Flecanaide pip

Hi everyone. I have had 3 bouts of A F two years ago and have taken Flecanaide 50 twice a day. My last episode was 18 months ago. I saw my cardiologist in October as a routine annual appointment and asked him if I could stop taking Flecanaide to see what happened. He was in agreement as long as I stayed on Apixaban. He said he would see me in a year and if I had been A F free then I could stop Apixaban. If I got A F I was to take 4 x 50 tablets as pill in pocket. I saw him in October and have been too scared to stop the Flecanaide. 4 pills seems a lot to take at once. On my previous episodes of A F I reverted to NSR within 3 hours. Please help. What should I do.

13 Replies

  • I take 2x50 as a pip and this works within a few hours for me. Others take more. It's probably a case of trial and error. If the AF attack is going to potentially ruin my day then I take the pip. If it occurs late in the day then I am more likely to go to bed and attempt to sleep it off without resorting to the tablets.

  • The maximum dose of Flecainde in any 24 hour period either in one hit or over time is 300mg so 4x 50mg is quite within that.

    We do not advise on medication (other than to advise continuation of anticoagulation) so you need to decide what you are comfortable with. It may be that the flecainide is what is keeping you out of AF as this is what it is designed to do but unless you look into that you will never know and in the meantime you are taking a powerful drug which you just may not need.

    I would seriously not stop anticoagulation just because you don't think you have had any AF and would want at least a seven day monitor to confirm that as many people are not aware of events which may occur during sleep or they just don't feel them There are after all countless asymptomatic AF patients who are only discovered by accident during routine medical checks.

  • Or they discover it after they have had a stroke.

  • I was trying to be more diplomatic than that Peter.

  • Lol Don't worry Bob. I know what he means.

  • I won't stop the anti coagulation.

  • Well, I know what I would do - reduce the daily dose of Flec to 2 x 25mg and see how I got on. If ok, then I would cut it out altogether. Your 50mg dose is really quite low, but I personally, think it's important not to stop taking drugs suddenly. After my third ablation In July I felt wonderful and my EP came to my bed to tell me I could stop taking my Flec (2 x 100mg). However, next day I had an unpleasant AF attack and ended up staying in hospital instead of going home. I was immediately put back on my medication.


  • I was told to creep forward with flecainide as a pill in the pocket - take 50mgs and if no joy in an hour, to take another 50mgs. Sometimes I take 100mgs in one go. It depends on how it fits in with meals as it should be taken on an empty stomach or an hour before food.

    Prior to ablation, I was taking 150mgs of flecainide twice a day.

  • And I took the maximum daily dose - 300 mg - all in one go and usually converted in about 3 hours. As always, advice varies depending upon your individual circumstances and different doctors so best to stick with what your own doctor advises.

  • Thank you everyone. X

  • I would try reducing it very slowly i.e. using a pill cutter 37.5 msg x2 per day for 3months at least.

    Don't worry about 200mgs of Flecainide I take that every day and if you go to A&E I have been put on a Flecainide drip, which I expect is equivalent or more. Initially my cardio put me on 100mgs per day but there was still a lot of AF breakout ( 9 episodes in a month), ablation was offered and declined and we tried 200mgs per day which has worked for nearly 3 years now with lifestyle changes and supplements.

    Good luck.

  • I was on sotalol and new EP weaned me off it over 4 days and gave me flecanide plus metoprolol to take as pip last may. First (and last) time I used it was in sept. Episode was very mild and only eent for 90 min. Now he wants me to wait an hour in to a fib before taking it to see if I self convert. Waiting an hour will be mentally difficult but if it remains mild I will be less anxious.

  • Thank you for all your replies. I feel much less scared about coming off Flecanaide now. I think I will try to start reducing it on 2nd January 2017 after all the festivities are over . Lol. Xx

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