has anyone ever heard that flecanide cannot be taken without a beta blocker??? Beta blockers are causing me terrible problems in my opinion. Has anyone ever heard this?

36 Replies

  • I don't take Beta-blockers yet have taken Flecainide for about nine years, for about 7 of them my dose has been 150mg x 2 a day. I only get AF now if I'm late taking Flecainide. I am asthmatic and generally asthmatics appear not to be given beta-blockers.

  • Like Thomas I suffer from Asthma, albeit quite mild

    I take 50 Mg Flecainide twice each day & although my BP can get a bit high my cardiologist no longer prescribes beta blockers.

    I was given Metroprolol when I was first diagnosed with AF but I coughed for days, non stop.

    Also my resting pulse is usually a few beats per minute below 60 and I recall my GP saying that this also precludes the use of a beta blocker.

    All the best


  • I have been prescribed both independently of each other. Ask to reduce your dose of the betablocker - that worked for me.

  • I took Flecanide for 7 years without any problems and it was only after a recent visit to an EP for a check up that he put me on Bisolprolol, its something about controlling the rate and rhythm. I did think that the Bisolprolol was causing me problems with a bad taste in my mouth so I stopped them for a month and didn't notice any difference so went back on them.

  • I take flecainade and I am supposed to take Nadolol 20mg x1, but I don't take it as it is a beta blocker it messes with my head, I just take the other.

  • Yes it can. I take it without beta blocker. Have done for years

  • I have been taken off Bisoprolol and onto Flecainide (by itself) by an EP!!!

  • I prefer not to have beta blockers but my doc wont give me anything else. Still, its my 1st ablation in 3 weeks, after that (assuming its successful) I will ask to change them/stop all together. If he doesnt listen I'll go somewhere else.

    I KNOW there are other options available, he wont have it though.

  • I stopped taking my Beta Blockers over a year ago and only use them now if I get a breakthrough episode of AF. For those of us with normal blood pressures they are not a good thing and turned me into a slug. I did my research before I stopped and had no side effects when I did. So, its Flec daily and nothing else and I now feel like myself and not a dumbed down version of me.

  • Finding this post really interesting marykhall13 since I asked my doctor about this only last week (and he is also a cardiologist) and he said 'they go together'. Am like Starboard13 and had normal blood pressure before being diagnosed with AF and would like to come off bisoprolol and ramipril if I could.

  • I take Flecainide as a 'pill in the pocket' for my AF/tachycardia. I was told to take a small dose of beta blocker along with this when my heart takes off racing as flecainide doesn't bring blood pressure down and mine shoots up with my fast heart rate.


  • Perhaps the two are recommended together when there's a rate AND rhythm problem? I don't have a rate problem so wouldn't know. Perhaps when the cardio said they go together he meant just for your situation.

  • The explanation I was given my my EP was that the Flecainide stops the break-through episodes (rhythm) and the beta-blocker (or equivalent) is there to control the rate should a break-through episode happen. Mine is paroxysmal AF.


  • Hello Mary k.

    Flecainide is a Beta Blocker,I was prescribed it,to be used as Pill in Pocket

    When I have an episode of Paroxysmal AF.

    I also take Bedranol 160mg daily,which is also a Beta Blocker,this replaced

    Inderal LA which I took for 27yrs,these medications do keep me well.

    Flecainide puts my heart back in rhythm 40mins to 2hrs normally,if not

    allow up to 8hrs and I go to A&E as advised by Cardiologist.

    Bedranol helps with Anxiety and keeps heart in rhythm most of the time.

    Good luck,keep well.


  • YES, it can be dangerous because Flecainide can convert atrial fibrillation into slow atrial flutter leading to ventricular tachycardia if there's 1:1 conduction through the AV node. This is what happens with me, in which case you need a rate control drug to keep your HR to a safe level. It doesn't have to be a beta blocker though, my cardiologist used Diltiazem expressly because it doesn't make you feel lousy like BBs.

    Flutter is harder to control with drugs than fibrillation, so if it all goes pear-shaped like mine did last summer one option is a hybrid therapy with flutter controlled by ablation, and fib controlled by drugs.

    Here's Heidbuchel et al:

    "Caution should specifically be exercised with the use of class 1 antiarrhythmic drugs in monotherapy in patients with AF. These drugs may prevent AF recurrences. They can, however, convert AF into slow atrial flutter, which may conduct one-to-one to the ventricles during situations of high sympathetic tone. Impregnation of the ventricles with the class 1 drug will lead to broad QRS complexes (resembling VT) and profound negative inotropic effects leading to cardiogenic shock and even sudden death. Class 1 drugs can be initiated for the prevention of AF episodes after previous evaluation has shown adequate ventricular rate control during exercise. Prophylactic ablation of the flutter circuit must be considered in athletes in whom therapy with class 1 drugs is indicated. The ‘hybrid’ therapy of class 1 drugs and the ablation of flutter may obviate the need for maintenance therapy with bradycardic agents."

