AF & Flecaineide useage: Been taking a low... - AF Association

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AF & Flecaineide useage

Blokey59 profile image

Been taking a low dose of Flec for a couple of years now (50mg twice daily) but now the AF seems to be creeping in a bit more lately. I take 50mg morning then 50mg before bed but I’m wondering if I should take an additional 50mg in the middle of the day to see me through. This would only increase my overall dose to 150mg which I think is still fairly low. Anybody tried this method? I have often heard people say that they ‘use it when they need it’. For the record my AF issue is of irregular beats & not fast beats & I also take meds for blood pressure, bisoprolol & Rivaroxiban as a Warfarin substitute.

I’m due to see the cardio doc in a few weeks but I thought I might try this out in the meantime.....worth a try??

8 Replies

Don't be surprised if moderators blank out a reply. I understand where you are coming from but feel you need to address this question to your healthcare professional ( s). Most people on here are patients/sufferers and any opinion expressed may only relate to them. It seems that with medication, there is no one size fits all.

We are not medically qualified and therefore we cannot answer your question. We are are all different and as Flecainide is such a powerful drug you should only vary anything with medical supervision.

As this drug can only be authorised by a specialist EP Cardiologist you should talk to yours. If you feel you cannot wait for your upcoming appointment then call the EP's secretary or your Arrythmia nurse and ask the question.


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We cannot advise you to alter your dose. I would call the doc and get their opinion. 50 my twice daily is a low dose. When I switched from PIP to daily I took 150mg twice daily. I talked my doc into backing it down to 100mg twice daily and so far so good.

Flecainide is a drug one cannot take if they have any coronary artery disease so your doc may want to see you sooner.

Hi Blokey, as already mentioned we don't advise on drug levels. All we do is recount our personal experience and any knowledge we have gleaned as a result of AF nb the latter can be very beneficial not just for preventing AF.

My personal experience suggests you should nip this in the bud asap with your cardiologists's support and increase to 100mgs mornings and the same in the evening - this is a medium dose; I take mine on waking and at 5pm to allow an early supper. The reason being the more episodes occur the more likely you will get more.

I also understand Flecainide is an 'old' tried and tested drug as safe as any drug can be IF you have Lone AF i.e. no other structural issues or co-morbidities. Hope something there helps.Good luck!

From my personal experience I was on the exact same meds as you flecinide did help for a couple of years but the afib got worse, my cardiologist upped my dose on flec and bisiprolol, in the end my QOL was quite poor 3 or 4 days in afib maybe a day or 2 in sinus then back in afib, I had an ablation in May and fingers crossed, touch wood etc I have been fine since just some eptopics, so there is light at the end of the tunnel.

From personal experience, several times, of being in a similar position. The key question is, why the increasing problem? Is it due to needing LESS flecainide, and is it due to needing MORE. Another question is the bisoprolol. Again, it could go either way. You do not mention the dosage of bisoprolol.

There are therefore nine options, only one of which is to keep the status quo.

Flecainide can be: |reduced|no change|increased|.

Bisoprolol can be |reduced|no change|increased|.

My experience over many years (and others may have had the opposite experience) is that reducing medicines, one at a time, is more likely to work than increasing them. UNLESS I know I am going through a very stressful time.

So, talk over the options. Tell the doctor you are comfortable with reducing medicines, because I think they live under the expectation from patients that the doctor will increase them. Tell the doctor you are willing to take the risk of experimenting, within limits they set. But as others have said, flecainide is tricky stuff. Increasing it can be nasty.

CDreamer profile image
CDreamer in reply to ILowe

Good points.

All I can say is similar experience,and my EP said to add in pill in pocket approach if AF breaks through,up to 300 mg in 24 hours.I two 50 mg twice day as maintainance dose.However I'm not telling you to do this before you check with Doc,but for info! Seems to be doing the trick for me so far,and feel better overall than when I was on 100 mg flec.twice a day.

Best wishes x

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