Flecanide is unlicensed for AFib!

[wilsond]

Hello all

I have had the longest episode of AFib i have yet had...36 hours and only just fading off.

Definetly caused by drinking 3 large pots of non decaff tea on Tuesday pm with my best friend..unwittingly thinking it was decaff. She also has AFib and has had similar!

Anyway,didn't know what to do as had taken 2x 100mg flec. Max is 300.

Rang gp..told to ring hospital,rang Arrythmia nurse..ansafone...Consultants secretary..ansafone,emailed kardia results to Proff Osman...

Went to pharmacy and he was very good. Got out his Big Book...and it said flec is actually unlicensed officially for AFib!it only gives dose for SVT (400))and ST(300)

Guessed 300 for flec.

Thought it was interesting !

Btw nurse just rang back ...confirmed that above , didn't know what I should do if it continues but will email EP.

[Jalia]

That's interesting ! Can I ask what sort of rate you were at during this time ?

Glad you are feeling better now . ( That was some coffee...😨)

[doodle68]

Hi Wilson sorry to hear of your latest episode , that is a long one I hope it has terminated by now.

You poor thing, you have had more than your share of health problems so far this year.

I have been offered Flecainide as a PIP and am considering it but would be scared of taking the first dose living alone miles from anywhere and technically my heart rate is too low to be taking it , it should be above 70 resting but no one seems bothered about these things .

Does Flecainide appear to have any effect for you.

[pottypete1 in reply to doodle68]

Your comment about over 70bpm is new to me.

My bpm rarely rises above 50bpm and I have been taking 100mg x 2 per day plus the occasional PIP (never over 400mg per 24 hours) for about 30 years.

Pete

Pete

[doodle68 in reply to pottypete1]

Hi Pete good to know you get on well with Flecainide,

My information came as a mention in a NICE PDF file about using Flecainide as a PIP so can't link to it ...

[Paulbounce]

Hi Wil.

Sorry to hear about your latest afib attack. Keep us updated and hope it clears soon.

Paul

[wilsond]

Hello all! Much better now .

Will be posting soon with more details...

Jalia ..my rate in AFib is not too bad....just crazy beats. In flutter ..my best effort was 220.. but that's a while ago xx

[ILowe]

I'd like to know what source your pharmacist used. I did some digging.

For teenagers it is licenced for AF. bnfc.nice.org.uk/drug/fleca... . For adults it is licenced for supraventricular arrhythmias bnf.nice.org.uk/drug/flecai...

It turns out that AF is a form of supraventricular arrhthmia, therefore presumably it is licenced for AF! hopkinsmedicine.org/heart_v...

[indy64]

It's the Big Book that bothers me. I presume it was an outdated PDR that was last printed three years ago, I believe. Most could find accurate and current data (most importantly, contraindications) on our phones. I'm am big fan of informed pharmacists. On more than one occasion mine has informed me that if I took a medication that was prescribed (by non cardio doc) while I was on tikosyn following an ablation, it would probably kill me.

[dwright12]

I have atrial flutters and my cardio dr. said flecinide causes flutters!

[ILowe in reply to dwright12]

Your cardiologist probably meant that flecainide CAN cause irregularities. This is well known, well documented, and can almost always, with care, be avoided.

1/ Your heart is thoroughly checked out before flecainide is prescribed. There are some abnormalities which make flecainide more risky to use

2/ It is usually initiated in hospital, with regular ECGs

3/ High doses are avoided if possible

4/ A betablocker is usually prescribed with it, in a small dose, to limit the risk.

5/ Possibly an annual ECG is done

When all these bases are covered, I think you will find flecainide has an excellent safety record.

[dwright12]

I had an ablation for flutters and off of flecainide and glad....it did not work well for me.