On capecitabine, fast heart rate

SandiaBuddy

Okay, I am four days away from ending capecitabine and last night I experienced a heart "flutter" then an elevated heart rate (109bpm) for a few hours.  I considered going to the emergency room, but made it through the night.  I have a call in to the doctor and the nurse said this is a known side effect to capecitabine.  While I am waiting for the doctor's response, does anyone have experience or advice with this?  It strikes me that a healthy beating heart is necessary every minute of the day, and keeping that heart working right should take priority over killing cancer.

NHMike

I have had times when it

I have had times when it feels like my heart rate is elevated but is normal when I check it. When I'm running, my target heartrate area is 150-160 BMP and I would run in this range for 30-60 minutes. I don't consider 109 to be that high - basically in the zone of light exercise. Did your heartrate come back down some time after taking the pills?

NHMike

SandiaBuddy said:

Heartrate

The 109 was in the middle of the night lying in bed.  By morning it had gone down to 81, later it was 71, and now it is a more normal 66.  After scanning the intenet a bit it looks like this symptom, as well as heart attacks, are a known side effect of the capecitabine.  However, this is news to me.  A nurse finally called back to say I should discontinue the capecitabine.  When I asked whether there was any permanent damage, she had to consult with the doctor again, and now they have ordered an echocardiogram.

Seaching the internet on this issue, it seems that in some cases the issue goes away when you stop the capecitabine, while in other cases the damage is permanent.  This is all new to me.  If I knew I could endanger my heart, I never would have taken this drug (the same issue exists in IV 5FU).  Looking at other forums and at professional publications, it seems like the heart issues are well known and pretty common.  I had not come accross this issue on this forum, so capecitabine users beware.

Here are a few articles in case someone revisits this post in the future:

multi-study: http://www.wellstattherapeutics.com/therapeutics/html/randd/compounds/polk.pdf
Single case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743815/
http://ascopubs.org/doi/full/10.1200/JCO.2011.38.5278
http://hellenicjcardiol.org/archive/full_text/2012/4/2012_4_320.pdf
https://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-7-212

 

 

 

Thanks for the research. This

Thanks for the research. This may be why they did an EKG on me way back when. What would the alternative to taking Xeloda be?

I will certainly keep an eye on heartrate.

I actually wish that I had a fitness tracker with wrist heartrate monitoring where I could set an alarm if the heartrate gets too high or too low.

SandiaBuddy

NHMike said:

Thanks for the research. This

Thanks for the research. This may be why they did an EKG on me way back when. What would the alternative to taking Xeloda be?

I will certainly keep an eye on heartrate.

I actually wish that I had a fitness tracker with wrist heartrate monitoring where I could set an alarm if the heartrate gets too high or too low.

Alternative

For me, as a post-surgery Stage3, the alternative would be no drugs at all.  I will surely regret the less than 10% reduction in my reoccurence rate if my heart is damaged.

I use a blood pressure test cuff I got at Walmart for about $20, but you could also just put a finger on your neck and count the pulses for ten seconds and then multiply by 6--or do it for a full minute.

But with the symptoms I had, you certainly would not accidentally miss it.  I guess from 2-20% of people have heart symptoms, so hopefully you will be in the majority, not the minority.  But the symptoms really do reach their maximum in the fourth month, according to the reports and my experience as well.

 

Tunadog

I had an increased heart rate

I noticed an increased heart rate the day of my follow up visit and mentioned it to my Oncologist 130 beats a minute. My doctor sent me to the Emergency Room where they ran some EKG tests and called my Cardiologist. They indicated it was "A Flutter" and gave me a shot of Metoprolol. I take a 50mg Metoprolol every morning.

My blood pressure and pulse rate are under control.

It could be from the Avastin (probably) or Xeloda.

 

Just my $00.02

SandiaBuddy

Tunadog said:

I had an increased heart rate

I noticed an increased heart rate the day of my follow up visit and mentioned it to my Oncologist 130 beats a minute. My doctor sent me to the Emergency Room where they ran some EKG tests and called my Cardiologist. They indicated it was "A Flutter" and gave me a shot of Metoprolol. I take a 50mg Metoprolol every morning.

My blood pressure and pulse rate are under control.

It could be from the Avastin (probably) or Xeloda.

 

Just my $00.02

two cents

I could not find a solid answer at to whether the heart damage is temporary or permanent.  I assume that since they did the EKG they think it is a temporary side effect for you.  However, it might be worth doing a little research because the heart sure is essential to every second of life.  I would not want to risk damaging it if there are alternatives available.

NHMike

SandiaBuddy said:

Alternative

For me, as a post-surgery Stage3, the alternative would be no drugs at all.  I will surely regret the less than 10% reduction in my reoccurence rate if my heart is damaged.

I use a blood pressure test cuff I got at Walmart for about $20, but you could also just put a finger on your neck and count the pulses for ten seconds and then multiply by 6--or do it for a full minute.

But with the symptoms I had, you certainly would not accidentally miss it.  I guess from 2-20% of people have heart symptoms, so hopefully you will be in the majority, not the minority.  But the symptoms really do reach their maximum in the fourth month, according to the reports and my experience as well.

 

I check my heartrate a few

I check my heartrate a few times a day via my wrist (my mother was a nurse and taught us how to do that a long time ago). I also have 2 Wrist GPS devices and they each come with chest straps with HRMs in them. I could use those but it's a lot of work to put them on when I can do a quick reading manually. I got the latest Running watch in January of this year and it's great. Then, in April, a new model came out with wrist-based HRM and it will monitor your HR all day long and you can look at graphs of it later on for any problems.

SandiaBuddy

NHMike said:

I have had times when it

I have had times when it feels like my heart rate is elevated but is normal when I check it. When I'm running, my target heartrate area is 150-160 BMP and I would run in this range for 30-60 minutes. I don't consider 109 to be that high - basically in the zone of light exercise. Did your heartrate come back down some time after taking the pills?

Heartrate

The 109 was in the middle of the night lying in bed.  By morning it had gone down to 81, later it was 71, and now it is a more normal 66.  After scanning the intenet a bit it looks like this symptom, as well as heart attacks, are a known side effect of the capecitabine.  However, this is news to me.  A nurse finally called back to say I should discontinue the capecitabine.  When I asked whether there was any permanent damage, she had to consult with the doctor again, and now they have ordered an echocardiogram.

Seaching the internet on this issue, it seems that in some cases the issue goes away when you stop the capecitabine, while in other cases the damage is permanent.  This is all new to me.  If I knew I could endanger my heart, I never would have taken this drug (the same issue exists in IV 5FU).  Looking at other forums and at professional publications, it seems like the heart issues are well known and pretty common.  I had not come accross this issue on this forum, so capecitabine users beware.

Here are a few articles in case someone revisits this post in the future:

multi-study: http://www.wellstattherapeutics.com/therapeutics/html/randd/compounds/polk.pdf
Single case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2743815/
http://ascopubs.org/doi/full/10.1200/JCO.2011.38.5278
http://hellenicjcardiol.org/archive/full_text/2012/4/2012_4_320.pdf
https://ro-journal.biomedcentral.com/articles/10.1186/1748-717X-7-212