Table of ContentsView AllTable of ContentsMedications to Avoid if You Have Atrial FibrillationSupplements to AvoidOther Triggers
Table of ContentsView All
View All
Table of Contents
Medications to Avoid if You Have Atrial Fibrillation
Supplements to Avoid
Other Triggers
This article will cover which medications to avoid if you’ve been diagnosed with atrial fibrillation and other potential triggers.
Getty Images /PhotoAlto/Frederic Cirou
Some drugs may worsen rapid heart rate, making them unsuitable for managing AF.Additionally, they can predispose you to other complications, interfering with treatment plans and increasing the risk of side effects.
OTC Pain Relievers
If you have AF, taking certain over-the-counter (OTC) drugs for pain relief, such asnonsteroidal anti-inflammatory drugs (NSAIDs)and aspirin, can increase risks due to other medications you may be taking.
Blood thinners, for example, are commonly taken medications in the AF population. Taking NSAIDs or aspirin with them may increase the risk of bleeding. Tylenol (acetaminophen) is generally considered a safer alternative for pain relief if an individual has AF.
Blood Thinners for Atrial Fibrillation
Decongestants
Decongestants, like pseudoephedrine, are commonly found in OTC cold and flu medications. However, they can raise blood pressure and heart rate, which may worsen AF.
Instead of these stimulant-based decongestants, individuals with AF should consider safer alternatives such as saline nasal sprays orantihistamineslike Claritin (loratadine), which are found in nondrowsy allergy medications.
Certain Antibiotics
Certain types of antibiotics are capable of increasing the risk of an irregular heartbeat.
Antibiotics that can affect heart rhythm include:
Therefore, these medications should only be taken under a healthcare provider’s approval and supervision.
If you have a bacterial infection, your provider may prescribe an antibiotic less likely to affect heart rhythm or use smaller doses and regular monitoring.
Stimulant Medications
Stimulant medications for treating attention-deficit/hyperactivity disorder (ADHD) can increase your heart rate and, therefore, worsen AF.
Examples of stimulant drugs include:
However, non-stimulant treatments, such asStrattera (atomoxetine), are generally considered safe for this population.
Should You Avoid Caffeine if You Have Atrial Fibrillation?Moderatecaffeineintake does not appear to have a significant association with AF. Some studies have reported a slightly reduced risk of AF in those who drank one to seven cups of coffee daily.Still, the effects of caffeine can vary from person to person because some people are more sensitive to caffeine than others. Consider how caffeine affects you and listen to your body.Talk to your healthcare providers if you have questions regarding food that could potentially worsen or trigger your condition.
Should You Avoid Caffeine if You Have Atrial Fibrillation?
Moderatecaffeineintake does not appear to have a significant association with AF. Some studies have reported a slightly reduced risk of AF in those who drank one to seven cups of coffee daily.Still, the effects of caffeine can vary from person to person because some people are more sensitive to caffeine than others. Consider how caffeine affects you and listen to your body.Talk to your healthcare providers if you have questions regarding food that could potentially worsen or trigger your condition.
Moderatecaffeineintake does not appear to have a significant association with AF. Some studies have reported a slightly reduced risk of AF in those who drank one to seven cups of coffee daily.
Still, the effects of caffeine can vary from person to person because some people are more sensitive to caffeine than others. Consider how caffeine affects you and listen to your body.
Talk to your healthcare providers if you have questions regarding food that could potentially worsen or trigger your condition.
Levothyroxine
Higher doses of levothyroxinecan increase the risk of heart arrhythmias, such as AF.
If you have both AF and a thyroid condition, talk to your healthcare team before stopping or changing any thyroid medications. For the best care, consider working with an endocrinologist (thyroid specialist) and a cardiologist (heart specialist). They can work together to manage both conditions effectively.
Your team will recommend that you check your pulse daily and your thyroid function every six to eight weeks. They may also need to adjust your thyroid medication dosage.
Antidepressants
Different types of antidepressants can have varying effects on the heart.Tricyclic antidepressants, for example, can sometimes cause heart rhythm problems. Zoloft (sertraline), on the other hand, is generally considered a safer option.
Sertraline, however, is known to have a relatively low risk of these side effects. It’s important to remember that everyone may respond to medication differently.
Therefore, close monitoring is essential when taking any antidepressant, especially for individuals with a history of heart conditions. The goal is to choose an antidepressant that is both effective in treating depression and minimizing potential risks to your overall health, particularly for AF.
Two herbs that should be taken with care because of the possibility of interfering with drugs areSt. John’s wortand ginseng.
St. John’s wort may affect heart rate,and ginseng may interact with drugs used in AF.To minimize potential risks and side effects, always talk to your healthcare provider or pharmacist before adding any supplements to your diet, including St. John’s wort or ginseng.
