought it was worth a try.

Jackie

Jackie -Thank You for the reply and the link to medschat. I agree with you that it's a no win situation to take another drug to counter the effects of the first drug. My belief is that most Medical Doctors are OK with and trained to treat symptoms rather than work to find the root cause of the problem. I have been researching Afib and the symptoms I have experienced and at the present time my working theory is that possibly a hormone imbalance could have been the initial cause and that the durgs I am taking , probabily the diltiazem is making matters worse.

With the concern about the raised blood sugar level, I read a book by Frank Shallenberger, MD" The Type2 Diabetes Breakthrough" . Basically by using Supplements, Diet , Exercise and life style changes many symptoms can be reversed. It also points to hormone imbalance as a possible cause. I also read on the internet that a 59 year old Afib patient was cured of Afib symptoms by hormone therapy. I believe that high Cholesterol can also be a result of hormones. Gynecomastia can be a result of hormone imbalance. So with all the evidence my Cardiologist's play book tells him it's time for a nuclear stress test, I'm waiting for those results. At least my primary care MD has scheduled a testosterone test for the blood work before my next visit.

Has any one with Afib had similar symptoms or been treated for hormone imbalance?

I developed afib during a prolonged colonoscopy. Have had "full blown" continuos a fib for over two years. Taking Eliquis and Diltiazem 120 mg (30×4).
My hair has started to fall out. I cannot tolerate this problem .