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Medications for Atrial Fibrillation

Other names: AF; AFib; PAF; Paroxysmal Atrial Fibrillation

What is Atrial Fibrillation?

Atrial Fibrillation (AF) is a common heart condition that causes an irregular and often rapid heart rate. Having AF increases a person’s risk of having a stroke or developing heart failure.

AF is a type of arrhythmia. Arrhythmias are disturbances in the way the heart beats and are commonly caused by changes to the electrical impulse within the heart. When your heart is healthy, a steady, electrical signal that originates in the Sino Atrial node in the right upper part of your heart keeps your heart at a regular beat, usually between 60 and 100 beats per minute. This is called sinus rhythm.

The electric signal in people with AF is random and chaotic which causes the two top chambers of your heart (the left and right atrium) to quiver and twitch. It becomes difficult for your heart to fill or empty itself of blood when it is quivering so much and out of sync with the two lower chambers (the ventricles), and blood may pool in the heart chambers and start clotting. Clots can dislodge from the heart and travel to vessels leading to the brain, kidneys, eyes, or peripherally in the arms or legs. The clot can block blood and oxygen flow to the brain or other organs.

There are three types of AF:

  • Paroxysmal AF: Episodes of AF come and go, sometimes in relation to exercise or stress. Episodes may last for minutes or hours but no longer than one week
  • Persistent AF: Episodes last for longer than one week
  • Long-standing persistent or permanent AF: AF episode has lasted longer than one year.

What Causes AF

Experts aren’t sure exactly what causes AF; however, they have identified several risk factors that make some people more likely to develop the condition. These include

  • Older age (particularly over 65 years)
  • Congenital heart disease
  • Coronary artery disease
  • Diabetes
  • Excessive alcohol intake
  • Exercise: Healthy middle-aged males who have been engaged in strenuous endurance training for more than 10 years have the highest risk of developing AF caused by exercise
  • Genetics: AF can sometimes run in families
  • Heart attack
  • Heart disease or damage
  • High blood pressure
  • High thyroid hormone levels or other metabolic imbalance
  • Kidney disease
  • Lung infections (eg, pneumonia)
  • Medications such as adenosine, dobutamine, ondansetron, paclitaxel, and anthracyclines
  • Obesity
  • Sleep apnea
  • Stress.

What are the Symptoms of AF?

Some people with AF have no symptoms and only get a diagnosis after a routine physical examination or an examination for an unrelated reason. Some people are not diagnosed until they have a stroke or mini-stroke.

Other people experience symptoms daily or only mild symptoms once in a while. Symptoms may include:

  • Heart flutters or palpitations
  • feel dizzy, weak or faint
  • Nausea
  • Shortness of breath
  • Chest pain, discomfort, or tightness
  • Fatigue
  • Having difficulty exercising.

How is AF Diagnosed?

See your doctor if you are experiencing symptoms of AF.

Your doctor will ask about your family history of heart disease and check your heart rhythm, heart rate, and pulse. The diagnosis of atrial fibrillation is usually confirmed with an electrocardiogram (ECG), a test that records the heart's electrical activity.

Sometimes a portable ECG called a Holter monitor, may need to be worn at home for 24 hours, if a person's AF is not consistent. Monitors are also available that can be used for longer than 24 hours if needed.
 

How is AF Treated?

Treatment varies depends on the type of AF but may include:

  • Anticoagulants (blood thinners)
  • Antiarrhythmics
  • Beta-blockers
  • Calcium channel blockers
  • Digoxin
  • Pacemakers
  • Radiofrequency ablation.

Drugs Used to Treat Atrial Fibrillation

The following list of medications are in some way related to, or used in the treatment of this condition.