Other Atrial Fibrillation Triggers
Stress, lack of sleep, and alcohol are the known triggers for AF.Besides medications, positive lifestyle changes, such as regular exercise, healthy diet, and stress management, are equally important in managing AF.
Simple steps like cutting back on alcohol, getting enough sleep, and practicing relaxation techniques can empower you to take control of your heart health.
The most effective approach to managing AF and improving overall well-being involves a combination of medical treatment and healthy lifestyle adjustments.
How Atrial Fibrillation (AFib) Is Treated
Summary
If you’ve been diagnosed with AF, you may need to avoid or be cautious with certain medications that can either worsen your condition or interact with AF treatments. These medications include certain OTC pain relievers, decongestants, some antibiotics, stimulant medications for ADHD, levothyroxine, and certain antidepressants.
Also, avoid certain herbal supplements to prevent unwanted interactions and consider other AF triggers when managing your condition.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Heart, Lung, and Blood Institute.What is atrial fibrillation?Tamargo J, Villacastín J, Caballero R, Delpón E.Drug-induced atrial fibrillation. A narrative review of a forgotten adverse effect.Pharmacological Research. 2024;200:107077. doi:10.1016/j.phrs.2024.107077Dalgaard F, Mulder H, Wojdyla DM, et al.Patients with atrial fibrillation taking nonsteroidal anti-Inflammatory drugs and oral anticoagulants in the ARISTOTLE trial.Circulation. 2020;141(1):10-20. doi:10.1161/circulationaha.119.041296Pundi K, Baykaner T, Hills MT, et al.Blood thinners for atrial fibrillation stroke prevention.Circulation Arrhythmia and Electrophysiology. 2021;14(6). doi:10.1161/circep.120.009389Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066Abdullah B, Latiff AHA, Manuel AM, et al.Pharmacological management of allergic rhinitis: a consensus statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022;15:983-1003. doi:10.2147/JAA.S374346Tisdale JE, Chung MK, Campbell KB, et al.Drug-induced arrhythmias: a scientific statement from the American Heart Association.Circulation. 2020;142(15):e214-e233. doi:10.1161/CIR.0000000000000905Topriceanu CC, Moon JC, Captur G, Perera B.The use of attention-deficit hyperactivity disorder medications in cardiac disease.Frontiers in Neuroscience. 2022;16. doi:10.3389/fnins.2022.1020961Childress AC.Novel formulations of ADHD medications: stimulant selection and management.Focus (Am Psychiatr Publ). 2021;19(1):31-38. doi:10.1176/appi.focus.20200032Cao Y, Liu X, Xue Z, et al.Association of coffee consumption with atrial fibrillation risk: an updated dose-response meta-analysis of prospective studies.Front Cardiovasc Med. 2022;9:894664. doi:10.3389/fcvm.2022.894664Gong IY, Atzema CL, Lega IC, et al.Levothyroxine dose and risk of atrial fibrillation: a nested case-control study.Am Heart J. 2021;232:47-56. doi:10.1016/j.ahj.2020.09.016Gluvic Z, Obradovic M, Stewart AJ, et al.Levothyroxine treatment and the risk of cardiac arrhythmias – focus on the patient submitted to thyroid surgery.Frontiers in Endocrinology. 2021;12. doi:10.3389/fendo.2021.758043Gutlapalli SD, Prakash K, Swarnakari KM, et al.The risk of fatal arrhythmias associated with sertraline in patients with post-myocardial infarction depression.Curēus. 2022;14(9):e28946. doi:10.7759/cureus.28946Fisher KA, Patel P, Abualula S, Concepion L.St. John’s wort-induced supraventricular tachycardia.Cureus. 2021;13(4):e14356. doi:10.7759/cureus.14356Lin JF, Fan LL, Li BW, et al.A study to evaluate herb-drug interaction underlying mechanisms: an investigation of ginsenosides attenuating the effect of warfarin on cardiovascular diseases.Eur J Pharm Sci. 2020;142:105100. doi:10.1016/j.ejps.2019.105100Leo DG, Ozdemir H, Lane DA, et al.At the heart of the matter: how mental stress and negative emotions affect atrial fibrillation.Frontiers in Cardiovascular Medicine. 2023;10:1171647. doi:10.3389/fcvm.2023.1171647
