General Warnings

Drugs That Can Cause Atrial Fibrillation

What’s atrial fibrillation?

Atrial fibrillation happens when the electrical impulses in your top two chambers (the atria) fire chaotically when they should be steady and regular, causing them to quiver or twitch (fibrillation).  If this happens you might feel an irregular and sometimes fast, heartbeat or pulse. Some people say it feels like their heart is fluttering or racing (known as palpitations).

Atrial fibrillation causes your heart to beat irregularly and sometimes much faster than normal. Also, your heart’s upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can make you feel tired, lightheaded, or dizzy. You may also feel like your heart is skipping a beat, fluttering, pounding, or beating too hard or fast. You may also feel chest pain. Blood may pool in your heart, which increases your risk of forming clots and can lead to strokes or other complications. Atrial fibrillation can also occur without any symptoms, which can make it hard to diagnose. Atrial fibrillation may cause heart disease or worsen existing heart disease.  If left untreated, atrial fibrillation can lead to serious and even life-threatening complications, like stroke or heart failure.

Drug-induced atrial fibrillation

Drug-induced atrial fibrillation occurs more frequently in patients with risk factors and co-morbidities that commonly co-exist with atrial fibrillation, such as advanced age, alcohol consumption, family history of atrial fibrillation, hypertension, thyroid dysfunction, sleep apnoea, and heart disease.

The following drugs have been associated with an increased risk of atrial fibrillation in some patients:

1.        Amphetamines

2.        Antiarrhythmics (e.g., flecainide, propafenone, sotalol)

3.        Beta-blockers (in rare cases)

4.        Calcium channel blockers (e.g., verapamil, diltiazem)

5.        Digoxin

6.        Diuretics (e.g., furosemide)

7.        NSAIDs (e.g., ibuprofen, naproxen)

8.        Theophylline

9.        Steroids (e.g., prednisone)

10.      Antibiotics (e.g., erythromycin, clarithromycin)

11.      Antidepressants (e.g., amitriptyline, imipramine, fluoxetine)

12.      Antifungal drugs (e.g., ketoconazole, itraconazole)

13.      Antihistamines (e.g., diphenhydramine)

14.      Antipsychotics (e.g., haloperidol, risperidone)

15.      Chemotherapy drugs (e.g., cisplatin)

16.      Methylphenidate

17.      Nicotine (including from smoking and vaping)

18.      Phenylephrine

19.      Pseudoephedrine

20.      Theophylline

It is important to note that while these drugs have been associated with an increased risk of atrial fibrillation, many people take these medications without any adverse effects. It’s essential to talk to a doctor or pharmacist if you have any concerns about the medications you are taking and their potential side effects.

Can I Prevent atrial fibrillation?

Not all cases of atrial fibrillation can be prevented. By taking steps to avoid coronary artery disease or high blood pressure, however, you can help avoid developing A-fib due to these causes. The basics include not smoking, following a heart-healthy Mediterranean-style diet (high in plant-based foods, fruits, and vegetables, and low in saturated fats), being physically active, and keeping to a normal weight (as indicated on a body-mass index chart).


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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