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AF Association
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Flecainide side effects

Hi guys, I am new here. I had been diagnosed with AF 3 weeks ago and I am still in a state of shock. I am 32 yo, active and very fit, not really sure where it came from. My cardiologist put me on 2X100mg Flecainide and 1x2.5 Bisoprolol daily and I think Flecainide is giving me terrible side effects. I either feel very dizzy or very short of breath. It is really annoying and negatively affecting my life. My cardiologist is on holiday until mid-April and I can't ask him to review it. How do you guys find Flecainide? Are there any ways to reduce the side effects?

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Hello. Welcome to the group. I was diagnosed aged 40 it is a real shock to the system but you do learn to live with it. I was put on 2 x 100mg flecanaide and 2.5mg bisoprolol. I too had side effects I had headaches every day and felt like a zombie constantly. I cut down to 75mg flecanaide in the morning and 100mg flecanaide at night I cut the bisoprolol down to 1.25mg and the side effects did go on this dosage. I would advise to speak to your GP to see if it's ok to do this first. Hope everything goes ok for you. I had my first ablation 9 weeks ago and fingers crossed I will be stopping all medication all together in the next week. Good luck

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Thank you very much for the kind response. How long have you had the AF for? How did you find the ablation?

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I have had it for just over a year. Ablation was fine If I ever have to have another one I would be ok with it not terrified like I was for the 1st. 😂. Fingers crossed it has worked for me. Good luck with everything you will be fine just need to get the right dosage that suits you. 😁.

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It may be the Bisoprolol not the Flecainide.

Talk to your Cardiologist. If the Cardiologist is not an EP too then it would be a good idea to get a referral if you can.

Pete

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Thanks, I had been on Bisoprolol for 5 years for panic attacks, which probably were confused with AF. I never had any problems with Bisoprolol.

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I have been on Flecainide for many years with no problems but I know some do have side effects. It may settle down for you but best to talk it over with the your Consultant.

Pete

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I think I developed Afib when I stopped taking antidepressants. Those drugs have dangerous side effects.

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Hmmmm, I didn't see this message before I post my other message.

Interestingly, I found lots of technically healthy and young people had panic attack/disorder before they have afib, including myself.

I guess having panic attack/anxiety somehow messed with our nervous system and that developed into afib when the imbalance reached to a critical threshold. - I can't find or cite any study or research, and none of my docs agree, just my observation.

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Your body will adjust over a short time to AF meds. There are others to chose from if you continue having issues. Sooner or later most cannot control it with meds alone and we choose to have an ablation. I did and no longer on any meds of any kind. I carry Flec as PIP (pill in the pocket) now for AF flare ups if they should occur. I was diagnosed @ age 55. The shock wears off in time and we learn to move forward and adapt. Good luck.

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Thank you very much!

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Hello and welcome. I agree with Pete that Bisoprolol may be the culprit - I had a similar reaction on 2.5mg. It’s important at your young age to have a full discussion and treatment strategy planned with a cardiologist who specialises in heart rhythm disorders - an electrophysiologist or EP for short.

Read up all you can on the main AFA website and ask any questions which you may have. We have all been where you are today.

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Thank you very much. My cardiologist is EP and he is suggesting to do the ablation. Everything is happening so fast. I am not sure that I am ready yet (

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I would do the ablation. I am 37 and have Afib. I feel like I lost a year of my life because I was put on flecenaide and wasn't told of my options. The drug makes me so weak. The weakness never goes away. I used to be a strong and fit man. But now I am a shadow of my former self. I have lost so much weight. I feel dizzy and lightheaded all the time. Thankfully I am scheduled to have an ablation in a couple weeks. Wish I would have done it sooner. Unfortunately Afib is something that comes and goes. Even when you think you are getting better, it can come back. And it is very debilitating.

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Thank you very much for your response! That's exactly how I feel at the moment! Good luck with your ablation!

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I take my Bisoprolol at night found it helps with lethargy

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Hello Londongul, welcome to the place you would rather not be. Firstly, if you were diagnosed only 3 weeks ago, I assume you have had a private consultation with a cardiologist. AF is a very complex condition that can effect people in many different ways. Do you have AF all the time (persistent) or does it come and go (paroxysmal). Often, AF is brought about by any one of a variety of different lifestyle issues but you say you are fit and healthy so maybe you are involved in what we call extreme sports, cycling, athletics or something similar which often causes AF in younger people.

