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flecainide dose

Crystalpalace profile image
31 Replies

hello

I recently increased my flecainide dose from 50mg twice a day to 100mg twice a day as the afib seemed to breaking through. Also take channel blocker

what I have noticed is when I exercise at lunchtime(normal for me) I suffer from palpatations a few hours later which last for maybe 4 hours on and off. could this dose be too high for me and could this be causing the palpatations?

Any thoughts or experience of this ?

thanks

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Crystalpalace
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31 Replies

I assume the change in dose was prescribed by your doctor. We are not medically trained therefore we unable to comment on prescribed medication but we sometimes hear that Flecainide can loose its effectiveness for some over time. Prior to my ablation, I took 50 mgs twice daily with no problems and the same when used as a PiP but others here may have other experiences. The only safe thing to do is to talk to your doctor because if your AF is progressing, now may the time to explore other treatment options.....

Crystalpalace profile image
Crystalpalace in reply to

thanks for ther reply. yea doctor and electrocardiologist said increase to 100mg if afib broke through. will discuss with them in a couple weeks . was Interested if anyone else had eexperienced anything similar

jeanjeannie50 profile image
jeanjeannie50 in reply to

I was told by my AF nurse that if you took Flec daily, then you couldn't suddenly up the dose and take it as a pill in the pocket too. Why oh why do different AF medics tell us different things!

in reply to jeanjeannie50

Help, I’ve done just that. Put myself on 100x2 a day. Plus 100 left for PIP. Just visited arrhythmia clinic. Nurse quite happy with that, said she would inform EP. EP appointment just put back 2 months so nobody seems too fussed!

in reply to

I’ll check you over on Thursday......😉

in reply to

Look forward to it 😌

Nick1957 profile image
Nick1957 in reply to

? Check over - do you do private consultations??

in reply to Nick1957

Absolutely not....see my latest contribution which should have just arrived!!!

in reply to

I’ve just twigged what you meant.......my wife and I are meeting Hylda and her hubby for lunch tomorrow........

Nick1957 profile image
Nick1957 in reply to

Cool.😀

in reply to jeanjeannie50

My understanding is that it’s OK as long as you don’t exceed 300mg in any 24 hour period but everyone must check with their medics because their circumstances may be different.

jeanjeannie50 profile image
jeanjeannie50 in reply to

My EP advised me to try and stay on 2 x 50mg Flec and increase my beta blocker if more medication was needed. I got the impression that he didn't like high dosages of Flec. I don't either, if you remember they gave me hallucination like dreams! Yikes, it was scary in the middle of the night to wake and find someone stood by your bed! My daughter asked how I saw them if it was dark and I guess that proves I was dreaming.

Jean

in reply to jeanjeannie50

😳

starry-eyes profile image
starry-eyes in reply to

Agreed. This is what I was also told by my consultant.

Bagrat profile image
Bagrat

I had no episodes on 100mg twice a day (I don't take any rate control meds as they drop my heart rate too much) I started getting runs of regular tachycardia when NOT taking gentle exercise. Another tey with beta bockers failed so GP reduced ( very slowly ovet a couple of months) to 50mg twice a day. Still happens sometimes but controlled by slow breathing, no AF episodes

in reply to Bagrat

It’s all a bit of a minefield because I have heard from many EP’s that regular daily Flecainide should not be taken without either a betablocker or calcium channel blocker as is can cause flutter......best to check it out......

in reply to

Perhaps I had better confess that I cut my Nebivolol from 2.5 to 1.25 at the same time. Heart rate that of a highly trained athlete 🤣xx

Bagrat profile image
Bagrat in reply to

Have discussed with GP and Dr S Gupta. Guess we're all different. Bottom line I s'pose is if it works for you. Benn on it since 2011!

Crystalpalace profile image
Crystalpalace in reply to

cheers yea I'm on calcium channel blocker with the flec.

jennydog profile image
jennydog

You say that you also take a channel blocker. Is this a calcium channel blocker such as Tidium which caused me swollen ankles ?

