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1284766 tn?1272809789

Rapid Heartbeat with Plaquenil

I've been on Plaquenil since being diagnosed with lupus in 2004.  The last couple of months I've noticed my heart rate has been quite high, like up to 120 bpm.  My general practitioner told me that my heart rate's been high for a while, between 90 and 110 (I do need to ask her if this has always been the case or if it's happened just since being on Plaquenil).  I've had a bunch of tests done: doctors say it's not a blood clot, it's not my thyroid.  I've been to a bunch of doctors, and no one seems to think that Plaquenil is the culprit (even though I've seen that listed as a side effect in online descriptions), but I've yet to get a definitive answer.  My rheumatologist told me to just go off the Plaquenil just in case, but it's been over a week now and the whole time I've been really sick to my stomach (acid reflux, diarrhea) and recently started to get joint pain and muscle spasms in my feet, so I was told to go back on it.  Heart rate is still fast, can't really tell if it was significantly better because of being off Plaquinel, especially because I've stopped drinking coffee too.  Has anyone else experienced an increased or rapid heart beat while on Plaquenil or hydroxychloroquine?  Would love to hear people's thoughts.
Best Answer
434278 tn?1324706225
Hi and welcome to MedHelp

I experience rapid heart rate when my symptoms are flaring.  Actually the plaquinel helped that as well as many other symptoms.  

Have they checked you blood sugar level?  Another thing to check is your C-peptide.  

God bless, Kara
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Avatar universal
Hello,i have had an increased heart rate since I was put on plaquenil-generic and my rheumatologist said that is not a side effect from the medication.My heart rate used to run 60 to 74 bpm and now up to 104 daily and with exercise like the treadmill it raises to 178 which is dangerous.
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3 Comments
Hello and welcome to the forum.  I think I would check back in with your doctor regarding this.  If that change in heart rate came after starting medication, that would seem quite coincidental.  Your heart rate can be up to 100 at rest and be normal.  And During exercise, your heart rate can increase to a target of 60 to 80 percent above your resting heart rate. Here are some basics on heart rate and exercise.  https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates  Your resting heart rate is a bit out of normal range but not by much and your heart rate during activity may be normal.  Again, please speak to your doctor and if you are not satisfied with the answer, please get a second opinion.  Best of health to you  
I do also want to follow up with this link that references rare side effects to plaquenil  that involve the heart  Because of this, I would indeed speak to your doctor again.  https://www.webmd.com/drugs/2/drug-6986/plaquenil-oral/details/list-sideeffects  Let us know how you are doing.
Hello, do you have any updates for us?  We are thinking  of you and wonder if you resolved this issue.  
434278 tn?1324706225
I know what you mean.  I was watching the lupus info commercial the other day and it said, "If you think you might have lupus, tell your doctor about ALL of your symptoms."  I thought, you've got to be kidding me.  When I do, they treat me like I'm making it up.  Soooo, why bother.  I certainly understand that whether or not the plaquinel was the cause of the tachycardia, it was real and was affecting your body.  Praise God someone took the time to help you.
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Avatar universal
Hi Missy,

You may not see this, since I am posting a long time after your original post, but I wanted to share that I was on Plaquenil for 2 years, during which time, I had the same problem arise.  I started noticing the rapid pulse when I would try to do any exercise.(It had been awhile since I had been able to really do any, since I was so ill before getting on the plaquenil, but I was always very consistent about exercising since the age of 12.. just have always been that way).  So it was interesting to me, and also scary, the way that just very slight exertion sent my heart rate way high, and I couldn't understand why.  This was around 2007, after I had been on the plaquenil for around 6-12 months already.  Previously, did not have this problem at all whatsoever.  This rapid heart rate started progressing to where I would get it every day, just from getting out of bed, or driving to work, anything that was even the slightest bit stressful.  Which then progressed in a short amount of time to full-on panic attacks, since I would drink a cup of coffee in the morning, and started having extreme tachycardia for the next five hours (previously never had this in the past with coffee either).  Oh, and I was suddenly no longer able to tolerate my allergy medicine, or any decongestants (previously could tolerate that fine as well).  So.... call me crazy all you doctors, but I still believe that it was the plaquenil that somehow caused this, even though every doctor I would bring it up to would just poopoo the idea.  There was one ER dr. at Mayo Clinic who mentioned to me when I had gone there during a bad tachycardic episode, that Plaquenil can be a drug that can be a cause of that.  When I followed up with Rheum and pcp, of course they all just dismissed any of that.  Still angers me more than anything to this day how many times over the years I have been dismissed, and how many times that patients with these troubling symptoms/episodes get completely dismissed as well.  I won't even get into what I've been through health wise, besides lupus, but I have been on a beta blocker (for the tachycardia I developed) for over 4 years now.  Thank God that one of my many doctors (an endocrinologist) had the sense to put me on it, or I would certainly not be here today, and I don't exaggerate at all when I say that.  God bless to every one of you who has had to deal with this, and I pray that you find answers, and most of all, comfort.
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434278 tn?1324706225
I had tachycardia before I went on Plaquinel.  That has been so much better since I've got the med in my system.  The only times I have tachycardia is when I'm having a lupus flare.