As others have said, beta-blockers often have side effects which can be similar to the symptoms of AF itself, but as a general rule, Flecainide is, for many, not too much of a problem. I suggest you checkout the many webpages available on the AF association webpage and then ask away and we will help in any way we can.....all the best

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Hi, thank you for the response. Yes, I was diagnosed privately. I managed to catch AF on the Kardia device. My AF comes and goes and on few occasions, my HR was as high as 230. I will definitely consider the ablation when my EP comes back from his holiday.

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just read your other replies.....if you were taking Bisoprolol regularly for panic attacks with no side effect problems, then its possible that anxiety/fear is the main reason for your current problems. We are not medically trained so therefore unable to comment directly on medication or treatments, but the general view expressed by most folk is that ablations are more successful the quicker they are carried out, particularly if the general heart condition is good......

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I had severe nausea when first starting Flec. my GP rang the EP and they suggested halving the rate for a few weeks to let the body adapt ,then go back on the higher rate.

It worked and I dont have any side effects now.

But I only started on 50mg x 2 a day so only ever half your rate to begin with.

the other things they mentioned were , take it with a large glass of water and at least half to a full hour before breakfast.

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It doesn't sound like you have been cardioverted yet you are on flecainide - which doesn't make sense? Or have I missed a chapter in this story?

Also, if you are on flecainide you should also be on a beta blocker. Not all cardiologists know this, especially if they are not that experienced in a-fib (yes, there are cardiologists that don't know a great deal about the electrics of the heart). Flecainide + afib without a beta blocker = big risk of atrial flutter.

The lastly, I stopped taking flecainide a month ago, but I am still on a beta blocker and xarelto and the side effects i thought were caused by flecainide are still very present.

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My understanding is that bisoprolol is a beta blocker, so i don't get your comment.

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Ok, my bad. Not sure why I didn't pick that up when i looked it up, the articles showed other uses of it.

My other point is are you in afib? if you are, I am not sure flecainide will be any help. It prevents afib and can 'cardiovert' as a PIP, but once in afib I don't think it helps.

Also, going back to your original post is that there is a good chance Flecainide is not causing the side effects.

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Cheers Jonathan. I just wanted to clarify, partly for Londongul's benefit.

A lot of info at the early stages of Afib can be worrying especially when it is difficult to get a slot with the EP's. Sometimes the info on here can make things more worrying rather than being beneficial

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I hear you. @Londongul this effects everyone differently.

I forgot to ask if you have you tried a magnesium supplement and Coenzyme Q10? They made a big difference to me (in terms of addressing the side effects).

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Thank you, I was taking Magnesium Citrate but stopped taking it when I started Flecainide and Bisoprolol because I was worried it will interfere.

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when I spoke to my pharmacist about the side effects she didn't hesitate to encourage me to take magnesium citrate and the co-enzyme. The afib meds are known to affect magnesium levels - most cardiologists will be impartial about supplements, but i can assure you they have helped me and many others on this forum.

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Thank you very much! I have just taken Magnesium Citrate to see if I feel any better. What dose of magnesim citrate do you usually take? Does it have to be taken with Coenzyme Q10?

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I take 100mg magnesium tablet per day (I could double that and still be within recommended dosage) and the coenzyme every second day.

Just to be clear (I have said this elsewhere): the magnesium and coenzyme assist with the side effects of the meds. I don't think they have any impact on the afib itself. This is an important distinction and one your EP or cardiologist may not be aware of, in fact neither my EP nor my GP appreciate the Mg/side effect issue.

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No, I have not been cardioverted. My AF comes and goes. I haven't had any symptoms since I have been on Flecainide but I have a lot of nasty side effects like low pulse, BP, shortness of breath and dizziness.

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Hi. It having taken years of af before I was prescribed flecainide, and still only taking 2 x 50mg - very successfully, I'm a bit surprised at your dose at such an early stage. Especially after what sounds like your first episode.

I'm not a medic but wonder whether it's worth trying to negotiate a lower dose until your body's used to it? It's possible you could try this by phone / email so that you don't have to wait for an appointment.