Drug name Rx / OTC Pregnancy CSA Alcohol Reviews Rating Activity
Xarelto C N 52 reviews 4.4

Generic name: rivaroxaban systemic

Drug class: factor Xa inhibitors

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

digoxin C N 9 reviews 5.0

Generic name: digoxin systemic

Brand names:  Lanoxin, Digox, Digitek

Drug class: inotropic agents, group V antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

metoprolol Off Label C N X 68 reviews 5.5

Generic name: metoprolol systemic

Drug class: cardioselective beta blockers

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

diltiazem C N 43 reviews 6.9

Generic name: diltiazem systemic

Drug class: calcium channel blocking agents, group IV antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

flecainide C N 93 reviews 7.6

Generic name: flecainide systemic

Brand name:  Tambocor

Drug class: group I antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

sotalol B N X 38 reviews 7.1

Generic name: sotalol systemic

Brand names:  Betapace AF, Sotylize

Drug class: non-cardioselective beta blockers, group III antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

carvedilol Off Label C N X 15 reviews 4.6

Generic name: carvedilol systemic

Brand names:  Coreg, Coreg CR

Drug class: non-cardioselective beta blockers

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

Multaq X N 34 reviews 7.1

Generic name: dronedarone systemic

Drug class: group III antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

propafenone C N 48 reviews 8.2

Generic name: propafenone systemic

Brand name:  Rythmol SR

Drug class: group I antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

rivaroxaban C N 56 reviews 4.3

Generic name: rivaroxaban systemic

Brand name:  Xarelto

Drug class: factor Xa inhibitors

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

Lanoxin C N Add review 0.0

Generic name: digoxin systemic

Drug class: inotropic agents, group V antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Coreg Off Label C N X 1 review 6.0

Generic name: carvedilol systemic

Drug class: non-cardioselective beta blockers

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Off Label: Yes

Tambocor C N 8 reviews 6.9

Generic name: flecainide systemic

Drug class: group I antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Digox C N Add review 0.0

Generic name: digoxin systemic

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

dronedarone X N 42 reviews 6.6

Generic name: dronedarone systemic

Brand name:  Multaq

Drug class: group III antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

Digitek C N Add review 0.0

Generic name: digoxin systemic

Drug class: inotropic agents, group V antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

clonidine Off Label C N X Add review 0.0

Generic name: clonidine systemic

Drug class: antiadrenergic agents, centrally acting

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Off Label: Yes

propranolol C N X Add review 0.0

Generic name: propranolol systemic

Brand names:  Hemangeol, Inderal LA, Inderal XL, InnoPran XL …show all

Drug class: non-cardioselective beta blockers, group II antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Rythmol SR C N 14 reviews 9.2

Generic name: propafenone systemic

Drug class: group I antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Coreg CR Off Label C N X 1 review 6.0

Generic name: carvedilol systemic

Drug class: non-cardioselective beta blockers

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Off Label: Yes

Betapace AF B N X 1 review 0.0

Generic name: sotalol systemic

Drug class: non-cardioselective beta blockers, group III antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Brevibloc C N X Add review 0.0

Generic name: esmolol systemic

Drug class: cardioselective beta blockers, group II antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

Corvert C N Add review 0.0

Generic name: ibutilide systemic

Drug class: group III antiarrhythmics

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

edoxaban C N 2 reviews 4.0

Generic name: edoxaban systemic

Brand name:  Savaysa

Drug class: factor Xa inhibitors

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph

esmolol C N X Add review 0.0

Generic name: esmolol systemic

Brand name:  Brevibloc

Drug class: cardioselective beta blockers, group II antiarrhythmics

For consumers: dosage, interactions,

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Learn more about Atrial Fibrillation

IBM Watson Micromedex

Symptoms and treatments

Mayo Clinic Reference

ICD-10 CM Clinical Codes (External)

Legend

Rx Prescription Only
OTC Over the Counter
Rx/OTC Prescription or Over the Counter
Off Label This medication may not be approved by the FDA for the treatment of this condition.
Pregnancy Category
A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
N Is not subject to the Controlled Substances Act.
1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3 Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4 Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5 Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X Interacts with Alcohol.

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