Worried about too larger a dose for Pill in Pocket for my weight. Got answer from EP today.

As researched I found that Flecainide should be dosed according to weight The EP confirmed this. Therefore, in my case I should only have 200 mg because I am less than 70 kgs. Furthermore, I should only receive the initial dose in hospital so that they can monitor me. So starting it at home is not a good idea and the EP was surprised that the GP had prescribed such a high dose and that I start the medication at home.

It has been agreed that I come off Amiodaron although I he said I could take it until January so as to help me over Christmas, eg. family gatherings. My husband and I decided it would be better to have a quiet Christmas.

In two weeks time it was agreed that I have a monitor fitted on me for three days. He suggested this when I said I was prepared to do this to pre-empt getting AFib. Otherwise, I just would have to wait for episodes to occur. If they did occur he prescribed that I take 2.5mg Bisoprolol. I thought this might be the case because when I started Amiodaron in the loading phase, I took 5 mg of Bisoprolol to stop an episode of AFib. Further, he said he would not advise taking Flecainide at this stage.

I hope this is comprehensive enough PeterWh :-D

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  • I love the comment!!!! Also the Halloween style smiling mouth!!! You have a good sense of humour.

    Very comprehensive and orderly. At least you are making process.

    PS I couldn't possibly know if you missed something since I wasn't there. [She breathes a sigh of relief that he wasn't the fly on the wall!!!].

  • PeterWh As our resident nerd you are keeping us all on our toes! 🤓 🤗

  • I shall be giving you all a break now. I think. Unless I think of or come across something else. ;- )

  • Oh! by the way PeterWh, the EP said I could have a little dark chocolate! Not too much obviously. As I mentioned before I do like 85% cocoa solid Black's organic chocolate. :-)

  • Very informative post, I've been taking Flecanaide for over ten years and was started at home with a 50mg twice daily dosage and have gone all the way to max dosage of 150 mgs twice daily . I have recently been slowly cutting back on mgs as I'm working at changing lifestyle , losing weight etc. my goal is to be able to use as pill in pocket. I weigh 128 lbs and am now very concerned that EP has never mentioned weight as a criteria for dosage. Thank you for sharing and I will surely mention to my EP on next visit , Gracey

  • You are very welcome. If you can walk or do gentle exercises to start off with. Physi.o could perhaps help. I am sure you know what to do, diet wise. Heather

  • I just read Flecainide can cause weight gain. So I hope you are not being hard on yourself. :-) I found that I have to be really rigid whilst on Amiodarone because that causes weight gain in that if you relax for a bit the weight just does not come off. Or not so easily when one does exercise. I have been walking 2 miles a day for the last six weeks but still carrying the extra 4 lbs I have gained.

  • Hi heatherfriend, pleased to hear your EP has confirmed your reluctance to follow your GP's instructions about taking Flecainide, and it sounds like since discussing your concerns with him you have a much better plan for the immediate future.

    I think that bringing this issue to the attention of others on the forum you have highlighted something that possibly a lot of us didn't know about (I for one definitely had no idea that Flecainide should be prescribed according to the weight of the patient, but then I am a bit of an ignoramus so it's quite possible I am the only one who didn't know!).

    Best wishes for a lovely AF-free Christmas, Kate

  • Thank you. No you are not an ignoramus. The GP ex-cardiologist should have known better. He also prescribed another drug that interacts with Amiodarone in a bad way. I am so glad I check things up and research on the internet. But I must try and take a break now.

    Best wishes to you too and wish you and all those on this Forum a lovely AF-free Christmas, Heather

  • hasteacademy.org/blogs/gues...

    4. If this does not occur, take a single dose of Flecainide (300mg if weight > 70kg, 200mg if weight < 70kg) or Propafenone (600mg if weight > 70kg, 450mg if weight < 70kg).

    I also found this advice on another link but found this one which is even more informative and concurs with the EP's advice.

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