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Old 06-17-2005, 05:47 AM   #1
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Digoxin & Frusemide...Help!

I have lived quite happily with CHD since 1986..I have 2 stents and an artificial mitral valve.

Then I began to feel breathless and after a heart monitor test, an echo and a myocardial perfusion test, the cardio. says my heart muscle is not working as well as it should and that I also have atrial fibrillation.

He started me off on 250 microgrammes of digoxin and 40 mg of Frusemide.

In addition I was already taking 50mg of Cozaar for BP. 10mg Zocor for high cholesterol and 5mg of Warfarin.

After just a day of taking the digoxin and Frusemide, I felt terrible. I persevered until Wednesday , but then contacted the cardio. He told me to stop the digoxin but stay on the Frusemide. This am I woke up feeling reasonably OK , but then I took the frusemide and inside an hour, I started to feel awful.

Has anyone else any experience of these 2 drugs?

I had been taking another diuretic, Bendrofluazide, which had no side effects.

Why is Frusemide the preferred drug?

I often have bad reactions to drugs, but I am desperate for the Cardio. to find a drug which relieves Atrial fibrillation without all these terrible effects.

 
Old 06-17-2005, 09:16 AM   #2
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by pennyann
I have lived quite happily with CHD since 1986..I have 2 stents and an artificial mitral valve.

Then I began to feel breathless and after a heart monitor test, an echo and a myocardial perfusion test, the cardio. says my heart muscle is not working as well as it should and that I also have atrial fibrillation.
Now that your heart has weakened and prone to beat badly, it is important to be on a healthy diet, avoid irritants and allergens that cause your heart to misfire, and to take the correct meds.

Quote:
He started me off on 250 microgrammes of digoxin and 40 mg of Frusemide.
Digoxin is a good medicine for a weakened heart. It helps the heart to beat stronger and it also slows the beat down.

Furosemide (Lasix) is a very strong diuretic. I can only take about 20mg, every other day. If I take more than that, it causes my heart to misfire. We are all different, so what happens to me might not happen to you.

Quote:
After just a day of taking the digoxin and Frusemide, I felt terrible. I persevered until Wednesday , but then contacted the cardio. He told me to stop the digoxin but stay on the Frusemide. This am I woke up feeling reasonably OK , but then I took the frusemide and inside an hour, I started to feel awful.

Has anyone else any experience of these 2 drugs?
I take both digoxin and furosemide, but as I said earlier, I can only take 20mg furosemide every other day. From what I understand, too much diuretic will deplete too much of the body's minerals, which will cause problems with the heart's ability to beat correctly.

Quote:
I often have bad reactions to drugs, but I am desperate for the Cardio. to find a drug which relieves Atrial fibrillation without all these terrible effects.
You might consider asking your cardio about trying digoxin again. It's been around forever, is dirt cheap, and comes with few side effects, and is still the favorite of many cardiologists for weakened hearts.

Best of luck and health!

Last edited by Machaon; 06-20-2005 at 05:01 AM.

 
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Old 06-17-2005, 10:53 AM   #3
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Re: Digoxin & Frusemide...Help!

Thank you so much for your reply, Beerzoids.

It is good to speak to someone on the same medication.

Tomorrow, I will take 20 mh of Frusemide and see how that affects me.

I think the cardio. wanted me to stop the Digoxin and keep on the Frusemide, so he can see how the Frusemide affects me. He may well decide to put me back on Digoxin, maybe at a lower dose.

We are lucky in UK, many of us do not pay for medication...I am over the age of 60,so qualifyy for free medicine.

I agree that 40 mg is a very high dose, as a starter.

Tonight I am rather breathless at rest. It is most unpleasant.

I have started to use a herbal tea, Redbush and have cut out alcohol and chocolate.
Re irritants and allergens..what did you mean by that? I want to do all I can to help my poor old heart!!

 
Old 06-18-2005, 09:01 AM   #4
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by pennyann
Tomorrow, I will take 20 mh of Frusemide and see how that affects me.

I think the cardio. wanted me to stop the Digoxin and keep on the Frusemide, so he can see how the Frusemide affects me. He may well decide to put me back on Digoxin, maybe at a lower dose.
In my case, diuretics only gave me problems if I took them more than one day in a row. I had to skip a day. You may be able to take a lower dose, 20mg, more often that I was able to. Everyone is different.

Diuretics, like Furosemide, reduce blood volume, making it easier for the heart to pump, and at the same time, lowering the blood pressure.

Quote:
Tonight I am rather breathless at rest. It is most unpleasant.
I've got heart failure, high blood pressure, atrial fibrillation, among other heart problems. The WORST symptom, one that I really hate, is when the breathing is difficult. I can deal with any other problem, but breathing problems can get to me. Fortunately, I am getting fewer and fewer problems with my breathing. I hope that your breathlessness got better and you are feeling OK too.