If tachycardia is a side affect of Plaquinel, I am not aware of it.
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Avatar universal
I'm on 200 mg Plaquinil twice a day and my heart rate goes up with any type of exertion.  With light exertion it goes to 110-118.  With moderate exertion it goes up to 140.  For obvious reasons I don't even try heavy exertion!!  Sitting still and doing nothing brings it back down into normal range.  I'm off Prednisone and all inhalers and have been for quite awhile now.  I also feel pretty sick when my pulse gets that high.  It's somehow comforting to know I'm not the only one having this symptom.  Cardiac work-up was all normal.  Have only been on the med less than one month so maybe I'll get used to it?  
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434278 tn?1324706225
thanks for the update.

Praying for you, Kara
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1284766 tn?1272809789
Just wanted to let you know that I got my echo cardiogram today, as well as the results of my 24 hr heart monitor, and everything thankfully looked fine. Both the cardiologist and my pcp think that my high heart rate was caused by extreme stress and anxiety, and that it's not the medicine.  My rheumy didn't necessarily agree, but he seems to think it's highly unlikely that the plaquenil is causing the tachycardia.  He doesn't think that it was caused by a flare based on the normality of my tests. They all think there has to be some other factor; the question is just what could it possibly be? All my tests are normal, my heart is fine.  But my heart rate does indeed, for whatever reason, go up when I take the plaquenil. So, my rheumy told me to go back on the plaquenil (220 mg), I took it and my heart rate went up to 110 bpm.  It was 74 at the doctor's office.  It was pounding quite hard for about an hour, but seems to have calmed down a bit. I pray to God that it's not the Plaquenil itself that is doing this to me, as it's the safest drug for lupus.  But again, there is that question, what could the tachycardia possibly be from?   I'm hoping that after a while of taking it easy, and maybe going back on my zoloft, this problem will resolve itself (fingers tightly crossed!).  Thanks for your support during this hard time; it means a lot :)
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434278 tn?1324706225
My heart goes out to you.  I hate that you are going through all of the flare type symptoms and can't take anything to help.  I pray that God help you and give your wisdom.  
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1284766 tn?1272809789
I remember when I was first diagnosed with lupus and was put on prednisone I actually loved all of the energy it gave me.  Made me feel normal :) It just scared me this time because it was my first dose of a 4 week course and it made my heart rate go up to 100 bpm. What would i have been like after a week, you know?
I was having a bad lupus flare up last night, and thinking that I needed to do something I took 100mg of plaquinel and my heart rate went crazy, my chest hurt, and I could barely sleep. And maybe it's in my head, but i think my joints felt more swollen after taking it.  My heart rate still feels high today too.  At least my stomach feels better.  But I know its not good to go back and forth between medicines so I figure I'll take 100mg every other day until my echocardiogram on monday.  That way the cardiologist can see my reaction to it.  It's just frustrating not knowing why the medicine that's supposed to be helping me is causing these horrible reactions. It makes me worried that it could be something like myopathy.  Again, I'm hoping the cardiologist will be able to give me some answers, and I'm crossing my fingers that they'll be positive.  Thanks again for your input.  I wish you all the best with your own health.
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434278 tn?1324706225
I am on 200 mg twice a day.  So that is a total of 400mg/day.  

Prednisone did make me feel jittery and full of energy.  I get a lot of work done when I'm on that.  It revs me up.  

When my heart races during a flare, other symptoms go along.  I have chest pains, and joint pain, muscle weakness and diarrhea.  

I would be more prone to think your racing heart issues are caused from stress, which could in turn cause the lupus symptoms to flare.
Helpful - 0
1284766 tn?1272809789
Thanks for your input, I appreciate it.  My doctor ordered a bunch of blood tests, but I'm not sure if they checked blood sugar level or c-peptide; I'll have to ask next time I see her.
When your symptoms were flaring, and you experienced the rapid heart rate, was your plaquinel increased? I was on 200 mg when all of this started, and have been for a while, but maybe I needed to be on a higher dose?  I was experiencing some other symptoms of a flare up, like joint pain and hair thinning (which I know can also be from the plaquinel). Like I said, for the past three years my heart rate has been between 88 and 112, but I'm wondering if that had anything to do with stress aggravating my lupus (I transfered to a really tough college in 2008, so I was definitely really stressed out during that time period, and when I really noticed the tachycardia about 2 months ago I was doing a really stressful internship).
I'm off the plaquinel again right now, b/c when I took it again it did feel like my heart rate went up, or at the very least was more of a pounding heart rate.  My rheumy put me on prednisone, I took 20 mg of that and my heart went crazy, so I've decided it's best not to take that right now (cardiologist seemed to agree with me).  I see the cardiologist Monday to get an ecocardiogram, so we'll see if he can shed any light on this issue. Thanks again.

Melissa
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