Flecainide 150 mg twice a day??? Anyone take this much???

[Spoiler]

Flecainide 150 mg twice a day?

Does anyone take this much flecainide? They just increased mine. Kind of scary since at 50mg failed a stress test with vtach. They said the drug caused it.

[BobD Volunteer]

300mg is the maximum 24 hour dose and usually only used as PIP.

[Paulbounce]

I`m not far off !

Started on 50mg twice a day then they increased to 100mg twice day. My understanding is your dose (300mg) is the max.

Good luck with it - I`m sure you`ll be OK.

Best,

Paul

[bigking]

I have the same dosage. Seems excessive to me too. Had a second ablation a few weeks ago, so hopefully my dosage will get lowered soon. I've also heard that 300mg per day is maximum.

[Finvola]

I take 200mg per day which holds my AF at bay but in your place I would discuss this increase to the maximum dose with my cardiologist (I assume the cardiologist prescribed 300mg).

Ask too about the stress test result and the vtach - Flecainide can initiate other arrhythmias such as AFlutter. Normally, a beta blocker is prescribed with Flecainide to slow the heart rate. Were you increased gradually from 50mg?

The only person who can really set your mind at rest is the prescribing cardiologist - ask plenty of questions to get the full picture. Best wishes.

[Spoiler in reply to Finvola]

Yes, was on 50mg for 7 months, no afib. They did a stress test and took me completely off because 4 minutes into the test was vtach. Never had it before, the EP Dr said no way for flecainide because it was not worth dying for. Then I went for a ablation at the Cleveland Clinic #1 heart center in the US. My EP there put me back on it at 100mg for 5 months, went into flutter March 11th, had cardioversion on the 13th and back on the 100 mg this time. Went back into flutter April 9th, cardioversion April 10th. So my discharge included the increase to 150mg. I am terrified to even think of being too active. Two EP Dr with different opinions, although my first one ended up re looking at the stress test saying when I stopped the stress test the vtach resolved without intervention. Who knows?

[pottypete1]

Yes I was on this dose for two years but this was reduced to 100mg x 2 per day about 18 months ago. I had been on the lower dose for the previous 25 + years.

Some cannot tolerate Flecainide so it is important to have supervision & guidance of meds by EP.

Pete

[Spoiler in reply to pottypete1]

In that time what type of side effects did you experience? I have tried all the other drugs, this is the last one. How many pvi ablations have you had? Tikosyn worked with first pill, second one was a cardiac arrest. Those little pills can be deadly😳

[pottypete1 in reply to Spoiler]

I have not had any side effects that I can clearly attribute to taking Flecainide.

I have had 7 ablations. 1 for Atrial Flutter followed by 5 for Atrial Fibrillation and the last 18 months ago for Atrial Tachycardia. These have been over a period of 10 years.

I have been having only a very few short lived episodes of AF since my last ablation but I still take Flecainide 100mg x 2 each day and Flecainide.

I have noted since contributing to this forum that EPs take many different approaches to treating AF. It is important to understand that we are all very different and it is important to adhere to your EPs instructions and advice.

Pete

[jeanjeannie50]

2 x 100mg of Flecainide and 2 x 12.5 of Metoprolol was giving me an abnormal heart rhythm. I stopped taking both and after two days my heart rate was normal.

Jean

[Spoiler in reply to jeanjeannie50]

Oh my goodness, does not surprise me! Give for rhythm and can cause a rhythm problem🙁

[Kitticat]

Yes I've been on the same dose 2 x 150mg daily flecainide for the last 10 years. It worked well to keep AF at bay for all that time but it stopped working a few months ago and I had ablation just over a week ago. They've kept me on the flecainide for a further six weeks then can start to come off it altogether.

