PIP order of medication

[Bhoyo]

I had a telephone appointment today with my cardio specialist( registrar), 6 monthly check up re my AF

I currently have PIP 100mg Flecainide and 25mg Metropolol.

I have had need to use these on a few occasions since last check up pre Covid.

During conversation and then after consultation with specialist, I was advised that I was incorrectly administering my medication.

I had been taking Fleainide first and then if required Metropolol(reluctant to take unless absolutely necessary) .

I was advised this was dangerous practice and I should be taking Metropolol first and then Flecainide.

I have been on PIP for long time and most times took both medications together until I inadvertently was over medicated on Metropolol at A & E and had bad reaction.

I now have face to face appt next week for ECG and review my medications.

Currently CHAD score 0, not taking anti coagulants .

Apologies in regards to incorrect use of paragraphs (previous post).

Stay safe

[Hidden]

We are not medically trained Bhoyo therefore for reasons I’m sure you understand, we cannot advise on prescribed medication. Of course we can comment on our own personal circumstances but I have only ever used Flecainide on its own as a PIP.

[Bhoyo in reply to Hidden]

Thanks for reply, yes the post was more FYI. I understand re prescribed medication and was mainly interested in others experiences.

Cheers

[jeanjeannie50]

Hi Bhoyo

I'm sensitive to Metoprolol too and like you was once overdosed with it in hospital was given 2 x 50mg one night, with the result I got out of bed next morning and collapsed. It takes my BP down dangerously low. Now I just take 12.5 along with my Flecainide, twice daily, recently my AF nurse increased the night time dose of Metoprolol to 25mg but was no good as it took my BP too low again.

Flecainide, taken on it's own, can sometimes produce a dangerous arrhythmia. Hence a beta blocker generally has to be taken at the same time.

Jean

[Hidden in reply to jeanjeannie50]

Yes, that is something we have heard many times at our Support Group meetings but they also say that it is not normally necessary if Flecainide is taken irregularly as a PiP. That said, I would imagine the majority of people using it as a PiP are likely to be taking either a calcium channel blocker or beta blocker (possibly!)

[pottypete1 in reply to jeanjeannie50]

I have a slow heart rate and have been taken off Bisoprolol a beta blocker.

I still take Flecainide twice a day without a beta blocker and have done for 3 years now.

Important thing is that nobody should amend their medication without the instruction of their EP.

Pete

[Profound15 in reply to pottypete1]

Hi Pottypete

Do you get ectopics at any time since you’ve been on the maintenance dose of flecainide please.

I’m on PIP but have been suffering from ectopics quite badly for the last week or so. Up to this point my ectopics hadn’t been too bad over the last six months or so. Haven’t changed anything in my diet and still take 200mg of magnesium taurate daily so it’s really getting to me.

[pottypete1 in reply to Profound15]

The last ablation I had was three years ago next month and for the first 18 months afterwards I did have regular ectopics. They very slowly declined and now I rarely get them although they do occur occasionally.

Pete

[Profound15 in reply to pottypete1]

Thanks Pete.

[Padayn01 in reply to Profound15]

Like you the last 6 weeks for me the ectopics have been really bad just come out if no where

[Bhoyo in reply to jeanjeannie50]

Jean,

Exactly what happened to myself re Metropolol and still lucky enough( if correct wording - differing opinions ) to take these medications as PIP.

Thanks for reply, hope flowers are still blooming.

[Paulbounce]

This is a very interesting thread for me - let me explain why. I really should draft out a new thread about this.

I too had my 'appointment' with my cardio by phone about a week ago. My CHAD score is also zero. I asked about stopping anticoagulant's and the answer was that's it's my decision. Stick with your 100 mg flec twice a day (which I have) but I've stopped the Pradaxa.

HR is now 46 first thing in the morning when I test. A little low but yesterday I felt really poorly - I wonder also if it's BP - stopping one but carrying on with the other. This had not occurred to me but could be the reason.

Will follow the thread with interest although I'm a little off topic. I wonder if it's a good idea to take anticoagulant's or not (for you and I).

Tough call.

Paul

[Bhoyo in reply to Paulbounce]

Paul,

I have often wondered in regards to the anti coagulant and have read varying different opinions on this site.

I am fully aware that I am guided by my specialist advise re medication.

I was advised this year to cease taking my daily aspirin after approx 3 years of a daily dose. I am aware this is not an anti coagulant but this was advised by a medical practitioner.

Even though my score is 0 there is still that nagging doubt in regards to susceptibility to stoke.

Positive thinking and healthy living and my specialist advise have me still anti coagulant free.

All the best

Cam

[Paulbounce in reply to Bhoyo]

Cam wrote

"Even though my score is 0 there is still that nagging doubt in regards to susceptibility to stoke"

Yep - I'm with you on this one. I'm pretty sure there's a blood test that can tell how susceptible you are to having a stroke - I seem to recall having it every 6 months or so is recommended. I'll try and find more and post here if I can get some more info.

Cam also wrote

"Positive thinking and healthy living"

Nice one - best way to go

Have a great weekend.

Paul

[Bhoyo in reply to Paulbounce]

Cheers Paul, I'll also enquire at my appt next week👍

[Harrythmia in reply to Paulbounce]

Hi ‘ Paul. I can’t say I’ve heard of a blood test that measures ‘susceptibility" to having a stroke. If true I’m sure it would help a lot of us with a family history.

I know about CHAD score which I thought was the generally recognised indicator of susceptibility but I may be wrong.

Can anyone throw any more light on this? Harry

[Hidden]

Odd to hear that- the private EP I consulted after the usual drugs prescribed proved dangerous for me (lowest dosage of bisoprolol brought heart rate down too low) prescribed flecainide and told me to take 2x 50 mg as PIP (introduced me to the Kardia to check) and then if heart rate over 140 twenty minutes later to take some bisoprolol. After almost three years, I had my first telephone conversation with a "registrar" (at my rquest) and he suggested taking the bisoprolol regularly again along with the flecainide- quite ignoring my previous experience! I tried the flecainide regularly again but it failed to prevent episodes and have since had to deal off and on with constipation from one or other drug!!!!