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Heart, Lung, and Blood Institute.What is atrial fibrillation?Tamargo J, Villacastín J, Caballero R, Delpón E.Drug-induced atrial fibrillation. A narrative review of a forgotten adverse effect.Pharmacological Research. 2024;200:107077. doi:10.1016/j.phrs.2024.107077Dalgaard F, Mulder H, Wojdyla DM, et al.Patients with atrial fibrillation taking nonsteroidal anti-Inflammatory drugs and oral anticoagulants in the ARISTOTLE trial.Circulation. 2020;141(1):10-20. doi:10.1161/circulationaha.119.041296Pundi K, Baykaner T, Hills MT, et al.Blood thinners for atrial fibrillation stroke prevention.Circulation Arrhythmia and Electrophysiology. 2021;14(6). doi:10.1161/circep.120.009389Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066Abdullah B, Latiff AHA, Manuel AM, et al.Pharmacological management of allergic rhinitis: a consensus statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022;15:983-1003. doi:10.2147/JAA.S374346Tisdale JE, Chung MK, Campbell KB, et al.Drug-induced arrhythmias: a scientific statement from the American Heart Association.Circulation. 2020;142(15):e214-e233. doi:10.1161/CIR.0000000000000905Topriceanu CC, Moon JC, Captur G, Perera B.The use of attention-deficit hyperactivity disorder medications in cardiac disease.Frontiers in Neuroscience. 2022;16. doi:10.3389/fnins.2022.1020961Childress AC.Novel formulations of ADHD medications: stimulant selection and management.Focus (Am Psychiatr Publ). 2021;19(1):31-38. doi:10.1176/appi.focus.20200032Cao Y, Liu X, Xue Z, et al.Association of coffee consumption with atrial fibrillation risk: an updated dose-response meta-analysis of prospective studies.Front Cardiovasc Med. 2022;9:894664. doi:10.3389/fcvm.2022.894664Gong IY, Atzema CL, Lega IC, et al.Levothyroxine dose and risk of atrial fibrillation: a nested case-control study.Am Heart J. 2021;232:47-56. doi:10.1016/j.ahj.2020.09.016Gluvic Z, Obradovic M, Stewart AJ, et al.Levothyroxine treatment and the risk of cardiac arrhythmias – focus on the patient submitted to thyroid surgery.Frontiers in Endocrinology. 2021;12. doi:10.3389/fendo.2021.758043Gutlapalli SD, Prakash K, Swarnakari KM, et al.The risk of fatal arrhythmias associated with sertraline in patients with post-myocardial infarction depression.Curēus. 2022;14(9):e28946. doi:10.7759/cureus.28946Fisher KA, Patel P, Abualula S, Concepion L.St. John’s wort-induced supraventricular tachycardia.Cureus. 2021;13(4):e14356. doi:10.7759/cureus.14356Lin JF, Fan LL, Li BW, et al.A study to evaluate herb-drug interaction underlying mechanisms: an investigation of ginsenosides attenuating the effect of warfarin on cardiovascular diseases.Eur J Pharm Sci. 2020;142:105100. doi:10.1016/j.ejps.2019.105100Leo DG, Ozdemir H, Lane DA, et al.At the heart of the matter: how mental stress and negative emotions affect atrial fibrillation.Frontiers in Cardiovascular Medicine. 2023;10:1171647. doi:10.3389/fcvm.2023.1171647
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Heart, Lung, and Blood Institute.What is atrial fibrillation?Tamargo J, Villacastín J, Caballero R, Delpón E.Drug-induced atrial fibrillation. A narrative review of a forgotten adverse effect.Pharmacological Research. 2024;200:107077. doi:10.1016/j.phrs.2024.107077Dalgaard F, Mulder H, Wojdyla DM, et al.Patients with atrial fibrillation taking nonsteroidal anti-Inflammatory drugs and oral anticoagulants in the ARISTOTLE trial.Circulation. 2020;141(1):10-20. doi:10.1161/circulationaha.119.041296Pundi K, Baykaner T, Hills MT, et al.Blood thinners for atrial fibrillation stroke prevention.Circulation Arrhythmia and Electrophysiology. 2021;14(6). doi:10.1161/circep.120.009389Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066Abdullah B, Latiff AHA, Manuel AM, et al.Pharmacological management of allergic rhinitis: a consensus statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022;15:983-1003. doi:10.2147/JAA.S374346Tisdale JE, Chung MK, Campbell KB, et al.Drug-induced arrhythmias: a scientific statement from the American Heart Association.Circulation. 2020;142(15):e214-e233. doi:10.1161/CIR.0000000000000905Topriceanu CC, Moon JC, Captur G, Perera B.The use of attention-deficit hyperactivity disorder medications in cardiac disease.Frontiers in Neuroscience. 2022;16. doi:10.3389/fnins.2022.1020961Childress AC.Novel formulations of ADHD medications: stimulant selection and management.Focus (Am Psychiatr Publ). 