Extra dose of flecinide: I am on 100 mgs of... - AF Association

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Extra dose of flecinide

Euve
Euve

I am on 100 mgs of flecainide twice a day, for my paroxysmal A-fib my EP tokd me that when I get afib I can take an extra 100 mg has anyone ever heard of this I do not take flecainide as pill in the pocket I take it everyday thank you

47 Replies
oldestnewest

Yes. If your EP has told you to do this I would follow the advice. Flex can convert you to sinus and acts quickly.

I would go ahead and do it if your EP said to do this. For sure ;-) Carry one with you at all times in case you go in to afib.

I do !

Best,

Paul

Hi Euve

The maximum dose of Flecainide that can be taken in 24hrs is 300mg. So as you are only taking 200mg per day in total now, you could take the extra 100mg, but no more. Do you take a beta blocker alongside it?

Jean

Euve
Euve
in reply to jeanjeannie50

Yes atenelol

jeanjeannie50
jeanjeannie50
in reply to Euve

That's good, Flecainide can sometimes trigger atrial flutter, but your beta blocker should help prevent that.

Euve
Euve
in reply to jeanjeannie50

How often do you need the extra dose? I'm in afib quite often and my EP told me he has to get back to me thank you

secondtry
secondtry
in reply to Euve

Sounds like maybe you have to consult your medics to increase the daily dose of Flec to the max 300mgs/day - several people here have been on this dose successfully. My cardio did not recommend taking Flec PIP too often as it is too much of a roller coaster for the heart - the aims should be I believe to stop the episodes asap and keep one even level of medication.

jeanjeannie50
jeanjeannie50
in reply to Euve

I have very rarely had to take as much as 300mg.

Have you noticed that your attacks of AF have started occurring more since you've been taking Flecainide? I would talk to your EP's secretary (call the hospital switchboard and ask to be put through to her) and ask her to tell him that you're still getting the breakthroughs of AF and are having to take 300mg almost daily. Does taking that high dose take you back into normal rhythm? Perhaps this drug isn't working for you. I found that at times it was keeping me in AF. I would stop taking it and my AF would disappear for months. I'm certainly not recommending that you do that, as your heart condition is probably totally different to mine.

Jean

I have been taking 100mg x 2 daily for nearly 30 years. My instructions are to take extra Flecainide if I get an episode of AF. It has worked probably 90% of the occasions.

It works well but do bear in mind that you might well feel very lethargic and generally horrible for about 36 hours after. Mind you the relief of NSR is a significant compensation.

We are all different but as there is a maximum dose in 24 hours, if it is successful I then miss the next regular dose.

I am not medically qualified therefore don’t just copy me but use my comments to discuss with your EP.

Pete

Euve
Euve
in reply to pottypete1

How much is your extra dose?

pottypete1
pottypete1
in reply to Euve

I take 200mg at a time when I have an AF episode.

However I would repeat you must not base your thinking or actions on what others on this forum do.

We are all different and for that reason you should only do what your EP instructs you to do.

Pete

Euve
Euve
in reply to pottypete1

The problem with it is I get a afib so often that my EP has reservations of letting me do it he hasn't made up his mind yet and will let me know how often you get a afib? How often do you need the extra dose?

pottypete1
pottypete1
in reply to Euve

Your first post stated that your EP said to take extra 100mg.

In your subsequent posts you go on to say your EP is unhappy with this as you have AF very often.

It seems to me you are very confused.

I have suffered from Lone Paroxysmal Atrial Fibrillation for nearly 30 years. Sometimes the episodes have been as frequent as weekly but now for example I have been 3 months since the last episode. An extra dose of Flecainide works for me but I must emphasis that we are all different.

It is also important to repeat that the maximum safe dose of Flecainide per 24 hour period is only 300mg IN TOTAL this includes your regular daily dose. Even then you can feel awful afterwards.

If you have AF sometimes more than once I cannot see how this solution can be effective for you.

As we have said before you must talk again to your EP to establish the best course of action.

Pete

Horse57
Horse57
in reply to pottypete1

I am curious if you are on blood thinners as well.

Euve
Euve
in reply to Horse57

Yes I am on a blood thinner

pottypete1
pottypete1
in reply to Horse57

I am on the anticoagulant Warfarin and expect to be taking it for the rest of my life.

Pete

Euve
Euve
in reply to pottypete1

Eliquis

Nsr?

TamlaMotown
TamlaMotown
in reply to Euve

NSR is normal sinus rhythm when your heart is beating normally ☺

Thank you, and your extra dose is 100 mg? Mybpronlem is I sometimes get more then one episode during the day and maybe only wants me to take one extra dose?

Paulbounce
Paulbounce
in reply to Euve

Pete`s advice is very good Euve. Jean has also nailed it - 300 mg is the max dose per day.

I think carrying the extra 100 mg with you at all times is a cracking idea - only on the advise of your EP of course.

I have cut one off the seal pack they come in and keep it in my pocket at all times. This way if the pill gets wet the tablet is always there a backup and does not get damaged or dissolve if it rains.

Hope you don`t need it - just in case though you always have an emergency quick fix as back up.

Best,

Paul

Euve
Euve
in reply to Paulbounce

My Ep has reservations of me doing that because I get afif so often he told me it was good for somebody who gets afib once every few weeks or once a month how often do you get AFib? it looks like I'm not going to be able to do that after all I'm very disappointed thank you

Euve
Euve
in reply to Paulbounce

How often do you need the extra dose?