Flecainide is a sodium channel blocker. I asked my EP if this affected my salt intake and he said it didn't.

secondtry profile image
secondtry

IMHO more likely to be the exercise or the channel blocker.

Eirecara profile image
Eirecara

Flecainide made my a.fib worse. Had to stop it completely. We are all different. Best wishes☘️

Spoiler profile image
Spoiler

I take 150 mg of flecainide 2x a day, so far ok.

Can't help you on the medication, but your exercise might be making you dehydrated a little. Here is a cut-and-paste of the data I have accumulated over the years that triggers my afib - might be the same for you:

------------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer (this is why all doctors agree that afib gets worse as you get older). If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate (afternoon) exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??

I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas or Thyroid - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

PS – there is a study backing up this data you can view at:

https//cardiab.biomedcentral.com/a...

How much sugar do you need to stop your afib? The answer is about 1/2 of what your daily sugar limit (threshold) is. My sugar threshold is about 80 grams a day right now. So if I go over that (and it's sooooo easy to do) my heart will start to afib. Then if I cut back to about 40-45 grams of sugar for one or two days, then the heart goes back to normal rhythm and stays there until I exceed my daily threshold of sugar again. (moderate exercise will shorten that time frame). I have gone 30 days under my sugar threshold with no afib once just to prove it is the sugar. And I have consumed my daily limit of sugar every day after going into afib and it stayed in afib for a week - just to prove that worked. So - as long as you know what your sugar threshold is you can control it, but that takes several weeks of experimenting to figure out. I use the following WEB site to know how much sugar is in different foods:

fatsecret.com/calories-nutr....

Crystalpalace profile image
Crystalpalace

Thanks to everyone for the replies last 24 hours or so. I didnt execise today and things were a lot better, although maybe a touch of something palpatation/flutter/afib not really sure, This was aound the same time of day around 8-9 hours after I took the 100mg of Flec + 60mg CCB. Thanks

Jmc43 profile image
Jmc43

I take Flecainide 50mg2x/day and have been for 1 ½ years since my last Afib episode (I had my first before that in January of 2018). I take a beta blocker as well. I was also advised that if I went into Afib, I could take an additional 50 mg whenever that happened. That has occurred once, about three months ago, in the middle of the night. I took the extra 50mg and I went back to regular sinus rhythm about an hour later. I have had no side effects as far as I can tell. Some other factors may be having a positive effect also. I have been doing Tai Chi regularly for the past 12 months, and am in the process of learning how to meditate. I have also lost a little over 12% of my body weight in the last year and a half...so some combination of the meds and perhaps these other factors have helped. I even have a couple of glasses of wine at this point with no ill effects.

Increased my dose recently to 100 mg a day not made a massive difference to be honest just more tired with it, got cardiologist appointment in Jan , he mentioned reconsidering ablation ( I backed out last year as flec working well), think I am a good candidate for it from what I've read, BMI 25 and echo more or less normal so in my head I am moving slowly towards it, have they offered it to you ?

Andy

Crystalpalace profile image
Crystalpalace in reply to

I'm seeing electrocardiologist mid Jan . I think waiting time is 9-12 months for an ablation certainly considering getting myself on the list before the flec stops working.

Lilypocket profile image
Lilypocket in reply to Crystalpalace

Sorry Crystal palace I meant to reply to you and Andy but just mentioned Andy.

Lilypocket profile image
Lilypocket in reply to

Hi

I agree with you. Sotalol didn't work so cardiologist put me on slow release Flec 200. Stopped ectopics but made Afib ( Paroxysmal) worse. Can't take a top up with slow release. Am now also working up to trying to see an EP to talk about an ablation but need a referral from cardiologist. This all takes time and I'm worried it will become persistent in the meantime which diminishes the chances of it working. So go for it Andy! I'm sure we will regret it if we don't try.

Best wishes ( and a hug)

Starboard13 profile image
Starboard13

The exercise is probably causing your palpitations particularly if you are pushing yourself hard or straining lifting weights. I have had to de-train myself over the years to settle my ticker after a lifetime of hammering myself physically. Ive been on max dose of Flec 300mg daily for 10 years with no major issues. Best of luck.

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