Medications

Medicine treatment decisions are based on the cause of your atrial fibrillation, your symptoms, and your risk for complications. You will likely take a medicine to help prevent a stroke. You may also take a medicine that controls your heart rate or your heart rhythm.

Prevent a stroke

Anticoagulants

Anticoagulant medicines, also called blood thinners, are recommended for most people with atrial fibrillation who are at average to high risk of stroke.

If you are age 55 or older and have atrial fibrillation, you can find your risk of having a stroke in the next 5 years using this Interactive Tool: What Is Your Risk for a Stroke if You Have Atrial Fibrillation?

Anticoagulant choices include:

• Warfarin (Coumadin).
• Anticoagulants other than warfarin.
  • Dabigatran (Pradaxa)
  • Rivaroxaban (Xarelto)

For help deciding if you should take an anticoagulant to prevent a stroke, or for help deciding which anticoagulant to take, see:

Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?

Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?

Aspirin and other antiplatelet medicines

If you are at low risk of stroke or cannot take anticoagulants, your doctor may recommend that you take aspirin. It is not as effective as anticoagulant medicines in preventing clots, but it does not have as many side effects.

Your doctor may have you take other antiplatelet medicines, such as clopidogrel (Plavix), along with aspirin or instead of aspirin. When aspirin and clopidogrel are used together, they may reduce the risk for stroke more than aspirin alone. But this combination is also more likely to cause bleeding than aspirin alone.

Safety and medicine

If you take an anticoagulant (also called a blood thinner), you need to take extra steps to avoid bleeding problems. These steps include the following:

• Prevent falls and injuries.
• Tell your doctors about all other medicines and vitamins that you take.

If you take warfarin, you also:

• Get regular blood tests.
• Eat a steady diet. And you pay attention to foods that contain vitamin K.

Warfarin: Taking Your Medicine Safely

Blood Thinners Other Than Warfarin: Taking Them Safely

Control your heart rate or rhythm

You may also need to take rate-control medicines or rhythm-control medicines (antiarrhythmics). Both of these types of medicines are effective treatments for atrial fibrillation. Your doctor will likely talk with you about which of these treatments might be best for you.

Control heart rate. Rate-control medicines are used if your heart rate is too fast. These medicines include beta-blockers, calcium channel blockers, and/or digoxin. They usually do not return your heart to a normal rhythm—in other words, your heartbeat will still be irregular. But these medicines can keep your heart from beating at a dangerously fast rate. You might not have symptoms from an irregular heart rhythm if your heart rate is lower than 110 beats per minute. Rate-control medicines may relieve symptoms caused by the fast heart rate. But these medicines may not be an option if you have severe symptoms with atrial fibrillation.

Control heart rhythm. Rhythm-control medicines (also known as antiarrhythmics) may be used for some people with atrial fibrillation. These medicines help return the heart to its normal rhythm and keep atrial fibrillation from returning. These medicines may help relieve symptoms caused by an irregular heart rate.

What to Think About

Some of these medicines may also be used to treat coronary artery disease, heart failure, and high blood pressure.