[Spoiler in reply to Kitticat]

Thank you, at least that makes me feel better about it. So, did you ever have to be cardioverted? I have had 17 in 5 years, my initial first 2 did not work due to the wrong medication they had me on, all the others worked the first time. My longest period to hold with meds was 20 months, my shortest was 6 days. This last one lasted 4 weeks😕

[David21]

I too have been on max. dose for a few years with no known side effects and largely working although recently I have experienced a few arythmias which is a little worrying. Finally found an EP whom I have confidence in. I must admit that the thought of an ablation terrifies me. Best of luck

[jennydog in reply to David21]

Don't be scared to have an ablation. I would do it all again if necessary. Bob says that root canal treatment is worse and I was determined to tease him about saying that but Bob is correct.

[jennydog]

I currently use 100 flecainide as a pip and consider it to be my best friend.

I have fibrosis in my left atrium because of radiotherapy to my left shoulder. I am not going to be offered another ablation if I deteriorate. My EP said it would be a pacemaker next.

Meantime I can progress to 2x50 flecainide daily, then 2x100. The EP, who is highly rated, actually said " You could even take 2x150 daily."

I have never been aware of any side effects and did take 2x100 daily for about a year, pre-ablation.

[Brenda-j]

I took 150 flecainide twice a day for many years which greatly helped my AF with no real side effects.I had an ablation 18 months ago and now take 50 twice a day although I am not sure I even need that and hope to stop.

If it suits you flecainide can really help.

[Thomas45]

I took 300mg for about ten years until I was found to be in persistent AF. It was a good drug which meant I only had a couple of short episodes a year.

[Another1]

I have been on 200 mg twice a day for a few years. GP said I was on the maximum does of 350mg per day in total but the Cardiologist increased it .

[007talullah]

When I have used 300 mg short acting Flec for PiP I find it really wipes me out - I feel woozy and a bit spacey for up to six hours but it is effective for CV out of AF.

If I take daily 300 mg controlled release Flec I don't feel woozy and it keeps me from going in to AF.

Currently, I only use Flec for PiP

The important thing is that the pills work and you feel OK

[Panthers]

I was on 150 mg of flecainide twice a day and 125 mg of metoporol twice a day with the option of taking 150 if needed. I was on this dosage for 4years (2014-2018). I was still having break throughs and had my second ablation on December 28,2018. I tolerated both doses of medication real well thank God. I pray you have great success with the Flecainide. I hope you stay in sinus rhythm and out of the hospital. God Bless You.

[Spoiler in reply to Panthers]

Goodness that is a lot of drugs! How many cardioversions did you have? I had a low heart rate my whole life, with these drugs they put in a pacemaker. I take 25 mg metoprolol twice daily. Hope you do well !!!! Keep us updated.

[Panthers in reply to Spoiler]

Spoiler I have had a total of 4 cardioversions since 2012...Are you from the UK or U.S.?

[Spoiler in reply to Panthers]

Yes, I am in the US. I have had 17 in 5 years.

[Spoiler]

The only time I have taken cardizem is when I am in ER and they do it in a IV bolus or drip. It immediately lowers my rate, but has never converted me. I take twice a 25 mg metoprolol, but it does not phase it at all, it is relentless. I have tried 100mg with a episode, no luck other than nauseating me.

[kbog]

Yes, I took 300 mg daily for many months due to breakthroughs. I'd been on 50 mg x 2, then 100 mg x 2, then the doc had me raise it to 150 mg x 2, but I lobbied for 100 mg x 3 (kind of a pain, but helped with keeping the blood serum level of the flec more consistent, and I think lessened the vision disturbance side effects). I only weigh about 125 pounds, so it was a mega-dose for sure. I still had a ton of ectopics and runs of SVT, and the vision disturbance effects were low-grade problematic, and I hate being on drugs! so I eventually opted for an ablation and am a week away from stopping flec completely (post-op dosage was 100 mg x 2). Will be so glad to be done with it!

[Spoiler]

Being off the meds has been my goal, not sure at this point. One ablation and still break throughs that require cardioversions.

[Spoiler]

I have wondered why they only use it on me when I am in ER in afib or flutter. I do not have a at home Prescription?