Followup to "many new symptoms since implant"

Short version is this- I believe the ultimate cause of all my ongoing my new symptoms is adverse side effects of Betapace AF. I have been taking it for years without any noticeable side effects other than fatigue which I eventually adjusted to. After my last stint in the hospital, my cardiologist upped my dosage from 60mg 3x daily to 120 mg 2x daily. I totally forgot about this increase when writing my original post because it was such a minor increase and because I have taken it for extended periods in much higher dosages than what I am currently prescribed.

Longer version is this- Wednesday I had a good day, no problems. Thurs am I went to take my morning meds and noticed I did not take them on Wed am (not a good thing but in this case, possibly a life saver as it turns out). I took my Thursday meds and about 20-30 minutes later, the symptoms I described in the earlier post began to hit me again. I am no math wizard, but it didn't take me long to put 2 and 2 together.

I researched side effects of Betapace AF and found my many different symptoms are ALL side effects of this medicine and that according to the information I have read online and in my pill book, I should have been in an emergency room several times a week over the past 3-4 weeks. The good news is I survived it and am still here to give you this update!

I have decreased my dosage by 50% as an interim measure and although the side effects are still apparent, they are much less severe than before. I have an appointment with the cardiologist in the morning and will discuss alternative meds with him then, if in fact, they are actually needed. Something else I discovered (or relearned) was that this medication is prescribed to help the heart remain in normal sinus rhythm . It was originally prescribed after my 1st cardioversion six or eight years ago. I have been out of normal sinus rhythm now for a couple of years and question whether it is even necessary at this point.

I guess this is one more example of relearning an old lesson. We all need to do our own research on our symptoms and possible causes and not just wait on someone else to take care of our problems. Had I looked at side effects of my meds earlier, I could have saved myself several weeks of problems, a chemical stress test, and a heart catheterization. Admittedly, decreasing dosages of medicines without your physicians’ blessing may not be the wisest course of action, but in this particular case, continuing at the same levels may have been devastating. Thanks for listening, for your concern, and for your prayers.

5 Comments

Good thinking

by ElectricFrank - 2011-01-11 01:01:25

One other thing to be aware of is the effects of "time release" meds. They don't release the meds evenly over time, but rather in steps. The 60mg and 120mg may have a different release pattern.

I found this out years ago when I was taking a time release antihistamine. There were consistent times during the day when I was totally wiped out. Turns out the capsules had 3 different colored small coated specs inside.

The engineer in me decided to take a few pills apart and separate the colored specs. I then put only the red ones (proper quantity) back in one capsule, blues, and greens the same. Next day I took a capsule with only reds and noticed when I felt wiped out. Now I knew when the reds kicked in. Next 2 days tested the others.

Imagine the doc's surprise when I took my data into him.

frank

YESSSSS Lets talk

by nrracing - 2011-01-11 03:01:18

I Was just put on this MED Satolol which I got from walgreens, and from the delivery system from work I had Betapace AF (Satolol AF). One is made by Maylan, the other is made by EON. I have herd there are two different version. I took my new med today and have been ok. I did not take the same Blue pill I have been taking. I have also been having side effects too I want to know what kind you are having.

Let talk about this cause there are not many people saying much about it. Also can you tell me who is the maker of your med. It should say MFG on the bottle some where. I was taking 80 MG a day and felt so bad, then went to 40 as the doc told me and have been a bit better but still having side effects. I have been on it for about a month.

Please lets talk

Whoops!

by ocala - 2011-01-11 06:01:34

I said I was taking 1/2 of a 120 mg tablet for each dose, 3x per day. That was my dosage immediatley prior to my implant. After I was hospitalized, my dosage was changed to 120 mg per dose, 2 x a day. AWhen i ws 1st perscribed it, I was taking 120 mg each dose, 3x per day. Hope this clears up any confusion.

Answers to comments on this post

by ocala - 2011-01-11 06:01:43

Good info Frank, but in my case the time release should have been fairly consistent because I was actually taking ½ of a 120 mg oblong shaped tablet for each dose as recommended by my cardiologist. Changes in the severity of side effects from day to day may have been due to the imprecise practice of breaking them in 2 rather than cutting them. Once they released though, the side effects would usually last for hours, and often feel as though they flared up and subsided in waves. I remember when I was 1st prescribed this medicine my cardiologist told me in so many words I need not be overly concerned about taking them at precisely the same intervals or times everyday because they were designed to maintain a constant level of effectiveness. The duration and intensity of my experience with the side effects seem to bear this out to some degree.