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My heart goes out to you, I was 69 when first diagnosed with permanent AF and the anxiety at first was bad, at your age it would have knocked me off my feet. It will lesson with time when you begin to take on board it hasn’t killed you. ;-) you also have to learn to fight your corner. If your in the NHS there should be a cardiac nurse you can contact between consultations. If a medication is problematic speak to GP there are other drugs which can replace it. Many people suffer from this condition so you need sharp elbows never feel your being a nuisance when you contact medics about your meds or fears. As important you need to stay calm, not easy at first for sure, but if you don’t you will worry yourself into the ground. Finally it is essential you try and find a way to live with AF not good ne

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Thank you very much for your kind words! I was diagnosed privately, so don't have NHS nurse. I went to see a GP today, but they couldn't help me because Flecainide is a specialist drug. I might need to ask my insurance company to send me to see another specialist while mine EP is on holiday.

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I would slowly reduce the dosage you are taking. Of course let your cardiologist know first. Also I would ask him about getting an ablation. At your age you don't want to be on drugs the rest of your life. Plus flecenaide is a dangerous drug.

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I was on 2 x 100mg Flecainide and 2.5mg Bisoprolol and it didn't suit me at all. My heart rate went dangerously low and I felt as if I was going to pass out. It was questioned whether I had Brugada syndrome but was put down to the effects of the Flecainide and so was taken off of it and put on Sotalol.

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Thank you very much for your advice guys! I went to see the GP today and she said that she can't help me because Flecainide is a specialist drug and I need to go back and see my specialist. I also was diagnosed privately, so I don't have the NHS Cardiac Nurse to talk to between appointments. I called Axa Nurse helpline, they couldn't help me either. My BP was 98/65 today and pulse 52. I feel very tired, dizzy and short of breath. I don't know how I am going to work tomorrow. Thank you very much for all your support!

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Sorry you have this crappy afib. I feel you so much! I'm 37 years old diagnosed in last August. Afib has ruined my career, financial and family life and affecting my kids. I hope you can get well soon.

Did you have anxiety/panic disorder before afib?

When did you have your afib? When you were sleeping or awake?

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Hi, thanks for the response. Yes, I had panic disorder before for approximately 6 years, I had 3 lots of CBT and daily Bisoprolol 2.5 which helped quite well. Around 2 years ago I have started having Ectopic beats. Since last November the ectopic beats started to trigger AF. I managed to catch the AF on Kardia device and was diagnosed 1/03. Most of the times I had my AF when I awake but I had some episodes when I was asleep as weel. I have to take Flecainide and Bisoprolol and it makes me feel very dizzy, short of breath and tired. I had to take time off work for 2 weeks and realisticaly I have no idea how I am going back to work next week unless I fix my side effects. I am really sorry to hear that AF had suc an impact on your life! Have you had an ablation?

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Hello to you. Just to let you know there are many drugs that interact with Flecainide. According to Drugs.com (used by medical personal to check interactions) using Flecainide together with bisoprolol may have effects especially dizziness, slow or irregular heart beats, fainting or palpitations. My advice is to check the literature about Flecainide. I wear a medical alert bracelet for Medication Alert because of Flecainide as there are numerous medications that interact with this medication. The bracelet was recommended by my cardiologist's nurse practitioner. Please check with your cardiologist office and inform them of the symptoms you are having. Good luck and hopefully you get feeling better.

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Like you I have PAF and was recently given bisoprolol and flecainde and apixaban ! My doses are 1.25 bisoprolol and 50 mg flecainide x 2 ! I was given 2.5 bisoprolol but it dropped my heart rate too much so switched to 1.25 which is more bearable ! The flecainide made me feel worse so I have dropped it as a daily dose and only have it if I have a bad attack ! The 1.25 bisoprolol is ok as like you I do a fair bit of exercise, gym classes, five a side football and hill walking and find I can still do that on 1.25 bisoprolol. If you go on you tube and look at Dr sanjay gupta's you tube channel he is a valuable source of information about AF! I would also recommend a magnesium supplement if you are not taking one ! As you are young I would ask for an ablation which is what I am currently waiting for ! My guess is that your doses sound high and I would advise asking your doctor to reduce them which should help !

Andy

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