I take flecainide 100mg twice a day, like many of u I guess. I ve two questions:
- if having afib episodes between one dose and the following, do u anyhow take 100mg flecainide as a pip?
- how long does it take for it to have effect to stop afib for u? A couple of hours?
Thanks.
Do you get any ectopics and if so does it help cause I’ll be going on that for my ectopics
Not the kind of response you are looking for but not medically trained therefore unable to offer an answer, so you really should ask your Doctor. That said, a daily dose of 200 mg is fairly high, so if you are still experiencing episodes, perhaps you should ask for a treatment review.
The only other thing I can say that you should never take more than 300mg of Flecainide in any 24 hour period.
I am taking 75 mg 2 x day.
For me the last time I had AF (a few years ago) it stopped in 15 min with an extra 75mg.
It worked very quickly but the AF was not very fast just irregular.
I keep an extra 2 days meds in a container on my key ring in case I need a PIP or I get stuck some where over night.
I reviewed with my doc that I can take up to 150mg between regular doses. I would take a 75mg dose and give it 20 min to work then if it didn't I would take a second 75mg. If I woke up in the morning and it was time for a dose I could take that and then upto 2 more 75mg. As long as I didn't exceed 300mg in 24 hrs.
The max 300mg in 24 hr rule seems to be a pretty strict so you really need to think back to exactly when you took your last 2 doses to see what how much you can take if the 100mg doesn't work. Anyways that is my experience.
You should probably double check with your cardio guy as to when and how much to take as PIP. This is a dangerous drug.
It is not helpful or accurate to say flecainide is a dangerous drug. There is minimal and out of date evidence that it might make things worse if you have a heart attack but this was a poor study based on few patients. Evidence based on it common usage supports its use in treating AF particularly if there are no structural heart defects.
Personally I have found it great. My private cardiologist recommended it to me and I persuaded my GP to put me on it. However my NHS cardiologist described it as a 'dangerous drug' when we had a recent telephone conversation. He didn't elaborate why but I got the impression they had issues with patients misusing the drug in the past, which is why that depends had stopped prescribing it. He warned me "it's not like taking aspirin". As if I hadn't worked this out already. In the end you get all the information you can and monitor your own progress. I much prefer it to Beta blockers.
Thanks - I know that I was a bit terse but I have come across that sort of comment before from GP's. I'm 68 and have been on flecainide (Tambocor) for half that time. It was a very eminent cardiologist (Professor Pentecost) from Birmingham who put me on it and I have never had any problems with it. No episodes at all for the last 5 years. The problem lies in a small scale paper that came out very soon after it reached the market that concluded that there was a small increased risk of dying from a heart attack if you were on it and had a heart attack. As far as I know, there have been no further large scale studies but the evidence for its beneficial use just seems to come from looking at the numbers of people who are on it and for whom it works well. I'm sure most drugs used to treat disease are dangerous if misused including that deadly substance, paracetamol.
Totally agree! It was Dr Tim Betty who recommended it to me and it seemed to me that a specialist electrophysiologist was probably in a better position to preserve appropriately than a generalist cardiologist. I don't really understand what the dangers are other than it can increase heart rate bit it depends what other meds you're on too. Dr Betts recommended that I change my BP meds to Tildiem to keep the heart rate down. I'm a relative newbie - six months in today! Been on Flecainide for just over three months..I did have an episode in the transition time but nothing since. Loving the idea of being episode free for 5 years I must say.
I agree with Flapjack you need to discuss with your cardiologist why your current level of Flecainide is not stopping all episodes and/or research and implement more lifestyle changes. I started on 100mgs per day of Flec & still got episodes so went onto 200 mgs and that stopped them but I didn't stop there and consulted a Naturopath who said he treats all his AF patients with a Magnesium compound and CoQ10 so I went onto that as well. Lastly, I read all the good stuff posted here and made some significant lifestyle changes. Bottom line is I have had no significant AF issues now for 6+ years after experiencing 9 episodes in just over a month at the start of my journey. QOL increases each year as I make further improvements to my daily life.
What magnesium supplement do you take as well as coq 10?
re your question of returning to NSR after taking Flecainide its usually 3 hours for me - and you are correct - do not exceed the 300mg you need to carefully calculate how much you have had before taking more - it can make things considerably worse ! You could ask your Cardio re another drug to try it there are alternatives
I had my dose increased from 50mg x 2 a day, to 100mg x2 a day, to 150mg x 2 a day. It is NOT a dangerous drug. I was on 150mg x 2 a day for about twelve years until I was found to be in persistent AF, so my GP stopped me taking it.
During those 12 years on 150mg x 2 Flecainide was it only the GP treating you? Also, how long were your episodes in AF before you went persistent? It seems to me, the more the frequency of your episodes combined with the longer the duration of your episodes, the closer you are to being persistent.
No I was seeing a cardiologist, not an EP, though. However the GP I saw is a nationally known expert on AF, and a Trustee of the AF Association.