For nrracing- I will summarize the side effects I have been through for you but just to be on the safe side, I would first like to mention a couple things that you probably already know-

1. If you are having severe side effects of any kind, get to the emergency room immediately!!! For seemingly less acute symptoms, I would still suggest you see or call medically trained professionals as soon as possible. What is irritating now may very well become debilitating (or worse) later.

2. If you suspect any particular drug (or combination of drugs) is giving you a problem or are uncertain if you should seek immediate attention and can't reach your doctor, call a pharmacist. They can usually tell you better than the doctor what you can expect from any given drug and are also a good place to seek advice about what to do if you aren’t sure.

3. There is a difference between Betapace and Betapace AF. If you have recently switched from one to another, this could be the reason you are now having problems.

4. A comprehensive list of the side effects of many drugs (Betapace included) by body system, dosage and the percentage of people affected by each can be found at www.rxlist.com.

5. Regardless of the seemingly small percentage of people affected by any given side effect, if you are one of them then the percentage is immaterial. It is still a problem for you and needs to be addressed!

6. Anytime you have more than one drug prescribed for you, you are at risk of interactions between them. Again, your pharmacist should be able to check on known interactions between medicines. The effect of some drugs can be also be affected by interaction with certain foods or alcohol . A prime example of this would be blood thinners (coumadin and warfarin come to mind). There is a search engine in place where you can check the known interactions between all of your prescribed meds simultaneously at http://www.drugdigest.org .

When I was first prescribed this drug several years ago, I too had a lot of fatigue. I eventually got past the overall fatigue part of it and I tend to do just fine as long as I am busy, moving, or engaged in some way such as in a conversation. But, I still have problems trying to sit and watch a 30 minute TV program in the evening. I am usually asleep in about 10 minutes or less whether I want to be or not. However, things have gotten better in that respect since I was prescribed an alertness medicine called Nuvigil. I have been told it is usually effective for about 12 hours so I generally try to wait until mid to late morning to take it and it seems to be pretty effective.
I have found my self dealing with the following symptoms in different combinations and degrees of severity since I had my implant done the first week in December. They usually began to manifest themselves in the morning, about an hour or so after I wake up. They usually began as something similar to a niacin flush but with a different sensation (more like a numbness or tingling) in my arms, neck, and face. My face would begin to feel as if there was a lot of pressure in it- similar to the feeling you get when squeeze off the blood circulation to the end of your little finger. That was usually accompanied by some light headedness, a feeling of being overall unwell, and often weak. At this point I also usually had this really bizarre feeling in both sides of my neck, again somewhere between a tickle and numbness, which was also often accompanied by an ache -similar to the onset of a muscle cramp just before it happens- in either or both sides of my neck, sometimes an inch or so below my jaw or sometimes more towards the base of my neck which I assume correlates to where my carotid arteries are. I sometimes had a gradual building sensation of minor pressure in my chest. And, I've had other sensations in my chest. There was often a dull but steady and significant pain in the left side of my chest, and as often as not there were simultaneously minor stabbing pains in the right side of my chest. These were generally of short duration and occasionally they would feel like they were more towards the center of my back. I often felt as if my heart was pounding harder (but not faster) during and after these times.
On the very first occasion I had a problem after my implant, my breathing became very labored or short for no apparent reason and didn’t recover for several hours. That i also felt my heart pounding but not racing, and over a period of time I felt as if there was a weight belt lying at the base of my rib cage. That time (even though it was probably among the mildest of my episodes) I went to the ER and ended up being admitted for a couple of nights. No one suspected drug side effects at that point because I was not taking any different drugs than before. I have checked my blood pressure during several of these episodes and found it to be somewhat elevated, but not dangerously so. On at least 2 occasions, I took a nitro tablet. While they seemed to ultimately help, it also seemed as if symptoms tended to intensify briefly before they calmed.
I think that pretty much sums up the whole gamut of the experiences I have had recently. I hope yours are simpler, fewer, and much less acute! By the way, my Betapace Af label says the mfr is Berlex Labs. Hope this helps you out!!!!

Time Release meds

by ElectricFrank - 2011-01-11 11:01:10

There are actually blood plasma level graphs over time that the med manufacturer supplies the FDA during the approval process. I used to frequent the libraries of medical schools back in the pre internet days and could often find them. The story was the same then that the level was nearly constant between dose, but the graphs were quite different. There were usually 2 peaks on a 8 hour dosing and 3 on a 12 hour.The curves were quite different between brand name and generic as well.

And finally, time release caplets are not intended to be cut in two. In some cases where they are combination doses of more than one med they aren't distributed evenly throughout the caplet. You could be getting an entirely different regimen from the two pieces.

frank

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