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What causes tremors inspite of being on Flecainide?

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Posted on Fri, 22 May 2015
Question: Hello - sturdyweed here ... I have A-fib and have been treated with multiple meds. Since none of them worked satisfactorily, I am scheduled for an ablation in XXXXXXX Responding to/with the others here: I also have lately developed jerking hands - so bad that it is hard to manage the mouse. I don't even try to write anymore! I am 82; got a pacemaker November 2011; broke my hip August 2014. Things seem to be going steadily downhill. My electrophysiologist doubled dose of flecainide and that intensified the jerking, plus created heartburn/upset stomach. Next: calling my PHC - I trust her, and would like your opinion also. Thanks/1
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Answered by Dr. Kathy Robinson (6 hours later)
Brief Answer:
caution with flecainide

Detailed Answer:
Hello and thank you for your question.
Flecainide is well known to cause tremors so that makes sense that it caused your tremor and that it worsened with an increased dose.
Flecainide is also associated with life threatening arrhythmias and according to UptoDate.com, "This drug may be potentially inappropriate for use in geriatric patients (Quality of evidence - high; Strength of recommendation - strong)."
I strongly suggest that you talk to your cardiologist about putting you on a different medication. I do not really understand why you would need a strong anti-arrhythmic agent like that if you have a pacemaker in any case. Hopefully with the ablation you will no longer need the medication.
Please be aware also that there is a very serious drug interaction between duloxetine and tramadol.
Regards,
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kathy Robinson (1 hour later)
Thank you, Dr. XXXXXXX I did not know about the interaction between duloxetine and tramadol. I'll ask the prescribing doctor about that.
And - I wondered too about the anti-arrhythmic agent and my pacemaker. I was told that the pacemaker was not intended to calm arrhythmia. Hm. I will submit further questions to my cardiologists, and get back to you before 2 days and 23 hours expires. Right now I am very pleased and very grateful.
~~~XXX
doctor
Answered by Dr. Kathy Robinson (1 hour later)
Brief Answer:
thank you

Detailed Answer:
Thank you for your response. I will be glad to hear what is going on with you.
I wish you the best
Dr. Robinson
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Kathy Robinson

General & Family Physician

Practicing since :1989

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What causes tremors inspite of being on Flecainide?

Brief Answer: caution with flecainide Detailed Answer: Hello and thank you for your question. Flecainide is well known to cause tremors so that makes sense that it caused your tremor and that it worsened with an increased dose. Flecainide is also associated with life threatening arrhythmias and according to UptoDate.com, "This drug may be potentially inappropriate for use in geriatric patients (Quality of evidence - high; Strength of recommendation - strong)." I strongly suggest that you talk to your cardiologist about putting you on a different medication. I do not really understand why you would need a strong anti-arrhythmic agent like that if you have a pacemaker in any case. Hopefully with the ablation you will no longer need the medication. Please be aware also that there is a very serious drug interaction between duloxetine and tramadol. Regards, Dr. Robinson