Quote:
I have started to use a herbal tea, Redbush and have cut out alcohol and chocolate.
Good moves on getting rid of the alcohol and chocolate. Personally, I would LOVE to have a beer, but can't any more. It doesn't like me.

I hope that you are doing fine today!

Last edited by Machaon; 06-20-2005 at 04:37 AM.

 
Old 06-20-2005, 09:03 AM   #5
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Re: Digoxin & Frusemide...Help!

Beerzoids, thank you for your good wishes. I found that taking 20 mg of Frusemide about 3 hours after the BP med. worked out OK..no side effects but i am still somewhat breathless.

Today, I took the frusemide with my meds. and felt rotten inside 1/2 hour..so that is no good. Taking Frusemide first maybe, and leaving other BP med until lunchtime may be better.

Tried another experiment with Digoxin. Took 125mg after lunch...wiped mee out. Still feel rotten, so I amthinking Digoxin is not for me.

I had no idea AFib could be so terrible. I just cannot do much at all.

I admire your fortitude and hope I can get some relief from this awful complaint.

 
Old 06-20-2005, 03:59 PM   #6
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by pennyann
Beerzoids, thank you for your good wishes. I found that taking 20 mg of Frusemide about 3 hours after the BP med. worked out OK..no side effects but i am still somewhat breathless.
I feel bad about your breathing problems. Have you contacted your cardiologist and told him about your continued breathing problems?

These boards are great to discuss medical problems and to share experiences, but the best source of help is your heart specialist.

 
Old 06-20-2005, 04:36 PM   #7
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by pennyann
Beerzoids, thank you for your good wishes. I found that taking 20 mg of Frusemide about 3 hours after the BP med. worked out OK..no side effects but i am still somewhat breathless.
One of the most common problems with a weakened heart is difficulty breathing. Breathing problems usually get worse when one lies down. Many people with a weakened heart have to sleep sitting up. Do you breath better sitting up?

When I am having problems breathing, and my heart is beating weakly, I wear a nurses mask, take a nitro under my tongue, and it usually results in more easier breathing.

Do you have access to nitro for under the tongue?


Quote:
Today, I took the frusemide with my meds. and felt rotten inside 1/2 hour..so that is no good. Taking Frusemide first maybe, and leaving other BP med until lunchtime may be better.
You are already on the diuretic, Bendrofluazide. I wonder if adding the other diuretic, Furosemide, is too much diuretic for you?

Quote:
Tried another experiment with Digoxin. Took 125mg after lunch...wiped mee out. Still feel rotten, so I amthinking Digoxin is not for me.
I cannot take Digoxin within 2.5 hours of milk, or any other food or drink that contains calcium. If I do it makes my heart beat fast and hard for hours. I wonder if you are eating or drinking something that interacts with the Digoxin? Also...... do you drink grapefruit juice?

You are on Zocor, which is a cholesterol lowering statin drug. I cannot take any of the statins. It either interacts with my Verapamil, a CCB, or my Digoxin, or both. Instead, I've gone on a very strict, high fiber, whole grain, frequent feeding, small portion UCLA diet, which has resulted in much lower cholesterol readings and much lower blood pressure.

Also...... I cannot take digoxin at night. I can only take it in the morning.

We all react differently, but I figured I might pass on some info just in case it can help.

 
Old 06-22-2005, 03:32 AM   #8
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Re: Digoxin & Frusemide...Help!

Hi Beerzoids,
Thanks for your helpful reply.

Re sleeping. I cannot sleep with just one pillow. This is very recent..only about 2 weeks. I have to prop myself up on about 3 pillows, which I do not find very comfortable and affects my sleeping pattern.

I do have access to Nitro Glycerine, so will try it out when my breathing gets very bad.

I no longer take bendrofluazide, just the Frusemide.I find I can tolerate 20 mgs. each day..any more and my heart starts starts flying about and I feel hot and uncomfortable.

My cardiologist has written to my GP asking her to change the Zocor 10 mg. to Atorvastatin, 10 mg...I am not sure why.

I have an appointment with my GP on Friday PM and I am going to raise my concerns with her.

In UK, we do have a National Health Service, which is free at the point of delivery. I also get all my medication free, whch is very good. The problem is that the NHS is trying to cater for a large population and has too few doctors to do so. If I waited to see a cardiologist on the NHS, it could take up to 6-9 months on a waiting list. Therefore people with private health insurance are lucky in that they get seen very quickly.

