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Hi, Male; 61 Years Old, 5.7ft , 152lbs. Can I

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Posted on Tue, 25 Feb 2020
Question: Hi, male; 61 years old, 5.7ft , 152lbs.
Can I stop Tembocor medication ( for prevention of paroxysmal AF due to recurrent painless thyroiditis) ?
Total thyroidectomy was done 5 days ago.
Tembocor medication ; 1T bid/ day. ( and synthroid 150 mcq/day.)
My cardiologist want to continue Tembocor medication. I am anxiety of side effect .
1. no Tembocor medication ( abrupt stopping or tapering) 2. pill in the pocket 3. continous Tembocor medication

2016.Aug ; First paroxysmal AF due to thyrotoxicosis (hashimoto; ? painless thyroiditis) was returned to normal within 2days
by medication . (TFT; T3 3.3 free T4; 3.7 TSH < 0.01)
* Ecocardiography ; chest discomfort, A-fib c RVR(sinus conversion)
1) No RWMA
2) normal sized cardiac chambers with normal global LV systolic function
3) pseudonormalization of LV filling pattern(E/E’ ; 11)
LVEF 75% LVEDD/ESD 51/30mm LAVI 24ml/m2 LA-AP 34mm
* Neck U.Sono ; Hx; R/O hashimoto’S Thyroiditis
IMP; diffuse thyroid disease without suspicious focal lesion
* cardiologist medication; Rytmonorm ; 120ds, Dilatrend ; 1 year and 4 months
* endocrinologist; ; hyperthyroid ( 4Ms) - hypothyroid (1 year ; synthroid med 50 mcq/day) - euthyroid.
2019.oct. ; second attack of thyrotoxicosis-induced paroxysmal AF.
returned to normal within 2days . ( medication; Tembocor + Dilatrend)
Now, Tembocor 1T bid ( no Dilatrend because of slow pulse rate under 50)
2020 . Feb 04 total thyroidectomy to prevent recurrent thyrotoxicosis- induced paroxysmal AF.
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Follow up: Dr. Ilir Sharka (0 minute later)
Hi, male; 61 years old, 5.7ft , 152lbs.
Can I stop Tembocor medication ( for prevention of paroxysmal AF due to recurrent painless thyroiditis) ?
Total thyroidectomy was done 5 days ago.
Tembocor medication ; 1T bid/ day. ( and synthroid 150 mcq/day.)
My cardiologist want to continue Tembocor medication. I am anxiety of side effect .
1. no Tembocor medication ( abrupt stopping or tapering) 2. pill in the pocket 3. continous Tembocor medication

2016.Aug ; First paroxysmal AF due to thyrotoxicosis (hashimoto; ? painless thyroiditis) was returned to normal within 2days
by medication . (TFT; T3 3.3 free T4; 3.7 TSH < 0.01)
* Ecocardiography ; chest discomfort, A-fib c RVR(sinus conversion)
1) No RWMA
2) normal sized cardiac chambers with normal global LV systolic function
3) pseudonormalization of LV filling pattern(E/E’ ; 11)
LVEF 75% LVEDD/ESD 51/30mm LAVI 24ml/m2 LA-AP 34mm
* Neck U.Sono ; Hx; R/O hashimoto’S Thyroiditis
IMP; diffuse thyroid disease without suspicious focal lesion
* cardiologist medication; Rytmonorm ; 120ds, Dilatrend ; 1 year and 4 months
* endocrinologist; ; hyperthyroid ( 4Ms) - hypothyroid (1 year ; synthroid med 50 mcq/day) - euthyroid.
2019.oct. ; second attack of thyrotoxicosis-induced paroxysmal AF.
returned to normal within 2days . ( medication; Tembocor + Dilatrend)
Now, Tembocor 1T bid ( no Dilatrend because of slow pulse rate under 50)
2020 . Feb 04 total thyroidectomy to prevent recurrent thyrotoxicosis- induced paroxysmal AF.
doctor
Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would agree with your doctor on the fact that the best would be not to stop Tembocor.

Anyway, if you really can not continue it any more, I would recommend first reducing the dose to half a tablet twice daily for a week and then stop taking it.

I would also recommend performing a 48 hours ECG Holter monitoring after stopping it, in order to examine your heart rhythm trends for a prolonged time.

You can take it as a pill in the pocket too, if you will feel an erratic heart pulse, shortness of breath, etc.. indicative of paroxysmal atrial fibrillation.

If episodes of atrial fibrillation reoccur after stopping Tembocor, I would recommend starting it again regularly and not stopping it any more.

In the meantime, that you are taking synthroid, I would recommend taking also a low does of betablocker (Dilatrend), in order to prevent possible tachycardia or cardiac arrhythmia.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need.

Kind regards,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

I passed carefully through your question and would agree with your doctor on the fact that the best would be not to stop Tembocor.

Anyway, if you really can not continue it any more, I would recommend first reducing the dose to half a tablet twice daily for a week and then stop taking it.

I would also recommend performing a 48 hours ECG Holter monitoring after stopping it, in order to examine your heart rhythm trends for a prolonged time.

You can take it as a pill in the pocket too, if you will feel an erratic heart pulse, shortness of breath, etc.. indicative of paroxysmal atrial fibrillation.

If episodes of atrial fibrillation reoccur after stopping Tembocor, I would recommend starting it again regularly and not stopping it any more.

