Question: I have been diagnosed with Arrythmia and currently take warfarin and amiodarone. This has not only increased the severity of regular headaches but also causes inability to ejaculate when having sexual intercourse. Is there any alternative drugs that would alleviate both these problems? I am 66 years old, am 6 feet tall and weigh 12 stone 10lbs and have always had a great sexual relationship with my wife, until now! My headaches have got worse and I seem to have a really bad one every 2 to 3 days!

Many thanks for your response. However, taking into account the following points;-
1) I do not have an erection problem at all, it is simply the act of ejaculation that is virtually impossible, and has not happened for months. Whilst my wife is very patient, it is decreasing our normal quality of life, what remains of it!
2) I have alternated with "amiodarone" and "bisoprolol fumarate", but find I do not feel so well with the "bisoprolol" with dizzy feelings, nausea & no energy. Both tablets seem to have the same effect on the sexual side of my life, although the "bisoprolol" may have been slightly better regarding severe headaches. Currently I am back on "amiodarone" as I do not know any different!
3) To put you in the picture, my consultant, Dr Bishop in October 2010, said "on examination I have a very marked pectus excavatum and a malar flush. My venous pressure flickers in my neck and I have a tachycardia with normal heart sounds. My ECG was very abnormal, and shows I am in atrial flutter with a very abnormal axis and quite marked T-wave changes in the lateral leads" As I do not really understand this, is this a serious case of arrythmia requiring both warfarin and amiodarone (or simalar) or do you think perhaps it may be over-reacting, especially as I have read these are all XXXXXXX drugs!
4) Whilst I have tried to consult with my GP he only suggested trying "bisoprolol" and shows no real interest in my head or sexual problems, more or less saying "it goes with the territory"
Based on my comments above and considering the points you have already made, if they are still applicable, can you tell me the following:-
1) Is "tylenol" compatible with warfarin?
2) Will "verapamil" assist with my sexual dysfunction?
3) Does warfarin, gabapentin and amiodarone all contribute to me having the 2 problems of headaches and sexual dysfunction?
4) I do not drink much alcohol but do try to enjoy an occasional glass of wine (max 2 small glasses every other night average) and possibly 1 pint of beer every fortnight. Will this cause me any problems?

Apologies for this being somewhat "long winded" but I am realing struggling here to find help. Thanking you in anticipation,

Yours sincerely
David Aggar

Many thanks for your prompt response. I still have a few questions however, as follows:-
1) I currently take "Maxalt Melt 10mg" for my severe headaches, but can only take a XXXXXXX of 10 to 12 per month. Do you think that "verapamil" might be just as effective but perhaps less lethal? Incidently, I have had bad heads ever since I was 16 years old and no GP and many neurologists have not been able to fathom these. Also of course, since taking amiodarone & warfarin they have considerably intensified.
I first went to Dr Bishop ref a connection with a posible hole in the heart and my bad heads. No hole in the heart, but consequently he discovered the arrythmia and was convinced my bad heads were due to hypoventilation and emerging pulmonary hypertension (quoting his letter) With hindsight, this is obviously not correct!
2) Considering my condition, as described in my previous letter by Dr Bishop, do you think that "verapamil" may be as good as "bisoprolol" which Dr Bishop said at the time would be ok. I always have the option of trying to go back and see my Consultant Dr Bishop to discuss this if you think it advisable (would not get an appointment that quick though, unless I go private of course)

Kind Regards,
David