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Continuance of verapamil in a patient with chronic AF.

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My question relates to the use of low dose Mogadon and its effect in relation to Atrial Fibrillation. After years on various AF medications during which I have always had sleeping problems I decided to take a small dose of Mogadon to gauge its effect. It did nothing for the sleep problems but apparently fixed my AF. Now I am approaching the possibility of eliminating Verapamil completely and maintaining the dose of approximately 2mg of Mogadon a WEEK for AF treatment. My cardiologists response was "anything that works but we did not talk about removing the Verapimil." Is it prudent to depend on Mogadon without formal heart medication? I've reason to believe the Verapimil is quite debilitating. I continue with my Comadin treatment. Thank you.

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Category: Family Physician-GP
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It is not advisable to depend on the effects of mogadon for maintenance of atrial fibrillation .Mogadon belongs to a group of grogs that are usually only to decrease anxiety and induce sleep. It does not have any direct effect on the conductance of the heart. It's only the calmness and sleep that is produced from the tablet that might have temporarily improved the symptoms of AF

I would recommend the following-

1)Continue with verapamil as it is a very good medication to prevent over excitation of heart in AF and prevents the complication.

2)Use megadon temporarily as it might cause dependence and worsens sleep pattern if used long term. Megadon is usually not recommended in patients above 60 years of age.

3) Megadon causes decrease in the potency of Coumadin and decrease the blood level of warfarin. This prevents the action of Coumadin and increase complication like thrombosis and stroke.

4)If megadon is absolutely necessary, use a low dose variety and use for short period of time.

5)Take regular INR test to prevent over dose or under dosage of Coumadin. Preferred INR level is abbot 2-3.

Thank you.

Dr. John Monheit
Category: Family Physician-GP
Residecny: North Colorado Family Medicine
Medical School: The Chicago Medical Center
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