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Flecainide as PIP question

Tux18 profile image
34 Replies

Recently I had a pacemaker implanted. . Prior to that I was unable to tolerate taking flecainide. A couple of weeks ago when I saw my cardio he said that I should try taking it again when I went into a fib. A few days ago I took one at the onset of afib. Six hours later I was finally in sinus rhythm. My question is how long on the average does it take for this medication to work?

One more question- is it important to take the pill immediately at the onset beginning of the afib episode?

My afib comes and goes generally having an episode 2 to 4 times a month and sometimes leaves in an hour and sometimes 12 hrs. I’ve been in afib 5 hrs now and haven’t taken the pill yet.

Thanks to all on this helpful forum.

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Tux18 profile image
Tux18
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34 Replies
pottypete1 profile image
pottypete1

When I take extra Flecainide to revert AF to NSR it normally takes between 3 & 6 hours to have the desired effect. It has on occasion taken up to 10 hours.

Pete

Tux18 profile image
Tux18 in reply topottypete1

Since I usually convert without the Flec, even if it's 12 hours, it seems hardly worth taking for me. As Flec makes me feel strange - not myself.

Camelia23 profile image
Camelia23 in reply toTux18

I feel like that too. I was given it as a pill in pocket. The first time was in June and I tried breathing through it but that didn't work. However I don't think I've suffered as badly as some of you on here.

pip_pip profile image
pip_pip

Hi.

Is there a reason you're holding back on taking the dose. ? It could take any amount of time (if it does the trick at all). Personally I would have taken it asap. That's why its a pip.

Phil

Tux18 profile image
Tux18 in reply topip_pip

Since it took six hours last time I thought by the time six hours past I might revert to NSR Without the pill.

Just took the Flec. as it had been in afib 9 hrs.

Thank you for your reply.

BobD profile image
BobDVolunteer

Firstly how much are you taking and secondly the usual advice is wait 20 mins and then take it. You must never take more than 300mg in any 24 hour period. Whne I was using flecainide as pip I was instructed to take the whole 300mg in one hit but surely your cardiologist gave you instructions?.

pottypete1 profile image
pottypete1 in reply toBobD

Bob

Many years ago after for 2 years of being advised to take 300 mg at one time as PIP, another EP threw his hands up in horror and said only 200mg at a time.

People like me who take it all the time anyway have to be extra careful to not exceed the limit of 300mg in any given 24hours.

I did on one occasion get the arithmetic wrong and I have to say it made me feel wretched and awful.

As we all know Flecainide is a very powerful drug and has to be treated with respect.

Pete

BobD profile image
BobDVolunteer in reply topottypete1

I was always told the max 24 hour limit WAS 300mg Pete.

pottypete1 profile image
pottypete1 in reply toBobD

I think that is good advice Bob I will edit the above. I must admit that I take 100mg x 2 twice a day and to revert to NSR from AF, when I get it, the only thing that works is an extra 200mg. 100 extra doesn't cut it so I have to time things which is always an issue.

A little knowledge is a dangerous thing and anyone thinking of PIP must do exactly what their EP tells them as we are all different.

Pete

in reply topottypete1

U

I take 100mg morning & 50 mg at ngiht of flecinaide. Took an extra 100 mg when having an episode & had the most excrusiating headaches & ended up in ED. Thats why the night tine dose was lowered.

pottypete1 profile image
pottypete1 in reply to

This is why we always say on here that we are all different and you must only use Flecainide in this way under the instructions of your EP.

Pete

Tux18 profile image
Tux18 in reply toBobD

No specific instructions were given - just take "one tablet by mouth as needed twice daily as needed". 50 mg.

Thank you for your reply

CDreamer profile image
CDreamer

I would always take PIP Flec about 1 hour after AF started as mine would sometimes self convert but if it lasted 45mins or more I knew I was in for a bad one. Always take on an empty stomach, made the mistake of not doing the consequence were such I never did again!

AF would normally convert to NSR within an hour of taking, when it worked. What dose? I took 300mg as PIP.

Tux18 profile image
Tux18 in reply toCDreamer

Did not know it was important to take Flec on empty stomach. I've been given 50mg. to take as needed. This morning at 3:00a.m. I took one after 7 hours of AFib. Did some meditation and went to sleep. So far today I'm in NSR.

Thank you for your helpful information!

Singwell profile image
Singwell in reply toCDreamer

Hi CDreamer, I usually take on an empty stomach just for convenience. Why is it important?

CDreamer profile image
CDreamer in reply toSingwell

The one time I forgot I had just eaten and took Flec I had extreme nausea, headache and just felt terrible for about 3 hours. I was warned by my then GP this would be the side affects if taken within 2 hours of food and he was correct!

Singwell profile image
Singwell in reply toCDreamer

Thanks for your response. That doesn't happen to me though it did the first time. In the morning it's usually 1.5 hours before I eat but closer in the evenings. Will discuss with cardiologist!

