Weaning of Flecainide

[Chicos]

I have PAF and have been taking 100mg of Flecainide 2x per day,Metroprolol 50mg 2x per day as well as 20mg of Zarelto. I have been very lucky with on a few episodes -my last being mid August. As a result my Dr. wanted to wean me off the Flecainide. My dosage was to be cut in half in the morning and pm for one week-then half a dose for another...3rd week I would take none.

I have had two episodes within 4 days...not lasting long but....I took my "pill in the pocket" to get back to normal rhythm.

Has this happened to anyone?. I really want to get off this medication.

Thanks.

[jwsonoma]

Hello Chicos,

In your case I would say this shows the Flec is working.

I have PAF and haven't had an episode for 3+ years. I went off Flec 6 mos ago. I started having various tachacardias after large meals. I am back on it.

My PAFib episodes were 1 yr, 6 mos, 2 mos, 1 mos. Every episode of AFib makes it a little bit easier to have the next one so I am putting up with the side effects of Flec.

After an episode while I was on 50mg 2x my Dr. prescribed 100mg. He didn't know I could get 150mg ones which I could cut in half. All has been well on 75mg 2x.

If I break through I can move up to 100 mg.

Maybe talk to your Doc about lowering your dosage to 75mg or 50mg 2 x a day and still keep a PIP. If you don't have high BP maybe you can go down on the Metroprolol. I am taking 1.25mg Bisoprolol which is the rock bottom mimimum purely to prevent the side effects of the Flec.

Hopefully it works for you. If you have another episode you want to increase the dosage.

You max out Flec at 300mg/day so you don't want to get there too fast.

Others may have better advice.

Cheers

[JackyMac in reply to jwsonoma]

After years of PAF and one Cardioversion I was put on Flecainide and Xarelto. Apart from two minor incidences I have been clear for nearly a year. I have no side effects and if it keeps me clear I'll stay on it forever! Only 50mg x 2 and know I can take a bigger dose if necessary. Good luck, I hope you will find the answer from this wonderful forum.

[trtoothdr in reply to jwsonoma]

What are the side effects you are experiencing at your present dosage of Flecainide?

[Bagrat]

I had 2 episodes of PAF 1 monrth apart in 2011 I was started on flecainide and increased to 100mg bd. I cant tolerate beta blockers. I had one more episode in 2013 after a viral illness. Again was on coronary care. In 2015 I was getting runs of tachycardia for no apparenrt reason. It was decided to reduce flec and I took 50 am and 100 pm for 8 weeks before reducing to 50 and 75 and 50 50 over another 6 .to 8 weeks. I have stayed on this dose since then. Still occasional short bursts of tachy. Doctors can be a bit gung ho about dose reductions and in my experience it needs to be a slow process. If you are getting episodes since reducing, sounds as if you need some form of control. I have had none. Still get ectopics and have just started oral magnesium having used spray for a couple of years. Hope you get sorted.

[Thomas45]

Hi Chicos, you say you want to get off Flecainide but not why. I took 300mg a day for 12 years and my episodes of AF reduced to one or two short episodes a year. I was then found to be in asymptomatic persistent AF so stopped taking Flecainide on medical advice. I don't believe that Flecainide had anything with my going into persistent AF.

[Chicos in reply to Thomas45]

Thanks for your post..guess I should have given the reason for weaning off...actually it was my doc who suggested it during an August visit. My Chad score was a one,so he stated and felt in no further episodes occur until our next visit,which would be December 5th,he would prescribed the Pill in the Pocket..150mg of Flecainide.

I enjoy reading all the posts and thank all of you for giving tons of information and "real" stories/experiences to someone like myself...a "Newbie"

[dmac4646]

not sure why you want off it ? I have been on it for 12 years at 2X50 mg per day with 1/2 episodes a year - sounds as if it works for you but if you want off it maybe AF is tolerable? Treatment for AFIB is all about QOL in my case EP doesn't think I would be much better with ablation and should await new developments but everyone is different.

[Bee-Honest]

Flecainide has been good for me over the last 12 years, now on 100mg x 2 daily, was initially 2x50g, but I know if I have any breakthroughs I can take an additional 100mg, but that does tend to upset my stomach. Hope you manage to get your dosage sorted soon.

[nikonBlue]

My doc tried lowering my dosage a few months ago and boy did I suffer! I might have some side effects from the flec but all in all I'll stick with my 150 x2 with an extra 50 if I have an 'episode' lasting more than a few of hours. It clearly does work for me when lowering the dose resulted in a definite increase in the symptoms.

stay well

Blue

[Melchet]

Hello Chicos,

AF begets AF, so unless you have addressed the condition through lifestyle changes and/or ablation, I think you may find it hard to come off Flecainide.

My EP told me to stop 2x100mg Flecainide four weeks after PVI Cryoablation in August 2018. Almost immediately, I had a couple of short AF episodes and frequent ectopics until I decided on 2x50mg dose. After two weeks, reduced to 2x25mg Flecainide with occasional ectopics which reduced as I recovered fro ablation. Have now stopped maintenance Flec dose completely but still reaching for PIP occasionally when ectopics return. I consider the ablation a success as it has improved my QOL and I’ve not had AF episode since October.

I wish you success in coming off medication and hope you will post your experience on here.

Best wishes,