On demand meds?

I have posted before about my afib attacks. I was on toprol and flecainide,but took myself off it because I was still having the afib attacks. I decided to take flecainide only when I have an attack. I had an attack while playing basketball the other day. I took 100 mg of flecainide as soon as I went home. I took another 50 mg. when I went to bed. I still had the afib when I woke up in the morning so I took 100 more mg. and a 50 mg of the toprol. I went back to nsr in another 2 hours. I thus avoided a trip to the hospitol for cardioversion.
I like the idea of meds only on demand....if I'm going to get the afib anyway. Maybe the drugs will work better this way. Does anyone take the toprol along with the flecainide? Previous posters only seemed to take the flec. to get out of the afib. What do you think about my treatment plan?
Doug

Doug,
I actually just commented on this in a prevous thread. My ESP actually told me that this was an option with Rhythmol. I did horrible on the flecanide which is also sold as Tambocour. I went off it right away. But different strokes for different folks.
One word of caution if you are taking a medication daily and then have an afib episode, you SHOULD NOT double or triple up on your dose and take it "on demand". You should continue as per normal. This is what Drs. Jones and Tchou told me at the CCF.

I just started taking Rhythmol 150mg, and am actually only taking it when I feel what I refer to as "pre-afib". I tried this two days ago and it did seem to work, I never went into afib and feel much better today..... I have not tried it yet during an actual episode.

For what it's worth (fwiw)...

Joe

Hello, Doug

I am not familiar with how long your afib usually lasts, but is it possible that you would converted on your own without any of the drugs that you took?

Carol

Doug,
I tend to agree with Carol, that was an awful long time, at least in my afib world, Mine tend to go from 8-16 hours or so. You probably did come out of it by yourself, unless your episodes tend to last longer.....
The conclusion that I have drawn from numerous posts here and others boards is that if you take these drugs on demand, it will cut your episode time in half or better.. or at least that is what I have gleaned from all the info..
Joe

When I was first prescribed Verapamil (120 mg) 8 years ago, the doc wanted me to take it daily. I did, and still got afib. I then decided on my own to take it on demand as soon as afib begins. I carry one pill in my pocket, car, golf bag etc. and take as soon as afib begins. It takes about two hours for my pulse rate to slow down and another 8 to 14 hours to convert to NSR. I tried not taking anything and I still convert, but it takes longer. I do not function well when afibbing and must sit or lie down and wait it out.

Lon

My previous two episodes of afib were treated with diltiazem or cardizem (same drug) which is a calcium channel blocker which, in my case, slows my rapid heart rate in afib, from about 160 bpm to 90 bpm. Once my rate is slowed, the afib ceases.

When I took these drugs, they were administered IV. I think it is quite possible that I would have converted without the drugs. I have never had an episode last longer than about 3 hours. There were no noticeable side effects of the drugs.

I asked my cardiologist for a prescription for the oral version of cardizem, which I have on hand to use on demand, just in case. I don't intend to let myself get back in a place where I am once again susceptible to afib, however.

I take flec on demand and it works great. Do not take more than
300 mg. in a twenty four hour period. This is maximum dose.
Otherwise it is far better than taking the drugs every day which only made
my condition worse.

Three weeks ago I had an episode, just a few days after seeing a new
cardiologist. I telephoned him and he told me to take 300 mg. of Propafenone
(Rythmol) and if it did not stop, to take another 300 in about 8 hours. I
had been on 150 mg. three timae daily since April 10. I took the extra
dosages and the fibbing stopped in about 30 hours. That's the usual length
of my episodes, sometimes more than 48 hrs. The previous cardio told me to
go to ER after 6 hours. I did that 6 times in the past 12 months and was
cardioverted each time. I was so happy to have the episode stop without
having the dreaded cardioversion!


Two weeks ago, late at night, I started fibbing and immediately took 150
mg. Propafenone - I converted about 1 hour later. Exactly a week ago I
stopped taking the drug and will do so if (when) an episode starts.


Like many on this BB, I don't like taking these powerful drugs all the
time, especially if the episodes only occur every few months.


Cheers, RK

RK
I take 300 mg Propafanone also on demand when AF starts. And my EP said to take another 300 mg after 3-4 hours if its has not stopped after first dosage. Wonder why you were told 8 hrs. By that time the first dose would of almost worn off.
All the best
Frank

Hi all,

I take Tambocor on demand, I use to take 50 mg. at onset then 50 mg.
after half hour. A poster on this bb said to try 100 mg. first off to get
up to therapeutic level quicker. It does work quicker, I am generally
back into NSR within one to two hours.

I take mine at onset of LAF with warm water crushed in the mouth.
Cold water if I am out somewhere, which is seldom as I get mine
early in the am.

I’m dammed if I know what has triggered my LAF, as I was free for
some eleven months. I have had minor or short busts, half to two
hours for the last few weeks every few days or so no rhythm to it,
just early, three to five am.

As Carol said above, I have not taken Tambocor for the last two or
three episodes and have gone back into NSR within about the same
time frame. But it does make one wonder if I am going to convert or not!

I have upped my Mg. to 600 mg plus the two lt. of WW a day, that
should give me 800/850 mg. Mg. plus I still eat my K foods. The sea
salt that I have been putting in my WW over the past week or so has
made no difference to my LAF duration or change of time.

The only other thing I can try is to change my Mg. type. I am on
Solgars Mg. citrate, I am also having difficulty finding the Glysinate type.

Any other suggestions PC if you read this post?

Stay well, David S vlaf, 66 yy.

I've been taking Cardizem at 120 once a day and I find that if I do it every day my beat slows to the forties (42 - 45) with long pauses between beats occasionally. So I decided to take the bull by the horns and just use it on a demand basis. Also the doc cut my dosage to 60 mg SR diltiazem ( you can't get the 60 mgs in the brand name of Cardizem) It seems so far that the on demand is going to work. I will only take it when I have trouble stopping the fast AF in any other fashion. I was going to ask if anyone on the board does it this way and I find now that quite a number of medications, including Cardizem, are used in this manner. For someone whose heart doesn't tolerate calcium channel blockers such as mine, this is an alernative that helps. And also a note to Jackie that I'm getting a test kit mailed to me so that I can have my MD take a sample and send it back to the company for an intracellular check to see if I'm deficient in magnesium. The only problem if I am deficient in magnesium, it is not recommended to take diltiazem and magnesium supplements together as it may lower the BP too much. Have you heard of anyone else in the same situation, Jackie. Anyway I wanted to say Hi to all on this great board. I follow it closely and have learned a lot from it. I've also found that if I take an extra lorazepam (a crisis medication, but I use it for sleep - 1 mg.) when I first feel any ectopic beats coming in I can avoid a full blown session of AF. Anyone else had this experience. I'm also four weeks out from my PVI ablation and am still getting AF although it is slower than before I had the ablation (120 compared to 140). Told the doc I wanted to hold off for another few months to see if it doesn't work eventually. If it gets to that point and I'm still getting AF I'll probably go for another ablation attempt. But, if the AF attacks are mild and far apart and I can get out of them easily, I won't risk another ablation.