Flecanide

[Kbuck1234]

Hi does anyone on here take flecanide as a PIP? If so how much do you take?

My pills say take twice a day 100mg until AF stops but I find taking 200mg in one shot gets rid of the AF.

[BobD Volunteer]

Whatever else you take the absolute maximum you can take in 24 hours is 300mg. When I took flec as PIP that is what I took. Then nothing for another day. Only on it for a very short time as EP switched me to Propafanone full time.

Please discuss with your EP as we are not medically trained and should not advice on drugs/

[F-M-C-MM in reply to BobD]

The first EP I visited said it was safe to take up to and including 400mg daily, which surprised me, as the recommended maximum dose in all scholarly articles online etc is 300mg, as you stated also. A cardiologist had earlier warned me that it was a somewhat problematic drug for some people, so one needs to do a little research and not be overly reliant on one person's opinion even if they have a brass plate outside their door!!

[jennydog]

My EP said to take 100 within 20 mins of AF starting with a further 100 if it hasn't worked 3 hrs later. Max dose is 300 per day.

Others have been told to take 300 in one go. That would terrify me!

I also take 2.5 bisoprolol daily and I understand that the flecainide / betablocker combination is important.

[Hidden in reply to jennydog]

I hope you don’t mind me mentioning this Jenny, and it’s very important that forum members check it out for themselves with their own doctor, but it is my understanding that irregular doses of Flecainide taken as a PiP do not need betablockers or calcium channel blockers. HOWEVER, regular daily doses of Flecainide MUST be taken in conjunction with a betablocker or a calcium channel blocker....please note I am not medically trained but is my understanding!

[Angie06 in reply to Hidden]

Well that's strange as I've been taking flecainide 2x50mg daily for the last 10yrs but never been prescribed any beta blocker or even given any advice on them . I'll ask about this on my next review with GPas only get to see my EP if there's a problem. Luckily I've never had to take a higher dose as this seems to keep it under control.

[secondtry in reply to Angie06]

Cardiologists evidently have different views, I have taken 200mgs per day for 4 years without a BB or CCB, as told they would make me unwell given my 115/60 BP and 50-55 pulse. I have queried this several times. Fingers crossed then!

[Bagrat in reply to Hidden]

Like the other 2 who've replied to you, because of low pulse , I don't take a beta blocker just flecainide regularly

[CDreamer in reply to Hidden]

Again I think it depends upon individual circumstances. The subject as whether or not to take any rate block is very controversial and I certainly took Flecainide without any rate drug and had no problems. Many with low BP or asthma would not be advised to take beta blockers but as you say - important to talk to your own doctor.

[Redders in reply to Hidden]

Morning flapjack, I was taking flecainide daily with no beta blockers for 19 months up until my ablation 3 weeks ago. I was in permanent af so the flecainide didn’t do a thing for me. I went back to work yesterday and by lunchtime I was back in af and I’m still in af now. Most disappointed. Val

[BobD Volunteer in reply to Redders]

I think that the reason beta blockers are recommended is that Flecainide can introduce some unwanted ventricular rhythms IN SOME PATIENTS. This is why the drug used to be only started in a controlled (hospital) environment . Flecainide is also not recommended if there are any problems with coronary arteries which is why checks need to be made. Again why GPs are not normally allowed to prescribe it in the first instance. This situation also applies to Propafanone a similar drug to Flecainide and what I was on for many years.

Strangely this proviso seems to be ignored quite a lot recently from what we see here. I wonder if there are any lurking doctors who would like to comment?.

[jeanjeannie50 in reply to BobD]

Yes Bob, I was one of those that Flecainide was giving unwanted ventricular rhythms too and I took a beta blocker alongside it. I had 8 months constantly in AF, completely unaware that it was caused by this drug. Grrrr!

As I've said before, we're prescribed drugs and then just left on them for ages and are often unaware of the side effects they can cause.

Jean

[Polski in reply to BobD]

BobD, are you saying that taking a BetaBlocker eg Nebivolol along with Propafenone, will prevent additional arrythmias from developing as a result of the Propafenone?

[BobD Volunteer in reply to Polski]

I was speaking specifically about the need to check coronary arteries before using these drugs. Propafanone doesn't need beta blockers as it is not the same as Flecainide.

[Polski in reply to BobD]

Thank you!