As for the second question, it is difficult to answer as I don't know when paroxysmal became persistent. It was between annual visits to the cardiologist, but I can't pin it down any further. How I felt didn't change. In the year before I had two 30 minute episodes of paroxysmal before going to bed. When I woke up from each night's sleep I was no longer in AF. In the year that paroxysmal became persistent I did not have any episodes of paroxysmal. So in my case your theory is not held to be the case. Flecainide, particularly at the higher dose reduced greatly both the number and the duration of paroxysmal AF. I should add that I was on the 150mg X 2 per day in part because I'm 6'7" tall, and weighed over 19 stone
I am always puzzled why some cardiologists do not refer their patients to an electrophysiologist.
"My theory" is not mine. I read the paper and printed it, but I would have to sift through too much paperwork to find it.
I am interrupting that you were asymptomatic when you became persistent, granted you had the help of meds for 12 years.
I have logged 68 members who are in permanent AF although I didn't record the start time. It is most helpful to have their input to understand this condition. Your contributions have always been noteworthy.
My cardiologist did consider referring me to an EP, but at the time, around 2003-4 electrophysiology was a relatively new technology. Ablations are used only to improve the quality of life, and my heart responded well to Flecainide. I did not have a poor quality of life which needed improving.
Yes my AF is asymptomatic, or at least any symptoms I may have could be put down to asthma which I've had since 1974.
I should add that the medication I take for a handful of ailments generally works so the ailments do not affect my quality of life.
The ablation technique now followed worldwide was pioneered by Dr. Haissaguerre and team in 1994 at Bordeaux, France. I do not know how quickly the procedure spread, but Dr. Hocini, of the Dr. Haissaguerre team, told me last year that they are still "trying to spread the word." Furthermore, they have built the LIRYC institute for the purpose of solving arrhythmia.
In terms of "quality of life," current literature is moving away from that mind-set or mantra as Bob.D. expressed to the point that even asymptomatic patients should be considered for rhythm control due to the medical benefits as per the EAST-AF NET trial. Having said that , I do wish you the best for a continued quality of life.
My cardiologist did consider referring me to an EP, but at the time, around 2003-4 electrophysiology was a relatively new technology. Ablations are used only to improve the quality of life, and my heart responded well to Flecainide. I did not have a poor quality of life which needed improving.
Yes my AF is asymptomatic, or at least any symptoms I may have could be put down to asthma which I've had since 1974.
I should add that the medication I take for a handful of ailments generally works so the ailments do not affect my quality of life.
My dose was increased from 50mg morning and night to 50/100mg. Last week I had a 3 hour af episode which finally settled about an hour after I took an extra 50mg. I now carry some Flec in my handbag, just in case!
I was on 50 mg twice a day for 7 months, no afib, but failed stress test in 4 min with vtach. Told me it caused the vtach and They dc it. Then Another EP Dr put me back on it after my ablation for 3 months. When I came off of it, two weeks later, in flutter and cardioversion, back on it by a different EP and increased to 100 mg twice daily. That lasted 1 month and back in ER and another cardioversion and increased to 150 twice daily. This worked for 13 1/2 months, suddenly in flutter 8 hours or so at a time, going in and out but in for only 2-3 hours at a time. It was very odd and I never actually went in and out of rhythm before? Sent me home to await another ablation. I started noticing that within 2 hours of taking my 150 I started spiking heart rates and it continued for 8 hours or so. My rate wld get to normal about 3 hours before time for meds. I figured out that it seemed to be the flecainide causing it? I thought I must be crazy, but I started documenting it and I have a apple watch and Iphone tracking it. As bazar as it sounds, something that had worked suddenly was actually triggering flutter. Saw my Dr. and I started reducing the dose until I am back at 50 twice daily and have been in COMPLETE NSR.... since. I think possibly after my ablation we stopped the drug maybe too soon at 3 months, I do not know? I was the same way with propafenone, it worked 20 months, then they increased to max dose and it backfired on me. I was concerned on the max dose of flecainide, but I did fine without any problems, WE ALL are so different and our EP Dr. studies each patient with all their medical history to determine the best plan. Hopefully for you, smooth sailing ahead. Best to you!
I take Flecanide 100 am and pm. If I go into AFib during the day I'll take an extra 100mgs. As soon as possible after AFib starts I usually sit back in my recliner with a blanket over me and relax completely well...as much as I can. I sometimes also take a Xanax 2.5mg to truly relax me and fall asleep. I can get back in normal rhythm in 3-4hrs . I keep some xanax especially to use for this. I don't normally get AFib very regularly but I've been affected by Lockdown and all that has gone with it. Stress in other words... I don't use Xanax too much as it is highly addictive. Very hard to get off if having it too regularly it seems. You need to be careful re taking too much Flecanide too....no more than 300mgs in 24hrs. Make sure you speak to your GP about all this. Having too much Flecanide can slow your heart too much. Good luck with it all
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