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What to do about severe sleepiness and fatigue after taking Amiodarone, Eliquis, Metoprolol, Losartan and Nifedipine?

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Posted on Wed, 17 Feb 2021
Question: My mother is 94. Within the last 3 months, she was taking plavix and multaq because of atrial fibrillation. However, due to more instances of afib and a TIA, 2 months ago, her electro cardiologist put her on Amiodarone (200mg.. once a day) and Eliquis blood thinner 2.5 mg... twice a day..( taking her off Plavix and Multaq).....she also was taking hctz 25 mg ... metoprolol 50 mg and nifedipine 90 mg....and Losartin. 25 Mg...
Since taking that new medicine, in the last month, she began feeling very sleepy and without energy , tired. Some confusion . Hands shaking . We went to her electro cardiologist yesterday and he told her to stop taking the 50mg metoprolol and only take 100 mg of the Amiodarone..... but keep taking everything else.
I would like your opinion on whether the changes in the medicine is ok ---- to possibly help reduce the tired , sleepy, lack of energy . Her usual blood pressure is 160/60... pulse rate is 55-60.
doctor
Answered by Dr. Sagar Makode (48 minutes later)
Brief Answer:
Yes, it's a right decision

Detailed Answer:
Hello,
Yes, he took a right decision. These side effects are likely to due to Metoprolol induced which are quite common. So it should help her. Just keep watch over her pulse rate as it may rise due to Metoprolol withdrawal, and may need modification of other drugs dosage if rises.
Also, for her bp, dose of Losartan may be escalated to 50 mg if bp is persistently above 140/90 mmhg. Also, she should have low salt diet, and diet low in fatty, oily food.
Hope this helps you and get back if you have any more doubts.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Sagar Makode (10 hours later)
Doctor....her electro cardiologist told her to take only Half of the 200 mg of amiodarone. Is that ok also? He thought that the weakness and maybe the tremors might be due to amiodarone dosage
doctor
Answered by Dr. Sagar Makode (3 hours later)
Brief Answer:
Yes this is also fine

Detailed Answer:
Weakness and other of her symptoms are probably due to Metoprolol only. However, Amiodarone may cause tremors. In elderly, we usually try to maintain dosage on lower side and in most of the elders, 100 mg once a day. So i am alright with 100 mg dosing. It's ultimately depends on control of atrial fibrillation, we should maintain the patient on lowest possible dose which would control afib. Also, her heart rate is on lower side so dose reduction is fine. All the best.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Dr. Sagar Makode

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Practicing since :2013

Answered : 1874 Questions

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What to do about severe sleepiness and fatigue after taking Amiodarone, Eliquis, Metoprolol, Losartan and Nifedipine?

Brief Answer: Yes, it's a right decision Detailed Answer: Hello, Yes, he took a right decision. These side effects are likely to due to Metoprolol induced which are quite common. So it should help her. Just keep watch over her pulse rate as it may rise due to Metoprolol withdrawal, and may need modification of other drugs dosage if rises. Also, for her bp, dose of Losartan may be escalated to 50 mg if bp is persistently above 140/90 mmhg. Also, she should have low salt diet, and diet low in fatty, oily food. Hope this helps you and get back if you have any more doubts.