The problem arises when all the tests are done. My cardio. did all these, decided on what his diagnosis was and wrote to my GP telling her what to prescribe...then my reactions to the drugs caused problems. Instead of being able to see the cardiologist, I had to send an email telling him about my reactions and getting an email back telling me to drop the Digoxin and keep on frusemide, taking it in the morning and delaying my other meds. for 12 hours.

So, now I am concentrating on getting the frusemide dose right. I cannot tolerate 40 mg, nor even 30mg..so am now on 20 a day and will see if that improves my condition.

Thanks for helping me and listening...it gives comfort to know you have the same problems.

I want to get it sorted out as we leave on a cruise next month and I want to enjoy it.

 
Old 06-22-2005, 12:13 PM   #9
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by pennyann
I do have access to Nitro Glycerine, so will try it out when my breathing gets very bad.
Have you considered trying a nurses earloop mask when you are having breathing problems? I take a nitro and put a nurses earloop mask on for at least 30 minutes. After about 15-20 minutes I notice a definite improvement in my breathing. It's not just for asthma. What the mask does is filter out irritants in the air, like dust, which makes breathing easier, if you can stand having the mask on. With a weakened heart, the easy we can make it on our systems the better.

Quote:
So, now I am concentrating on getting the frusemide dose right. I cannot tolerate 40 mg, nor even 30mg..so am now on 20 a day and will see if that improves my condition.
I think that you are being very smart about the furosemide. From what I have read, it is very important for a weakened heart, since it reduces the strain on the heart. I'm hoping that you can find a dosage and schedule that works for you.

Quote:
Thanks for helping me and listening...it gives comfort to know you have the same problems.
I hope that something that I posted helped. When we discuss these health matters we both can learn something.

Quote:
I want to get it sorted out as we leave on a cruise next month and I want to enjoy it.
Cruise!? You didn't tell me that this was an emergency!

Take care, and here's wishing you a wonderful cruise!

 
Old 06-24-2005, 10:22 AM   #10
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Re: Digoxin & Frusemide...Help!

just a quick update..got the nurse's mask and have the Nitro. and tried it..not much difference.

Saw the GP and she told me that as the meds. do not work, the pacemaker suggested by the cardio. in his last letter to her would be the best way forward.

I have now emailed him( trying to see him is harder than getting an audience with the Pope!) and told him of my current horrible situation and asked him about the pacemaker.

Evidently, the type of pacemaker that regulates fast beats as well as slow beats is available ibn Europe but not in the USA..is that so?

Cheers
Ann....the weather here has broken and at last it is cool again. Wimbledon is washed out as is usual!

 
Old 06-25-2005, 06:39 AM   #11
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Re: Digoxin & Frusemide...Help!

Furosemide is a potent diuretic and if a less potent one gave you no side effects, I would stick with the less potent diuretic. I assume you have also been Rx'd potassium supplements to counteract the mineral loss caused by the diuretic being effective.

Digoxin is often used to stabilize and strengthen the heart muscle but I know of no studies indicating its effectiveness or comparing it with other options.

Atrial Fibrillation can have many causes or co-mormidities:
sleep apnea, H. pylorii infection, poor oral hygiene, heavy metals, particularly molybdenum in drinking water.

And ofcourse one of the significant predictive factors for atrial fibrillation problems is 'low sex hormones'.

Last edited by FoolsGold; 06-25-2005 at 07:37 AM.

 
Old 06-26-2005, 07:33 AM   #12
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Re: Digoxin & Frusemide...Help!

Let me tell you this... Frusemide is a diuretic which reduces serum potassium; unfortunately this low potassium level, increases digoxin's toxicity. Those two drugs should not be used together. Digoxin also causes arrythmias especially atrial arrythimias, and paradoxically it is also used to treat atrial arrythmias. it is confusing.. but ur cardio must be careful with those drugs. if im not mistaken, he should also perscribe other antiarrythmic drugs like class 1 and 3. check with your cardio.

 
Old 06-26-2005, 09:02 AM   #13
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Re: Digoxin & Frusemide...Help!

thanks for that information.

I am taking the frusemide twice a day...20mg each time.

The cardio. will see me tomorrow or Tuesday. He is thinking of implanting a pacemaker..it would be a Medtronic.

I am not usre what you mean by class 1 and 3 antiarrythmic drugs?

 
Old 06-26-2005, 10:48 AM   #14
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Re: Digoxin & Frusemide...Help!

Quote:
Originally Posted by Lukus
Those two drugs should not be used together.
Do you have any authoritative source indicating their simultaneous use is contraindicated?

 
Old 06-27-2005, 02:45 AM   #15
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Re: Digoxin & Frusemide...Help!

i dont have any experience, but im studying about them. for your information you could take a look at katzung & trevor's pharmacology.
i prefer you ask your doctor to clarify everything.

 
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