Rivaroxaban with dinner + fish oil review + patch monitor (12 wks update): Background: I have paroxysmal AFib, hypertension, and metabolic syndrome — what worked for others here?
Background: I have paroxysmal AFib, hypertension, and metabolic syndrome. I take metoprolol succinate 50 mg and rivaroxaban 20 mg. My watch gave frequent irregular-rhythm alerts, and I was taking fish oil 2 g/day. What I changed with my care team: (1) I took rivaroxaban with my largest evening meal, as the label directs for the 20 mg dose. (2) We stopped the high-dose fish oil and discussed AFib risk. (3) I wore a 14-day patch monitor to compare against the watch. (4) I moved magnesium glycinate (200 mg elemental) to bedtime. The patch showed fewer AFib episodes than my alerts suggested, and several flags lined up with exercise motion. Resting heart rate on my watch settled around 58-64 bpm. I also kept appointments for labs including kidney function. This is only my experience and not medical advice.
The rivaroxaban DailyMed label states that the 15 mg and 20 mg doses should be taken with food, and that 20 mg once daily with the evening meal applies for CrCl above 50 mL/min in nonvalvular AF. A 2021 Circulation meta-analysis linked marine omega-3 supplements at doses above 1 g/day with about a 49% higher AF risk.