How much flecainide is too much for afib?

[willec49]

My usual dose of flecainide for paroxysmal afib is 150 mg day. 50 mg. day and 100 mg night. My cardiologist said I could take an extra 50 mg. before my known trigger situations and events. I took 250mg. total today. Do I have anything to worry about?

[jennydog]

No problem. Maximum daily dose is 300.

[willec49 in reply to jennydog]

Good! Thanks so much for your quick reply.

[pottypete1]

No, nothing to worry about particularly as you are following the instructions of your cardiologist. However you would be advised to not take more than 300mg in any 24 hour period.

If you are at all unsure of anything you must talk to your cardiologist, we are not medically trained.

We are all different and it is unwise to generalise.

Pete

[willec49 in reply to pottypete1]

Thank you very much. That helps.

[CDreamer]

I used to take 100mgx2 daily with an extra 100mg if AF broke through. My understanding was that 300mg daily was the maximum daily dose and that I should leave 24 hours if I took the maximum before taking my next dose.

[willec49 in reply to CDreamer]

Thanks. I see that the half-life is between 12 and 27 hours.

[CDreamer in reply to willec49]

If you are at all uncertain I would ring your doctor or talk to a pharmacist for competent professional advice but if you have no symptoms and feel good, I wouldn’t add worry to the mix.

[BobD Volunteer]

Absolute max in any 24 hours is 300mg. Any more becomes poison.

[willec49 in reply to BobD]

Thank you.

[willec49]

I had seen this paper during my research but never actually read the whole thing. Thank you.

[secondtry]

Hi Will, just a side issue my cardio didn't advise taking different doses in the morning and at night (even though afternoon/night was when AF broke through, never in the mornings). He said it was too much of a rollercoaster for the heart that needs to settle into a standard rhythm . You might want to run that past your medic at the next appointment.

[willec49 in reply to secondtry]

Thank you.

[ILowe in reply to secondtry]

I disagree with the viewpoint. Doctors are trained to love a steady state. I need flecainide most during the day

and do not need it much at night. Too much at night, in my view, will cause problems. So I switched from 100mg am 100mg pm to 100mg am and 50mg pm.

There is another fact: a certain amount of irregularities is desirable and healthy. You do not want your heart to be totally regular. healthunlocked.com/afassoci... and ncbi.nlm.nih.gov/pmc/articl...

[willec49 in reply to ILowe]

That seems to be my situation. I was on 50 mg. of flecainide in both morning and night but started to have some arrythmias without going into afib at night so my cardiologist upped the night time dose to 100 mg. That seems to be generally working for me so far.

[ILowe in reply to willec49]

Excellent. The importance is that it worked. For me, I assessed the increased ectopics in the evening as being possibly caused by too much flecainide in the evening. When I cut it down in the evening, I still get a few (the healthy ones??) but they were a lot less.

We now have it, official, that a cardiologist varied the morning/evening dose.

[Hidden in reply to ILowe]

Exactly the reasin my disage was swit hed.

[jennydog]

Thank you for this posting. It is useful to scroll to the end to see CONCLUSIONS.

Flecainide is a huge help to me as a pip. It's quite an old drug now and I understand that it is inexpensive.

[Hidden]

I take 100mg at morning & 50mg at night.

[willec49 in reply to Hidden]

Oh, Just the opposite to me. Whatever works is the ticket.

[Hidden in reply to willec49]

100mg at night was giving me weird dreams sometimes seeing things like spiders & shadows. My cardiologist suggested halving it & has worked thank god.

[willec49]

I'm glad to hear that it worked for you. So interesting how we are all so different in that regard. I found that sex could be a trigger for an episode so my Cardiologist said to take an extra 50mg. when I plan sexual activity. So on those nights I have 150 mg. on board.