Propafenone (Rythmol) or Flecainide (Tambocor)

[AAB13X2L]

I started taking propafenone this past Tuesday (4 days ago) and it makes me very lightheaded and increases my breathing difficulty, I have copd, using Metoprolol and an inhaler. It also drains my energy. The EP nurse said I could stop the Propafenone and after a few days they would start me on Flecainide. I see a lot of people on the forum are taking Flecainide and my question is which one has the least side effects. I know that we all are different and results vary.

[Hidden]

Please ask your medical provider, but I thought if I took Flecainide daily it needed a 2nd medication to balance it out. For me that was Diltiazem.

[BobD Volunteer]

Propafanone does have some beta blocking qualities so if you have COPD it probably isn't the drug for you. Every drug has some side effects so it is really a matter of trying different ones till you find what is right for you.

[AAB13X2L in reply to BobD]

Thanks Bob, I went for my daily walk around the block which I do with no problem. When I got back my chest was tight as a drum and I was wheezing bad. Call the EP nurse and she said to stop it and call them back Monday and report how I am doing. If everything returns back to what I call normal for me then I will know for sure it was the Propafanone.

[Buffafly]

Before I was prescribed Propafenone the consultant asked me if I had bad asthma so it is obviously not suitable for people with severe breathing difficulties.

[Hidden]

No side effects from Flecainide 200mgs/day for 2 years - taken on its own for Lone PAF at 62yo coupled with lifestyle and supplements.

[AAB13X2L in reply to Hidden]

Thank you for the information, I have been looking at some web sites and it seems that Flecainide, works well with beta blockers. The EP nurse said that would be the next drug they would try.

[Hidden in reply to AAB13X2L]

Flecainide is an old tried and tested drug and often prescribed with Beta Blockers unless like me you have a lowish HR around 55 on Flec in which case not a good idea - as my cardiologist but not everyone pointed out.

[AAB13X2L in reply to Hidden]

The Metoprolol keeps my HR between 60 and 70 bpm, but allows it to go up when I exercise or do a stress test. I started taking it for PVC"s 15 years ago and it stopped them. I like the idea that Flecainide, works with beta blockers. I took my last dose of Propafenone, yesterday afternoon and my breathing is getting a lot better. Thanks for the reply.

[JonathanPittsCrick]

Propafenone has some beta-blocking effect which can make asthma worse and lower your blood pressure, especially if you are also taking metoprolol, a more powerful beta blocker. Flecainide does not do this (in fact has no side effects in most people) so it is well worth trying - it may also allow you to reduce the dose of metoprolol which would be helpful in terms od energy and breathing. Another option is dronedarone (which is like amiodarone without most of the side-effects - but expensive)

As you say, everybody is different so if one drug doesn't suit you there is probably another which will.

[AAB13X2L in reply to JonathanPittsCrick]

Thanks for the reply Jonathan, and I agree that in my case Flecainide , is the next one I want to try. Been doing a lot of reading up on it and from the reports it seems that it works well with beta blockers. EP nurse said they would start me on it after the Propafenone, was out of my system. I am going to read up on the other one you suggested also. I am on 25MG of metoprolol twice a day as well as FORADIL, a long-acting beta2-adrenergic agonists (LABA). It would be good to have more energy and be able to breath better. Again thanks, good forum with good people.

[JonathanPittsCrick in reply to AAB13X2L]

It's a bit unusual to be taking a beta stimulant and a beta blocker at the same time as they are, to an extent, working against each other. The logic is that the Foradil is a beta2 stimulant (mainly acting on the lungs) while the metoprolol is a beta1 blocker (mainly acting on the heart) but unfortunately they are not 100% specific so there is some overlap. This means that the Foradil is making your AF worse and the metoprolol is making your COPD worse. It's a difficult (and not uncommon) situation and I think that the dronedarone (which would take the place of both the flecainide AND the metoprolol) could be the best solution and could allow you to reduce the dose of Foradil.

You may like to discuss this with your EP doc.

[dmack4646 in reply to JonathanPittsCrick]

Jonathan is there a chance that dronedarone can work when flecanaide has failed - do they work in different ways ?

[JonathanPittsCrick in reply to dmack4646]

Yes, flecainide is a "Class Ic" and dronedarone is a "Class III" antiarrhythmic, which means they work in quite different ways. As I have mentioned before, verybody is different in how they respond to medications (because we all have slightly different enzyme pathways and different versions of the arrhythmias) so even if one doesn't work or have side-effects, another may work fine.

The slowing effect of beta blockers can be alternatively achieved with other drugs such as diltiazem and digoxin (which don't affect asthma), so these can be used with flecainide.

[dmac4646 in reply to JonathanPittsCrick]

Many thanks for your reply

[Bikica1234 in reply to JonathanPittsCrick]

Sorry,,

what does PVC mean? Maybe it's heart skips? I have heart palpitations (SVES and VES). I take bisoprolol 2.5mg and it doesn't do anything for me. It just reduced my heart rate to normal. However, for SVES and VES they don't help me. I'm thinking about whether metropolol would help me.

[Bikica1234]

Sorry,,

what does PVC mean? Maybe it's heart skips? I have heart palpitations (SVES and VES). I take bisoprolol 2.5mg and it doesn't do anything for me. It just reduced my heart rate to normal. However, for SVES and VES they don't help me. I'm thinking about whether metropolol would help me.