2021;19(1):31-38. doi:10.1176/appi.focus.20200032Cao Y, Liu X, Xue Z, et al.Association of coffee consumption with atrial fibrillation risk: an updated dose-response meta-analysis of prospective studies.Front Cardiovasc Med. 2022;9:894664. doi:10.3389/fcvm.2022.894664Gong IY, Atzema CL, Lega IC, et al.Levothyroxine dose and risk of atrial fibrillation: a nested case-control study.Am Heart J. 2021;232:47-56. doi:10.1016/j.ahj.2020.09.016Gluvic Z, Obradovic M, Stewart AJ, et al.Levothyroxine treatment and the risk of cardiac arrhythmias – focus on the patient submitted to thyroid surgery.Frontiers in Endocrinology. 2021;12. doi:10.3389/fendo.2021.758043Gutlapalli SD, Prakash K, Swarnakari KM, et al.The risk of fatal arrhythmias associated with sertraline in patients with post-myocardial infarction depression.Curēus. 2022;14(9):e28946. doi:10.7759/cureus.28946Fisher KA, Patel P, Abualula S, Concepion L.St. John’s wort-induced supraventricular tachycardia.Cureus. 2021;13(4):e14356. doi:10.7759/cureus.14356Lin JF, Fan LL, Li BW, et al.A study to evaluate herb-drug interaction underlying mechanisms: an investigation of ginsenosides attenuating the effect of warfarin on cardiovascular diseases.Eur J Pharm Sci. 2020;142:105100. doi:10.1016/j.ejps.2019.105100Leo DG, Ozdemir H, Lane DA, et al.At the heart of the matter: how mental stress and negative emotions affect atrial fibrillation.Frontiers in Cardiovascular Medicine. 2023;10:1171647. doi:10.3389/fcvm.2023.1171647
National Heart, Lung, and Blood Institute.What is atrial fibrillation?
Tamargo J, Villacastín J, Caballero R, Delpón E.Drug-induced atrial fibrillation. A narrative review of a forgotten adverse effect.Pharmacological Research. 2024;200:107077. doi:10.1016/j.phrs.2024.107077
Dalgaard F, Mulder H, Wojdyla DM, et al.Patients with atrial fibrillation taking nonsteroidal anti-Inflammatory drugs and oral anticoagulants in the ARISTOTLE trial.Circulation. 2020;141(1):10-20. doi:10.1161/circulationaha.119.041296
Pundi K, Baykaner T, Hills MT, et al.Blood thinners for atrial fibrillation stroke prevention.Circulation Arrhythmia and Electrophysiology. 2021;14(6). doi:10.1161/circep.120.009389
Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
Abdullah B, Latiff AHA, Manuel AM, et al.Pharmacological management of allergic rhinitis: a consensus statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022;15:983-1003. doi:10.2147/JAA.S374346
Tisdale JE, Chung MK, Campbell KB, et al.Drug-induced arrhythmias: a scientific statement from the American Heart Association.Circulation. 2020;142(15):e214-e233. doi:10.1161/CIR.0000000000000905
Topriceanu CC, Moon JC, Captur G, Perera B.The use of attention-deficit hyperactivity disorder medications in cardiac disease.Frontiers in Neuroscience. 2022;16. doi:10.3389/fnins.2022.1020961
Childress AC.Novel formulations of ADHD medications: stimulant selection and management.Focus (Am Psychiatr Publ). 2021;19(1):31-38. doi:10.1176/appi.focus.20200032
Cao Y, Liu X, Xue Z, et al.Association of coffee consumption with atrial fibrillation risk: an updated dose-response meta-analysis of prospective studies.Front Cardiovasc Med. 2022;9:894664. doi:10.3389/fcvm.2022.894664
Gong IY, Atzema CL, Lega IC, et al.Levothyroxine dose and risk of atrial fibrillation: a nested case-control study.Am Heart J. 2021;232:47-56. doi:10.1016/j.ahj.2020.09.016
Gluvic Z, Obradovic M, Stewart AJ, et al.Levothyroxine treatment and the risk of cardiac arrhythmias – focus on the patient submitted to thyroid surgery.Frontiers in Endocrinology. 2021;12. doi:10.3389/fendo.2021.758043
Gutlapalli SD, Prakash K, Swarnakari KM, et al.The risk of fatal arrhythmias associated with sertraline in patients with post-myocardial infarction depression.Curēus. 2022;14(9):e28946. doi:10.7759/cureus.28946
Fisher KA, Patel P, Abualula S, Concepion L.St. John’s wort-induced supraventricular tachycardia.Cureus. 2021;13(4):e14356. doi:10.7759/cureus.14356
Lin JF, Fan LL, Li BW, et al.A study to evaluate herb-drug interaction underlying mechanisms: an investigation of ginsenosides attenuating the effect of warfarin on cardiovascular diseases.Eur J Pharm Sci. 2020;142:105100. doi:10.1016/j.ejps.2019.105100
Leo DG, Ozdemir H, Lane DA, et al.At the heart of the matter: how mental stress and negative emotions affect atrial fibrillation.Frontiers in Cardiovascular Medicine. 2023;10:1171647. doi:10.3389/fcvm.2023.1171647
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