    Heidbuchel et al:

    Recommendations for participation in leisure-time physical activity and competitive sports in patients with arrhythmias and potentially arrhythmogenic conditions.

    Part I: Supraventricular arrhythmias and pacemakers.

    P. 2006 European Society of Cardiology


    (Class 1 antiarrhythmics are sodium channel blockers, Flecainide is Class 1c.)

  • Very interesting and thought-provoking, ectopic.

  • I have a letter in front of me from my highly respected EP stating that I use Flecainide as Pill in the Pocket but must be taking a Beta Blocker in order to do so as it is contra indicated not to do so otherwise.

    I recall an EP at last years Patients Day who also has AF saying he had taken an antiarrhythmic drug without a beta blocks when he was younger and not to do it.

    Hope this helps.


  • Oh yes I remember that. I'm sure he said he had collapsed. X

  • Flecanide NEEDS to be taken with a BB. Certain calcium channel blockers can be used in some cases. Please consult with your Cardiologist or EP.

  • I tried beta blocker bisoprolol for a month until my second episode of AF 4 years ago. It was stopped as heart rate low and not stopping paroxysmal AF. I'm 71 and take 100mg Flecaininde twice a day ( and warfarin) and have had only one episode since starting flecainide. Seem to remember reading somewhere ( sadly can't remember where) that if you have AF triggered by a vagal response beta blockers can make it worse.

  • Yep I was told that I should have a low dose of beta blockers as well as flecanide because flecanide has the potential in some people to induce a high heart rate. X

  • No, I took Flecainide without Beta blocker.

  • Sorry I haven't heard of this , however , I can't take Beta blockers as they make me ill. Bebe.

  • Yes the cardiologist who is the medical director of our support group has mentioned this

  • I take betablocker every day and a high dose flecanide when needed for P/A/F which always seems to start about 4am I do not take beta blockers when I take flecanide because I find my already low B/P drops to low but as with anything to do with A/F what works for one is not always right for some one else

  • This is slightly random but i havent seen any responses from Bob is he ok?


  • I dont know him but I hope he is ok

  • He's just replied to my research question, so yes, he's in the land of the living!


  • very good

  • Years ago before I had my heart valve replaced I was getting bad a/Fib from over training and they put me on Flecanide along with Atenolol in those days .

    The Flecanide worked for about 4 years then it broke though and it stopped working .

    The biggest problem with Beta Blocker which I take (Betaloc 190mg daily ) in it has ruined my sex life completely , I would not take drugs like Viagra as I am in perm A/fib and it makes it worse.

    I often curse Beta Blockers !

  • thank you for replying. yes beta blockers make me so fatigued

  • The Beta blocker I take is Metoprolol 25 mga twice a day with no affect to me. thank God.

    I also take Flecainide 50 mgs twice a day with no affect also.

    I also take 400 mgs Magnesium twice a day 800 in total.

    Since taking this my episodes are not as frequent which I think contributes to the Magnesium.

    I hope this helps you.

    Regards. Rob x. It is very frustrating having AF until the Meds are sorted out.

    Good luck lets know how you go.

  • magnesium hummmmmm

  • THank you ssoooo much. I am so frustrated but I need to add magnesium I think. My afib is controlled and now they suggest a pacemaker to get my heart rate up. I was told it could be sinus node disease or med side effects.

    This concerns me because if the meds fail again I have a pacemaker and who knows why. Also I had a hugh improvement in low heartrate when my beta blockers were reduced. Still sorting it our. I go to OSU and have a great dr. Due to the pacemaker recommendation I will probably get a second oppinion at cleveland clinic for my own peace of mind that the plan is the best one. I am so grateful to have found this group. I have been struggling with this for about 8 years. I have had 3 ablasions and all sorts of meds. Now I am paying 3,000. for a dental device that is supposed to stop my sleep apnea as I could not tolerate c pap . that was a long story thanks for any further advice

  • I was on a Flecainide for some 9 years without a beta blocker. My EP never once indicated that I should also have a beta blocker.

    There may be circumstances that require a beta blocker ( rate control) to be used in conjunction with flecainide (rhythm control) and perhaps you should discuss this with an EP as AF may arise from complications within the heart that mine didn't have. ( I had lone AF). I eventually had a PVI ablation that I consider has been a success only taking a substitute rhythm control drug , Propafenone, as a PIP. as and when needed.

  • I was prescribed BB when after stress test showed BP increased under heavy stress , but am also on Losartan - mind you v small BB dose (1.5 Bisoporol)

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