the Precautions of Heart Medications: A Patient's Guide

Contraindications of Xinsuping

Hello Dr.
Tsai, I apologize for taking up your time.
I have been taking Catapres and other cardiology medications for about six years, but in the past year, I have experienced occasional missed beats, sometimes mild and sometimes severe.
After several electrocardiograms and echocardiograms, the doctors said there was no issue, but in early February, during a follow-up examination, the doctor mentioned that the missed beats were less than one percent.
However, they switched my Catapres to Cardizem and advised me to take half a dose.
I currently have the following questions:
1.
During this time, I have also been taking neurological medications, Cinarizine and Diphenhydramine, for dizziness.
I would like to know if there are any interactions or additive effects between Cardizem and these two medications.
I noticed that the contraindications for Cardizem mention cerebrovascular issues, which makes me concerned due to my lack of understanding.
(The neurologist noted a narrowing in one area of my intracranial vessels during a carotid ultrasound but could not determine if it was congenital or acquired.
They only advised me to continue taking aspirin and statins as prescribed by my cardiologist.
For the past four years, I have asked the neurologist if further follow-up is needed, and they have said no.)
2.
After my follow-up in early February, the issue with missed beats suddenly resolved that afternoon and has not returned since.
Therefore, I still have some Catapres left and have not yet switched to Cardizem.
3.
Information available online can be both beneficial and detrimental.
If I were unaware, perhaps I wouldn’t worry as much.
The side effects of Cardizem and Catapres seem quite similar, but the contraindications differ.
Am I possibly overthinking this?
Thank you for your time and assistance, Dr.
Tsai.

Mr. Zhang, 50~59 year old female. Ask Date: 2020/03/04

Dr. Cai Guiqin reply Cardiology

I recommend that you discuss the above situation with your attending physician to obtain accurate information.
Thank you, and wishing you good health!

Reply Date: 2020/03/04

More Info

When it comes to managing heart conditions and the medications associated with them, it is crucial to understand the potential interactions and side effects of the drugs prescribed. Based on your situation, you have been on heart medications for several years and have recently experienced some irregularities, such as missed beats. Your doctor has switched you from Kadycin to Xinshuping (心舒平) and advised you to take half the dose. You also have concerns about potential interactions with neurological medications you are taking, such as Sinanqing and Difenidone, as well as the implications of your previous tests.

Understanding Your Medications
1. Medication Interactions:
- Xinshuping (心舒平) is generally used to manage heart rhythm issues and may have some contraindications, especially concerning neurological conditions. It is essential to discuss with your healthcare provider whether it is safe to take Xinshuping alongside Sinanqing and Difenidone. While there may not be direct contraindications, the concern arises from the fact that Xinshuping has warnings related to cerebrovascular conditions. Given your history of a narrowed area in your brain, it is wise to approach this with caution.

- Always inform your neurologist and cardiologist about all medications you are taking, as they can provide the best advice on managing potential interactions.

2. Missed Beats:
- The fact that your missed beats improved after your last check-up is a positive sign. It is not uncommon for heart rhythm issues to fluctuate. However, it is essential to continue monitoring your symptoms and maintain regular follow-ups with your cardiologist. If you have leftover Kadycin, consult your doctor before making any changes to your medication regimen.

3. Information Overload:
- The internet can indeed provide a wealth of information, but it can also lead to confusion and anxiety. It is essential to rely on trusted medical sources and your healthcare providers for accurate information. If you have concerns about the side effects of Xinshuping compared to Kadycin, discuss these with your doctor. They can explain the rationale behind the switch and help alleviate your worries.

Recommendations for Managing Your Health
- Regular Monitoring: Keep a log of your symptoms, including any missed beats, dizziness, or other side effects. This information can be invaluable during your medical appointments.

- Open Communication: Don’t hesitate to ask your healthcare providers about any concerns you have regarding your medications. They are there to help you understand your treatment plan and ensure your safety.

- Lifestyle Adjustments: Consider lifestyle changes that can support your heart health, such as a balanced diet, regular exercise (as tolerated), and stress management techniques. These can complement your medication regimen and improve your overall well-being.

- Follow-Up Appointments: Ensure you attend all scheduled follow-ups with both your cardiologist and neurologist. They can provide ongoing assessments of your condition and adjust your treatment as necessary.

Conclusion
Navigating heart medications can be complex, especially when considering potential interactions with other treatments. It is crucial to maintain open lines of communication with your healthcare providers and to stay informed about your medications. If you have any lingering concerns or experience new symptoms, do not hesitate to reach out to your doctor for guidance. Your health and peace of mind are paramount, and proactive management is key to achieving the best outcomes.

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