How safe is flecainide: I was diagnosed with... - AF Association

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How safe is flecainide

Sandyc2705 profile image

I was diagnosed with PAF three years ago. Initially my cardiologist tried me with a variety of medications including beta blockers and calcium Chanel blockers - none of which suited

I was given 1.25 bisoprolol as a PIP.

Until 4 weeks ago I had only 4 short episodes, I took 2 x 1.25 bisoprolol and I was back in NSR in less than 2 hours

Not sure if it is relevant but since August I have been in a lot of pain with a prolapsed disc in my neck and I have needed to take a lot of painkillers (Zapain containing codeine)

Unfortunately I have had 2 episodes of AF in the last 4 weeks both lasting 8 hours and needing 5 mg of bisoprolol to get back into NSR

I have been referred to a new Electrophysiologist who has recommended that I start to take 50mg of flecainide twice a day

I always thought that the first time that this drug was given was always under medical supervision but my consultant has said that was advice given 10 years ago and it is perfectly safe

I know you should not google but I am now too afraid to start it in case I experience one of the “black box” warnings listed

I know 2 friends who were rushed to A&E after their first doses

Am I worrying unnecessarily?

18 Replies

I was concerned too when I had to start 2 x 100mg Flecainide at home over four years ago!! It’s sensible to be informed but we also need to trust our EP’s so I waited to take my first dose until after a holiday weekend - belt and braces so to speak. I’ve had no adverse symptoms and Flecainide has been a real friend in helping me back to a stable condition.

Best wishes with your dose.

I was first prescribed Flecainide as PiP about a year after my cardioversion started to falter and as episodes became more frequent, I was put on a daily maintenance dose of 2 x 50mg and it successful kept AF at bay until my first ablation. Like you, I was concerned about the recommendation that the first dose should be taken under supervision in hospital but I had confidence in my Cardiologist and I’m pleased to say that I didn’t have any problems with Flecainide. The only thing I would suggest is that you clarify with your EP if you should only take Flecainide daily if you are also taking a betablocker or calcium channel blocker. I’m not medically trained, but I understand that there might be a risk of provoking Atrial Flutter if Flecainide is taken regularly on its own......

I too had difficulty with a calcium channel blocker. Flecainide has been my best friend, first as a daily dose of 2x100 daily pre- ablation and now as a pill in the pocket,. I have had no problems with it whatsoever.

Thank you for your replies - it is reassuring that you have not experienced problems

Flecainide has hel p ed me enormously. I started itnearly 8 years ago and I started at home and was fine.

I've been on 2x50mg flecainide for 11yrs now and haven't had any really bad side effects.

I was on 2 x 50 for 10 months after being cardioverted by flecainide infusion in Hospital after pretty much 8 days in high HB AFIB (130-195 resting). No real problems and the only time I got AF during that period was the night I forgot to take the flec.!

I not taking it now as I had an ablation in January.

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Sorry to be the elephant in the room, but I can’t get on with Flecainide or any of the betablockers or calcium channel blockers. As my AF episodes are becoming more frequent and my hr is usually below 90 in an episode I have made the decision to take nothing for the time being.


Jhcoop55 profile image
Jhcoop55 in reply to Hidden

Do you mean that you don’t take Flec due to the side effect profile or are you merely are choosing not to go on meds? Your call, but as an FYI, the more uncontrolled AFIB events you experience, the less effective the meds will be down the road. After two failed ablations my flec and beta blocker combo keeps me in NSR and feeling great. Not one event in 7 months.

Best of luck.

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Hidden in reply to Jhcoop55

Flecainide made my Afib episodes stronger so stopped it. EP has suggested either Dronedarone or go into permanent AF. The jury is still out on that one looking at side effects of Dronedarone. Liver blood test tomorrow.


Jhcoop55 profile image
Jhcoop55 in reply to Hidden

Understood. Problem with these meds is they affect everyone differently. Best of luck to you.

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Hidden in reply to Jhcoop55

Many thanks

Took 2 x 50 mg a day for months with no issues. Seemed effective.

i was worried about starting as a friend said it was an awful drug (she uses it as a PIP)but I'm happy on 50mg morning and evening (started 2 month ago no side effects that I've noticed). It's such a relief to feel that I am not going to have an AF episode, I'm much more relaxed. Before I was given the prescription I had to have a CT with contrast to check my coronary arteries. Cardiologist said that was routine as Flecainide can have adverse effects on people with coronary disease. So also nice to know my coronary arteries are clean too. :-)

I'm on WL for an ablation.

I did not get on with 1.25 mg bisoprolol taken daily as it brought my heart rate down too low but by going to see an EP privately I got flecainide prescribed which I take as a PIP and it works very quickly- if the heart beat is over 140 20 minutes after taking 1 (or sometimes 2 flecainide tablets) I am advised to take a 1.25mg bisoprolol and that sorts it out. My episodes never last more than a couple of hours so cannot be doing that much harm. When the episodes were getting more frequent, I was advised to take flecanide regularly but I found that taking them when I was fine made me feel a lot worse (increased blood pressure etc) so I just use as PIP if/when needed. Of course we are all different but I hope my experience helps.

Sandyc2705 profile image
Sandyc2705 in reply to SandiBee

Thank you all for your advise

I am still quite scared to start the treatment despite a lot of positive feedback from many of you

I have not had blood tests nor any checks on my coronary arteries ( my dad died at 64 with hardening if the arteries)

I react badly to most medication and in general my quality of life is good with my AF (6 short episodes in 3 years)

I am thinking of asking my consultant if I can use it as a PIP as I do with bisoprolol now

11 years Flec 100mg twice a day no probs whatsoever (60mg Diltiazem MR with am dose). Has kept AF episodes to no more than a couple of times per year. First ablation in Bordeaux 3 months ago and now nervously about to start weaning myself off it!

Used Flec as PIP for several years - gradually as episodes increased it took longer to get to NSR. Had first ablation in 2017 and was not on any meds - nine months then developed flutter- took Flec 50 mg two times day for six weeks then had second ablation. Back on Flec four months later as I still have Flutter Nd didn’t want to stay on Amiodarone nasty drug.

Problem for me with Flec is that I-have a long QRT wave length on EKG which is monitored and if it increases I can’t take Flec. Flutter is controlled with Flecanide and Metoprolol- will no doubt have third ablation in next year but I am not in a hurry. If I do have event been told the third ablation will happen then

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