the Risks of Combining Medications for Heart Rhythm Issues

Please consult the director?

Hello, Director: I have a problem with arrhythmia, and my doctor has prescribed Concor 1.25 mg, one tablet in the morning and one in the evening, as well as Amlodipine 240 mg, one tablet in the morning.
I checked the medication leaflet online, and it seems that Amlodipine (a calcium channel blocker) is not recommended to be used in conjunction with Concor, as it may have adverse effects on the heart (decreased myocardial contractility and delayed ventricular conduction).
I have been experiencing persistent numbness in my hands and feet lately, and I cannot find the cause.
I wonder if this could be related to these side effects.
Could you please clarify this for me? Thank you!

Li Zhenfang, 60~69 year old female. Ask Date: 2019/06/25

Dr. He Dongjin reply Cardiology

Hello, since I am not clear about the severity of your arrhythmia issue, it is difficult to say.
Generally, cardiologists do not commonly use both medications together unless there is a specific consideration.
I recommend returning to discuss this with your physician.
As for the symptoms of hand and foot soreness, it is also difficult to determine if they are side effects.
You could try stopping the medication; if the soreness in your hands and feet improves, it may be a side effect.
If the impact is not significant, it may not be necessary to stop.
Changhua Hospital cares about your well-being.

Reply Date: 2019/06/25

More Info

When it comes to managing heart rhythm issues, the combination of medications can indeed pose risks, particularly when certain drugs are contraindicated or may interact negatively with one another. In your case, you are taking Concor (Bisoprolol) and Amlodipine (a calcium channel blocker), and you are concerned about the potential adverse effects of this combination.

Understanding the Medications:
1. Concor (Bisoprolol): This is a beta-blocker that is commonly used to manage hypertension and heart rhythm disorders. It works by slowing down the heart rate and reducing the force of contraction of the heart muscle, which can help in controlling arrhythmias.

2. Amlodipine: This is a calcium channel blocker that helps to relax and widen blood vessels, making it easier for the heart to pump blood. It is often used to treat high blood pressure and angina.

Potential Risks of Combination:
While both medications are effective for managing heart conditions, combining them can lead to certain risks. The primary concern with using a beta-blocker like Bisoprolol alongside a calcium channel blocker like Amlodipine is the potential for additive effects on heart rate and contractility. This can lead to:
- Bradycardia: An excessively slow heart rate, which can cause symptoms such as dizziness, fatigue, or fainting.

- Heart Block: A condition where the electrical signals in the heart are delayed or blocked, which can be serious and may require medical intervention.

- Reduced Cardiac Output: This can lead to symptoms of heart failure, such as shortness of breath, fatigue, and fluid retention.

Symptoms You Are Experiencing:
The symptoms you describe, such as hand and foot weakness, could potentially be related to the medications you are taking. Weakness in the extremities can sometimes be a sign of reduced blood flow or could be related to side effects from the medications. It is essential to consider other factors that might contribute to these symptoms, including electrolyte imbalances, dehydration, or even anxiety.

Recommendations:
1. Consult Your Physician: It is crucial to discuss your symptoms and concerns with your healthcare provider. They may want to reassess your medication regimen, considering the potential interactions and side effects. Adjustments in dosage or switching to alternative medications may be necessary.

2. Monitoring: Regular monitoring of your heart rate and blood pressure is essential, especially when on these medications. Your doctor may recommend periodic ECGs or Holter monitoring to assess your heart rhythm and ensure that the medications are not causing adverse effects.

3. Lifestyle Modifications: Alongside medication, lifestyle changes such as a heart-healthy diet, regular exercise (as tolerated), and stress management techniques can help improve your overall heart health and may alleviate some symptoms.

4. Report New Symptoms: If you experience any new or worsening symptoms, such as increased weakness, dizziness, or palpitations, seek medical attention promptly. These could indicate that your current treatment plan needs to be reevaluated.

In conclusion, while the combination of Concor and Amlodipine can be effective for managing heart rhythm issues, it is essential to be vigilant about potential side effects and interactions. Open communication with your healthcare provider is key to ensuring that your treatment plan is safe and effective.

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