[Hidden in reply to Redders]

Awww Val, that’s a real bummer.....but still very early days so let’s hope you settle soon. Can you speak to an Arrhythmia Nurse as they might suggest using Flecainide as a PiP.....best of luck, John

[Redders in reply to Hidden]

Trying to get hold of the arrhythmia nurses is practically impossible. I took 50mg of flecainide early this morning but probably not enough. Val

[Hidden in reply to Redders]

Probably not.....but I’m saying nothing! 😇

[jeanjeannie50 in reply to Redders]

Have you left a message with them, explaining the situation?

[Redders in reply to jeanjeannie50]

Just spoke to Debbie and she said to take 50mg flecainide now and she’ll try to speak to GH but she wasn’t sure he was in today. X

[jeanjeannie50 in reply to Redders]

Oh no Val, I'm sorry to hear that! Have you let your AF nurse know and sought her advice? My AF came back after my third ablation and I went back to the hospital for a cardioversion and have been more or less fine ever since. Don't go giving up hope of being cured yet.

Jean

[Redders in reply to jeanjeannie50]

Thanks Jean, I’m trying to get hold of the arrhythmia nurse but nobody answering. I’ll keep trying x

[jeanjeannie50 in reply to Redders]

Can you leave a message? I guess they may be at a meeting as there's usually someone non medical manning the phone there.

[Vonnieruth in reply to Redders]

So sorry your back in AF

[Hidden in reply to Hidden]

I’m only repeating what has been said on three different occasions by three different specialists at our support group meetings. It was said that Flecainide on its own can cause Atrial Flutter and is one of the reasons why Flecainide is supposed to be first administered in hospital under medical supervision. Not sure this always happens either, hence the usual comments about checking with your own doctors. Maybe I ought to have said “SHOULD” and not “MUST” but all three were quite specific.

[Hidden]

As has been said, it is important to follow the instructions given by your doctor. Flecainide is a very potent drug and people can react to it differently which is why “Doctor knows best”. I was instructed to take the max daily dose of 300 mgs in one go and in the last year or so I have probably had to do it around 6 times and for me, it was not a problem. You really should clarify the best dose for you with your EP.....

[Jay10]

Hi Kbuck1234,

I was told to take 100mg when needed and an extra 50mg if things didnt settle within 1 hr.

I am also on Felodipine (CCB) 10mg daily.

As others have said I am only giving you an idea of what works for me and I am not medically trained.

Speak to you gp or heart consultant if you have problems or concerns.

Jackie

[Rubymurray25]

As we always say we are all so different from one another and even we are different ourselves from one day to the next, which I guess makes sense as each stress or anxiety attack can be so vitally different or whatever trigger might bring on an episode ! I was told by a cardiologist whilst on holiday to take 100mg flecinaide 30 mins on from the on set of an AF episode and then 100mg after a further 30mins if it was still going . The first time it worked brilliantly within the first 30 mins, job done, second time I had to take the second one. I was quiet clearly told that if after taking two 100mg it didn’t work then after 1 hour I needed to go to A&E , which again goes to show , different views by different consultants on our individual levels of the condition.

[CDreamer]

Very personal according to medical advice - when taken as a PIP I took 300 mg straight away and then nothing for 24 hours but there was 1 occasion when my EP asked me to take another 100 mg during a very problematic episode after ablation about 10 hours after taking the 300 mg. When taken daily, I took 150 mg every 12 hours but if an episode happened between I took 100 mgs straight away, then missed my next dose. That often worked!

[KMRobbo]

I have flecainide as a PIP since my ablation . Happily I have never needed to use it. However my instructions are 200 mg initially then 100 mg not to exceed 300mg.

Pre ablation was on 2 x 50 mg plus 200mg diltiazem rate control.

Flecainide sorts out you rhythm but can cause a high rate in some people.

I assume that I was given rate control as my AF was characterised always by a high resting Hr (greater than 160 bpm) so was prone to high rate anyway. Other people do not appear to have this AF with high rate so maybe this explains the difference is prescription?

[babayaga]

I have PAF and take Flecainide 50mg twice a day or sometimes 3 times. I also take Bisoprolol, very low dose. Not getting any episodes recently, so it seems to be working. I was also told to take a maximum of 300 mg but I only take extra if the heart is playing up. I carry some around with me just in case.