Paulbounce
Paulbounce
in reply to Euve

I`m in sinus at the moment - this will be the third week after my CV. Hopefully I won`t need the extra dose to often !

Best,

Paul

Some people just take it as. Needed, intake it every day

I take 200mg of Flecainide daily and have done for several years, earlier this year after the flu jab I had two episodes of AF, about 10 days apart and told to take additional 100mg when required, so yes 'pill in pocket' is just taking an extra Flecainide for me.

Euve
Euve
in reply to Be-Honest

I understand but my doctor said I get afib too frequently so I have to take an extra dose every other day but she's not too fond of doing at this point

I see other's have covered this, but I want to reinforce them: take a maximum of 300mg flecainide a day and always take beta blockers with it (regardless of the dose of flecainide).

Hi, yes I was told the same. I'm on 150x2 and was told I can take an extra 50 if I need to which I have to do at least once or twice a week when the 'episodes' last too long. Yesterday was a prime example with the whole day with that bag of worms jumping around!! For me though if I have to take that extra dose, it usually takes an hour or so to kick in.

Stay well,

Blue :-)

I have been on Flecainide for many years (50 mg.) twice daily, along with Eliquis (5 mg.) twice daily. If I have an episode of A-fib, I take another Flecainide (no matter how long it's been since last dose.) Then I wait, sometimes a couple of hours, other times many more. But it works, and is better than going to ER.

Yes. I was diagnosed with paroxysmal afib last year and was started on the beta blocker, metropolol. When that didn't stop the approximately monthly or bi-monthly episodes, I started on flecainide, 50 mg. morning and evening. which has been working. I was having a few arrymithias, not frequently, at night so the night dose of flecainide was increased to 100 mg. So now I am on 150 mg. daily.

To answer your question, I identified two situations which pretty much always caused an afib episode: sex and long flights. My cardiologist told me to take an extra 50 mg when I plan on having sex and before flying. The sex thing has pretty much worked and I haven't tried flying yet. As others note here, the maximum dose of flecainide is 300 mg. per day so you are ok if you only take the extra 100 mg. once in a day.

My cardiologist said the "pill in the pocket" is only for those who have maybe one or two episodes per year. I know there is a variety of opinions on that. I am in the U.S. Best of luck with your regimen. As you see, many people are on flecainide for decades.

Paulbounce
Paulbounce
in reply to willec49

Whatever you do don`t join the mile high club Will ;-)

Best,

Paul

I was advised with my PAF to only take the tablets when i’m having an episode and to take 2x 100mg to get into the therapeutic range and if no improvement in 2+ hrs to take a 3rd 100 mg. (Max 300mg per day).

This has worked well for me.

As you can see by the posts everyone is different- in answer to your original post . Yes some people have taken an extra dose while on a daily dose of Flecanide- up to 300 mg per 24 hr period. Do consult with your DR if you have concerns. Best wishes

Hi yes I have been given the same instructions by my highly skilled master at ablations EP😁

Yes mine saud that but not done it

HI Euve, I as well am on Flecinade 100 mg twice a day. I was told I couldnt take an extra one. As of now my aflb is leading me to have ablation.

Euve
Euve
in reply to Delrosario

What was the reason?

He told me it would be too much for me to take since my episodes were too far apart. At this time im haveing them more often so we are talking about doing ablation. Often meaning like every other day that last minutes to hours. There are other things that may attribute to having episodes as he told me. Caffeine for one , another for me is my vitamin d is very low so i started taking vitamin d . My next appt. Is in july will decide whether to go for ablation depending on my episodes. It is very frustrating and when we stress over it, it also aggravates our episodes.

I am on 25mg Metropolol beta blocker (twice daily), and when I tried to stop it too abruptly, I got a 150 beats flutter. I immediately took at 50mg and followed it a few hours later with a 25...The flutter went by bedtime... I checked my BP / Pulse first coz I didn't want to send my Pulse down into the 40s where my heart actually stopped in the hospital... So yes, beefing up the dose of stuff during an event works, but only if your vital signs are not flagging danger zones... and taking a pill is not as easily reversed as turning off a drip at the hospital..

I’m on 50mg twice a day & was told not to take extra 200 mg all at once but 50mg 10 min apart, for if I went back into bar then my heart rate could be very low, does that sound right ?

Euve
Euve
in reply to Nugger

I'm very confused by your answer but I know this whole thing is confusing

Nugger
Nugger
in reply to Euve

I asked my cardiologist if I went into AFib could I take 200mg extra to try and convert me back to bar, she said no, take one tablet every 10 min to see if it put me back in nsr, any clearer ?

Euve
Euve
in reply to Nugger

Ok thank you

One thing nobody ever mentions is body weight. I also take 2x 100mg, and my EP does not want me taking any more than that based on my weight. I weighed 74 kg at the time, but meanwhile I gained almost 10kg thanks to the meds, so I want to ask her again if I can take another 50 mg (250 in total)... unfortunately I have been feeling the af trying to break through lately and I wanna nip it in the bud...

Flecainide really has been a blessing for me, I guess I will have to have an ablation when it stops working!! It’s only been a year, I was hoping I would be like some other members here for whom it works for many years, but it seems that’s not my luck!

Euve
Euve
in reply to Funkygirli

Let me know what the doc says thank you

Hi, I take 50 mgs flecainide twice a day for PAF and when I get an episode I take 100gm to hopefully get rid of it. I also do a breathing exercise, breathe in for 4, hold for 4 then slowly breathe out for 4., do several times. This has worked a few times for me. Hope this helps.

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