In the meantime, that you are taking synthroid, I would recommend taking also a low does of betablocker (Dilatrend), in order to prevent possible tachycardia or cardiac arrhythmia.

Hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need.

Kind regards,

Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ilir Sharka (5 hours later)
My PAF is thought to be secondary
due to thyrotoxicosis .
So, total thyroidectomy was done.
There were no palpitation between
two attacks .
Two attacks was converted to
normal within 2 days.
I have readen a article that no med
-ication is possible after total
thyroidectomy in not-severe secondary PAF.
And Tembocor makes a lot of side
effect. Now l have no problem with
TEMBOCOR medication.


default
Follow up: Dr. Ilir Sharka (0 minute later)
My PAF is thought to be secondary
due to thyrotoxicosis .
So, total thyroidectomy was done.
There were no palpitation between
two attacks .
Two attacks was converted to
normal within 2 days.
I have readen a article that no med
-ication is possible after total
thyroidectomy in not-severe secondary PAF.
And Tembocor makes a lot of side
effect. Now l have no problem with
TEMBOCOR medication.


doctor
Answered by Dr. Ilir Sharka (7 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I understand your concern, but you should know that although you have gone through total thyroidectomy, the fact that you are taking levothyroxine may impose you to hormonal imbalances time after time, and this can lead to possible cardiac arrhythmia.

So, there is no way to predict if you will experience again or not atrial fibrillation.

That is why I recommend taking a betablocker at a low dose (dilatrend) to help prevent possible cardiac arrhythmia.

You can stop gradually Tembocor ( as I explained above) and use it as a pill in the pocket, if you experience possible erratic pulse associated to shortness of breath.

I hope you will find this answer helpful!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

I understand your concern, but you should know that although you have gone through total thyroidectomy, the fact that you are taking levothyroxine may impose you to hormonal imbalances time after time, and this can lead to possible cardiac arrhythmia.

So, there is no way to predict if you will experience again or not atrial fibrillation.

That is why I recommend taking a betablocker at a low dose (dilatrend) to help prevent possible cardiac arrhythmia.

You can stop gradually Tembocor ( as I explained above) and use it as a pill in the pocket, if you experience possible erratic pulse associated to shortness of breath.

I hope you will find this answer helpful!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. Ilir Sharka (4 hours later)
Thanks.
There were no palpitation between
two attacks without any rate or
rhythm drug during 1.5 yrs.
After tapering Tembocor , dilatrend
( 3.125 mg bid ) which is more safe
than Tembocor will be my medi-
cation.
Always I will keep Tembocor in the
pocket.
Tell me if you advise more.



default
Follow up: Dr. Ilir Sharka (0 minute later)
Thanks.
There were no palpitation between
two attacks without any rate or
rhythm drug during 1.5 yrs.
After tapering Tembocor , dilatrend
( 3.125 mg bid ) which is more safe
than Tembocor will be my medi-
cation.
Always I will keep Tembocor in the
pocket.
Tell me if you advise more.



doctor
Answered by Dr. Ilir Sharka (9 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

That is exactly what I recommend you!

Dilatrend 3.125mg bid as long term therapy, gradually reduce the dose of Tembocor until stopping and hold it as a pill in the pocket tablet.

I hope you will not have any episodes of atrial fibrillation any more!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

That is exactly what I recommend you!

Dilatrend 3.125mg bid as long term therapy, gradually reduce the dose of Tembocor until stopping and hold it as a pill in the pocket tablet.

I hope you will not have any episodes of atrial fibrillation any more!

Wishing all the best,

Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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Hi, Male; 61 Years Old, 5.7ft , 152lbs. Can I

Hi, male; 61 years old, 5.7ft , 152lbs. Can I stop Tembocor medication ( for prevention of paroxysmal AF due to recurrent painless thyroiditis) ? Total thyroidectomy was done 5 days ago. Tembocor medication ; 1T bid/ day. ( and synthroid 150 mcq/day.) My cardiologist want to continue Tembocor medication. I am anxiety of side effect . 1. no Tembocor medication ( abrupt stopping or tapering) 2. pill in the pocket 3. continous Tembocor medication 2016.Aug ; First paroxysmal AF due to thyrotoxicosis (hashimoto; ? painless thyroiditis) was returned to normal within 2days by medication . (TFT; T3 3.3 free T4; 3.7 TSH < 0.01) * Ecocardiography ; chest discomfort, A-fib c RVR(sinus conversion) 1) No RWMA 2) normal sized cardiac chambers with normal global LV systolic function 3) pseudonormalization of LV filling pattern(E/E’ ; 11) LVEF 75% LVEDD/ESD 51/30mm LAVI 24ml/m2 LA-AP 34mm * Neck U.Sono ; Hx; R/O hashimoto’S Thyroiditis IMP; diffuse thyroid disease without suspicious focal lesion * cardiologist medication; Rytmonorm ; 120ds, Dilatrend ; 1 year and 4 months * endocrinologist; ; hyperthyroid ( 4Ms) - hypothyroid (1 year ; synthroid med 50 mcq/day) - euthyroid. 2019.oct. ; second attack of thyrotoxicosis-induced paroxysmal AF. returned to normal within 2days . ( medication; Tembocor + Dilatrend) Now, Tembocor 1T bid ( no Dilatrend because of slow pulse rate under 50) 2020 . Feb 04 total thyroidectomy to prevent recurrent thyrotoxicosis- induced paroxysmal AF.