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AF Association
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Flecainide- help or hindrance???

Just experienced my 3rd bout of afib in 3 years. Unfortunately, my afib meansheart rate above 180; hospitalization, and cardiovert; although I put myself back into rhythm after flatlining for 12 seconds. Consequently, The doctor increased my flecainide rom 50 mg 2 X a day to 100 mg 2X a day. Has anyone experienced side effects from flecainide??? I am concerned about the increased dosage. Any advice?

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The main concern is if you have any evidence of coronary artery disease. I trust you have had a coroanary angio or CT angio to look at your coronary arteries??

If not request one form your cardiologist - they should know it is recommended to do


I was on 150mg x 2 daily at AF worst but I was having 2-3 episodes a week then which was before ablation. I tolerated it reasonably well but not a drug I wanted to be taking long term. After about 12 months of daily use my AF progressed so that Flex became ineffective.

My care plan now states that if I have episode of fast AF zap cardioversion or by IV Flecainide.

As you have such infrequent episodes I wonder if you have asked about using it as a PIP rather than daily use?

Ensure you have regular blood draws - I think mine were about every 12 weeks for that dose of Flec - liver and kidney function.


I think any side effects have to be weighed up against the benefits one might get. Flecainide can be a very effective drug and many of us take it or have taken it. I feel the less one takes of it the better, but not taking it could have worse consequences than taking it. Alternative medications may be less attractive.

150mgs x 2 per day is the top dose and like CD I took that for several months and was earlier on 100mgs x 2 for two and a half years.


I have been taking 2 x 100mg of Flecainide for 3 years and it has controlled my AF completely for that time. The only side effect which I have noticed is short runs of AFlutter very occasionally, lasting about 20 minutes. My EP says these are caused by Flecainide organising the rogue signals into AFlutter.

For me, the benefits of being free of roughly 6 episodes per month of AF, even more frequent runs of tachycardia, fear and the ruination of my quality of life far outweigh the half dozen or so Flec-induced Flutter runs in the last 3 years.

Your AF is very infrequent, though intense and I also wonder if pill in the pocket approach has been discussed with you? This approach, if appropriate, would free you from the need for constant doses of Flecainide.


My cardiologist has not discussed pill in the pocket as an option to controlling my AFIB; however, I will ask him at my next appointment. I worry about the long term effects of the medication; although hospitalization, cardioverting, and flatlining is not preferable either!! Thank you for your suggestion.


The only tests I have had are nuclear stress test, an echo cardigam and several EKG's. Are these sufficient?


I can't take it as it gives me palpitations.


I think your doctor would agree with mine, who said better to stabilise things by taking a regular dose of Flec (100mgs/twice daily is a middle level dose) rather than PIP. 50mgs was not enough for me as was still getting AF episodes.

I have been on this dose for 3 years with no side effects but like you I know it will do something and looking to come off it as soon as I dare. I regard the drug as a way of buying time until I can hopefully sort it with lifestyle/diet/supplement changes and very slowly reduce the Flec after that.


I've been taking it 50mg x2 daily for 10yrs now and the only side effects are hot flushes which are annoying but preferable to AF. I've been told that I'm on them for life as Afib rarely goes away and my lifestyle is already devoid of alcohol, tobacco, excess caffeine and bungy jumping!

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I have been taking Flecainide for 10years. The dose has been increased gradually over the years so that I now take 150xtwice a day- the max dose. I have had no side effects and it has helped my AF greatly so have been very glad of it, much as I hate taking pills. I am now planning to have an ablation as that seems to be the next step to take. I haven't considered ablation before as It wasn't an option to begin with although ideas have now changed. I have been able to have a full life, playing sport 3 times a week(tennis, golf) Flecainide if it suits you can only be good. I am now 69

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