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I am taking metoprolol 25 mg x 2 and flecainide

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Posted on Tue, 26 Feb 2019
Question: I am taking metoprolol 25 mg x 2 and flecainide 50 mg. x2 daily for Afib. I started taking the 5-day course of azithromycin for a respiratory infection. I am feeling somewhat dizzy. What is the danger here, if any?
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Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on -Ask a Doctor- service!

I understand your concern and would like to explain that the concomitant use of Flecainide and Azithromycin is associated with an increased risk of QTc prolongation on ECG.

This may lead to an increased risk of cardiac arrhythmia occurrence.

Coming to this point, though your actual daily Flecainide dose is low and this risk is quite low, it would be wise to check the QTc interval and your actual cardiac rhythm by performing a resting ECG.

If it results normal, then other causes should be sought to explain your unpleasant feeling of dizziness (control your blood pressure values, check an arterial blood gas analysis, blood electrolytes level, blood glucose level, etc.)

You need to discuss with your attending doctor on the above mentioned issues.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again.

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7359 Questions

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I am taking metoprolol 25 mg x 2 and flecainide

Brief Answer: I would explain as follows: Detailed Answer: Hello! Welcome on -Ask a Doctor- service! I understand your concern and would like to explain that the concomitant use of Flecainide and Azithromycin is associated with an increased risk of QTc prolongation on ECG. This may lead to an increased risk of cardiac arrhythmia occurrence. Coming to this point, though your actual daily Flecainide dose is low and this risk is quite low, it would be wise to check the QTc interval and your actual cardiac rhythm by performing a resting ECG. If it results normal, then other causes should be sought to explain your unpleasant feeling of dizziness (control your blood pressure values, check an arterial blood gas analysis, blood electrolytes level, blood glucose level, etc.) You need to discuss with your attending doctor on the above mentioned issues. Hope to have been helpful to you! In case of any further questions, feel free to ask me again. Kind regards, Dr. Iliri