Success it seems, reducing Metoprolol & Flecainide re: Tiredness

I began a topic down below asking about weaning down Metoprolol and Flecainide, basically curious (as a newbie, 1 1/2 years Afib but just "caught and named" 2 months ago when I was in the hospital for something else), I was curious about pulling back on dosing then seeing if I could continue without meds if I somehow had stably "converted" (and that didn't work out...)

BUT, GeorgeN suggested a reduction, and I actually have had success with that (but some questions for our knowledgeable community here).

"Disclaimer", as we all know, everyone's body is different and maybe some won't do well trying to lower their dosing, but frustrated at 2 months feeling in a fog and sedated, I cut my 25mg Metropolol (twice a day) and 50mg Flec (twice a day) to "cut in half pills" (so, 50% daily reduction), and That Worked For Me, I didn't slip back into Afib (as I did when I attempted earlier to see if "I had been converted").

I actually feel a lot better at the half doses, my rhythm is staying fine, and my heartrate came up from around 45 or so to maybe 67 average now, that is probably helping me feel better as well. In hindsight I should have done this more gradually than "I'm cutting this in half, today", and I re-read GeorgeN's suggestions from that earlier discussion below, and I've got a few questions: George's post;

"My suggestion would be to decrease your flec dosage gradually and see what happens. The Metoprolol is likely not keeping you in rhythm, but will mitigate the risk that flec could put you in atrial flutter. It is most likely the reason you feel tired. Once you've reduced the flec (you can do this with a pill cutter if you need to), then step the Metoprolol down. You may find there is a dose of flec you need to stay at to maintain NSR or maybe you don't".

Thanks for your help George, and re: "most likely the reason you feel tired", did you mean the Metoprolol being the main culprit on the cause of tiredness?

Working to understand the best outcome re: what you expressed above, were you expressing to step down the amount of flec, but stepping the Metoprolol down eventually to a discontinuance (if my body allows that), staying on a (reduced) amount of flec, is that what you meant?

I read on a post recently that it takes a while for Magnesium to "reach effect" or be assistful, possibly a reason I'm holding OK at the half doses is it's been a month now on Magnesium (and potassium and taurine, I've got to study a bit more on K2, Jackie posted some great detail info on that recently).

If my particular situation can tolerate it, I'd love to drop the meds even a slight bit down from "now cut in half", so any suggestions on which to reduce first etc would be greatly appreciated. I'm checking often with my finger pulse-waveform meter, so far so good...

Quote
FrankInFlorida
"My suggestion would be to decrease your flec dosage gradually and see what happens. The Metoprolol is likely not keeping you in rhythm, but will mitigate the risk that flec could put you in atrial flutter. It is most likely the reason you feel tired. Once you've reduced the flec (you can do this with a pill cutter if you need to), then step the Metoprolol down. You may find there is a dose of flec you need to stay at to maintain NSR or maybe you don't".

Thanks for your help George, and re: "most likely the reason you feel tired", did you mean the Metoprolol being the main culprit on the cause of tiredness?

Working to understand the best outcome re: what you expressed above, were you expressing to step down the amount of flec, but stepping the Metoprolol down eventually to a discontinuance (if my body allows that), staying on a (reduced) amount of flec, is that what you meant?

I read on a post recently that it takes a while for Magnesium to "reach effect" or be assistful, possibly a reason I'm holding OK at the half doses is it's been a month now on Magnesium (and potassium and taurine, I've got to study a bit more on K2, Jackie posted some great detail info on that recently).

If my particular situation can tolerate it, I'd love to drop the meds even a slight bit down from "now cut in half", so any suggestions on which to reduce first etc would be greatly appreciated. I'm checking often with my finger pulse-waveform meter, so far so good...

My point is that flec does have a flutter risk associated with it. To the extent you can reduce the flec (I think - I'm NOT a doc), you likely reduce your flutter risk and can, with more confidence you aren't taking a flutter risk, reduce your Metoprolol dose.

My experience is that magnesium (or more recently lack thereof) has a very immediate impact. Not taking mag is almost a certain recipe for an afib episode within the next 24 hours for me. In addition to my high daily mag intake, if I go out of rhythm, I take a bunch extra mag and potassium with my PIP flec. Had an experience where I had done this in addition to 300 mg flec. The episode had converted to a possible flutter at 122 BPM, but likely that mixed with afib. It was lasting much longer than a usual PIP flec conversion (for me). At around 5.5 hours, I took another 2 grams of mag (total 1.7 mag before since start of episode), 2 grams of potassium (I'd already taken 2) and 4 grams taurine. After about 15 minutes, I put my legs and knees on the bed and I converted to a 90 BPM rhythm that Kardia labeled "unclassified." The rate continued to declined till, about 40 minutes later, I got one that was labeled "normal" at 79 BPM.

I am being conservative in my response. The month I took flec daily six years ago, I took it without a beta blocker without issue. I'm willing to take risks I know about, after weighing the consequences. I'm hesitant to recommend others do the same.



Edited 1 time(s). Last edit at 05/13/2018 07:02PM by GeorgeN.

Thanks for the info and the sharing of experience George - I think finally having a bit over a month on a good amount of Magnesium has helped me / has allowed me to get away with reducing my Metoprolol and Flecainide (as described above). And I'm taking D-ribose, eye of newt etc.

And I think you said this perfectly; "I'm willing to take risks I know about, after weighing the consequences. I'm hesitant to recommend others do the same".

Sharing that same hesitation, as well I'm glad (for me, we're all different) I'm glad I took the risk of reducing dosages, it's made a very big difference in how foggy and drugged up / tired I feel. I'm doing much better, checking my heartrate and "pattern waveform" on my meter often, so far kissing the ground no relapses. And yeah I know, "Afib isn't famous for being stable or friendly".

I really appreciate the help and knowledge of the community here, I wish we had a thank-you button!

I had nothing but problems with Metoprolol. I consider that stuff deadly. It made the incidences of Afib more intense and quite draining. My heart felt like it was going to explode through my chest. It wasn't until I began using d-ribose that the intensity of the Afib calmed down. Now, when an episode of Afib occurs I have to check that it is happening. I still think there is something better than what is available now. They all seem to have drawbacks of some sort.



Edited 1 time(s). Last edit at 06/01/2018 12:48PM by alxndr01.