AF Association
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Flecanide

I get my AF episodes like clockwork every 8 days, lasting 2 days or so each time. I've recently been prescribed Flecanide 50mgs or 100mgs to try as a pill in the pocket. However on day 1 of my episode this week, I waited half an hour to make sure it was a full on AF episode and then I took one 50mg tablet, to no effect. On day 2 of the episode I took 2 x 50mgs in one dose, again no effect. Other than my AF lasted over 3 days this time instead of the usual 2 days.

Am I to presume the Flecanide won't work for me or should I try again when I get the next episode? I'm not due to see the EP again until June. Anyone with any experience of Fleacanide or advice would be greatly appreciated.

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I think you need to go and report back to your EP.

When I took Flec as a pill in the pocket the dose was 300mg - but I couldn’t take another for at least 48 hours as 300mg is maximum dose. 50mgs & 100mgs are normally daily doses - I wonder what your doctor’s reasoning was to try the lower dose? Did you take on an empty stomach? Was your first dose under medical supervision?

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The answer to both your questions are No. I was given no instruction other than to try one tablet and if that didn't work try 2. I wasn't told any other information. I was offered to take it a couple of days before the onset of my expected AF episode but preferred the p.i.p. option. I also take 2.5mgs of bisoprolol both am and pm and he said to reduce this to 1.25mgs when i started on the p.i.p. as bisoprolol makes me very tired. I have yet to reduce the bisoprolol dose as I'm waiting for the prescription to be issued.

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I have flecainide pill in the pocket. I take 100mg at onset, we!l within half an hour and another an hour later. usually works. Have you asked your e.p. Whether you might take it as a regular dose and see how you go.

Mine let's me make my own decision on that and is there to support me ongoing, we work together on my care. Could you ring and ask advice from yours rather than wait till your next visit.

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I will try 100mgs at my next episode. If this doesn't work I will try and contact my EP but he is very elusive. He only attends my hospital once every 6 weeks. I was supposed to have a 3 month follow up as I also have a phrenic nerve injury from a failed ablation back in August but June is the earliest appointment I could be given. My dose seems quite low compared to most others I have read on here but I wonder if this is because I had my kidney removed about 6 weeks ago. I don't really know. I am just so fed up of losing at least 2 days a week to AF as its very debilitating for me. I had pinned a lot of hope on the Flecanide working.

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Given your recent kidney op it would be wise to speak with your e.p. or arrhythmia nurse at your hospital for advice on dosage before increasing yourself, better safe than sorry.

Hope you get sorted soon.

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Flapjack I wasn't actually asking for medical advice. I perfectly understand people on here are not medically qualified. I was interested really if anyone else on Flecanide found it didn't work for them either or if it may have worked after a few tries. Basically grasping at straws that if someone else had the same experience as myself, that it might work eventually.

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Surreyhunni, as you know, we are unable to offer advice on medication because we are not medically trained therefore you must seek help from your EP.

In my case, I was back in AF around a year after my cardioversion. My consultant asked me to take 300 mgs Flecainide in one dose which is the maximum you can take in any 24 hour period. I was told to take the full dose in one go and not to do it in stages as this would reduce the effect. I was then told that once 24 hours had elapsed, and as it happened, I did revert back to NSR, to then continue to take 50 mgs Flec twice a day as a maintenance dose. I remained in NSR right up to my ablation. This is what was prescribed for me.....it is IMPORTANT that you find out from your EP what is best for you!!!

I was also told only to take continuous does of Flecainide with either a betablocker of a calcium channel blocker whereas this was not necessary if used occasionally as a PiP.....please, please seek professional advice!

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the earlier post went quicker than it should have done!!!

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Hi Surreyhunni, I would make sure you take 100mgs minimum (max I believe is 150mgs at one time and then only after checking with your medics) this needs to be 3 hours after eating, tricky if AF comes on after a meal and then don't eat for one hour after taking the pills.

My personal experience at RSCH with the cardio there after 9 AF episodes in a month, daily 50gms x2 per day didn't do it but 100mgs x2 per day did stop it for 4 years and counting. My cardio also said in view of my regular episodes he favoured a regular dose of Flecainide (I wanted PIP) and of course it is then easier to follow the above rules on an empty stomach etc.

I would add as you are getting regular episodes you need to look at other lifestyle/diet/supplements and accept that your nervous system (Vagus Nerve) may well be contributing to triggering AF and will need some time to calm down after your kidney op.

Good luck.

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I can' be very helpful other than I get my AF also like clockwork every 10 days and it lasts 2 days. (You'd think it would be possible to figure out why with such a regular pattern). I am very lucky in that mine is not really debilitating and is just fast for an hour then uneven at about 70 bpm in a fits and starts. I started on Bisoprolol which did nothing other than slow my heart from 50 to 40 bpm in normal condition and made me feel a bit breathless. I'm now on a low dose of Soltalol (40 mg 2x a day) and that doesn't seem to do much other than maybe take the peaks off the high speed bit but at least it doesn't have any side effects that can I feel. I do take an extra 40mg in an episode but that doesn't do much either. I think my EP is going to look at Flecanide next time round.

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I was told that 100mgs twice a day, that is 200mgs is the normal adult dose but up to 300mgs a day in two doses can be taken if required. If it doesn't work for you then as you know, you will need further advice.

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I used flecanide as pill in pocket for many years . I was always told that once I was in AF I needed 150mg in order to cardiovert. That was a result of trial and error. The lower dose is usually for keeping AF at bay if it is ‘permanent’ and it does sound like yours is

Also on a couple of occasions they had to give it to me intravenously and it took about half an hour to work

Of course you should not on any account increase the dose without Say so from a cardiologist as your heart has to be otherwise in good shape to sustain flecanide anyway and there are alternatives. I am telling you this to encourage you to insist that your GP refers you back to a cardiologist and also to give you some hope.

I have now had an ablation and touch wood no episodes for nearly 18 month’s

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Thank you to all taking the time to reply. I appreciate your comments.

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