CDreamer profile image
CDreamer in reply toSingwell

If you don’t get those symptoms then I wonder if you need to? Drugs affect everyone very differently. Also taking a maintenance dose is very different to taking a PIP dose of 300mg.

pip_pip profile image
pip_pip

Bob's right. I discussed a plan of action with my ep. What to do if afib hits. Immediate dose first, increase over couple hours, but if things go awry, A & E. This is a plan for me only. Fortunately it hasn't come to that for at least five years. I do not take flecainde myself. Horrible drug.

Be well.

Phil

Tux18 profile image
Tux18 in reply topip_pip

And I agree horrible drug. Before I had pacemaker I took it once and felt worse than I'd ever felt - could hardly move, walk, etc. Having the pacemaker has helped in that I'm not so weak, but I still don't feel strong and just not as alert. Thank you for your reply.

Singwell profile image
Singwell

Following with interest. Am on lowest dose of Flecainide twice a day and get periodic episodes of AF. I'm fairly new to AF so no clear pattern yet. When I take extra dose as PIP it's worked within 30 minutes except that last time when I had to take one more. So altogether that dose I took 150 and had had 50mg earlier. When I took the triple dose I felt very weird for half an hour. Don't want to do that again! Paying to see cardiologist next week to get some decent advice on this - he prescribed it and by and large I do well on this drug.

Bhoyo profile image
Bhoyo

I take Flecainide as PIP and have been advised, as stated by several members previously, no more than 300mg in a 24 hr period. I take 100mg at a time and have taken the 300mg over 24hr period, still not reverting. I have also been advised to take my beta blocker Metropolol (12.5mg) concurrently with Flecainide. My body does not react kindly to Metropolol. I have ended in A&E on several occasions even after taking PIP.

All the best

Palpman profile image
Palpman

Calling Flecainide a horrible and strong drug will put fear into people who need the drug.

Only a few members of this forum experienced adverse reactions but most did not experience any at all.

I had all the bad reactions listed but stuck it out and now am happy I did. Not had any arrhythmia for a year since starting the drug.

Put your big girl pantyhose on and take the suggested 100mg tablet x 2 daily. You will not be sorry.

Tux18 profile image
Tux18 in reply toPalpman

You are right the drug does seem to help a lot of people which is wonderful for them. I either have the wrong dosage or maybe haven’t taken it long enough to get used to the side effects which for me have not been good. I will check with my doctor. I do appreciate your reply.

opal11uk profile image
opal11uk

I have a Pacemaker fitted too and much to my annoyance still have to take drugs, name Bisoporal mornings and Disopyramide night time, I take these as a matter of course, having reduced the dosage myself over the past year without ill effect. My pacemaker and the drugs keep me stable and I thought this was their purpose so my advice is go back to your doctor and ask to come off Flecanide if its not working, you should be able to have an A/F free existence now with the correct drug, and your pacemaker, sometimes trial and error but it would be nice to have that choice. Good luck

Tux18 profile image
Tux18 in reply toopal11uk

Yes , I think you are right I need to go back to doctor. And I’m just now realizing what you said is correct , that it’s trial and error. Knowing what others have gone through and how they’ve handled it is so helpful. Thank you for your reply. And best to you.

Tux18 profile image
Tux18 in reply toopal11uk

Afib free would be terrific, but that’s certainly not happening for me right now. Thank you for your response!

Crystalpalace profile image
Crystalpalace

I usually take a 50mg flec as soon as I feel afib coming on, It takes around 1 hour to work for me sometimes quicker. I have been cardioverted at Hospital with full 300mg dose previously. I have no qualms taking the tablet, it works realy well for me.

As mentioned previously by others, don't take more thn 300mg in a 24 hour period

Tux18 profile image
Tux18 in reply toCrystalpalace

Thank you for your reply as it’s helpful. Maybe I should have been given a larger dose. I’ll check with doctor. So glad it works for you.

OurCoach profile image
OurCoach

I was told to take it immediately as it will bring the heart rate down to a more tolerable level as the AF runs it’s course. I had 2-3 a week that lasted between 3-7 hours. Hope that helps.

LouBrig profile image
LouBrig

I am not medicated Ordinarily but when I have an AF episode my EP told me not to hang on but to take Flecanide at about 20 mins. This is to avoid your heart remembering the AF and it coming more frequently. So I take 200mg at about 20 mins which usually takes about 45 mins to work. I’ve only taken the final 100mg once , equating to 300mg . I was told never to take more than 300mg in any 24-hours. Last week I managed to bring my self back in to rhythm through slow deep breathing, coughing and running on the spot, thus avoiding taking anything.

sanotrader1 profile image
sanotrader1

Hello all,

I'm new here but I take 100mg of Flec twice a day and it has really helped me stay in rhythm.

Tux18 profile image
Tux18 in reply tosanotrader1

Your reply and others have been a big help to me. I’ve learned one thing that people like you are definitely taking a larger dosage than the doctor prescribed for me and maybe that’s the problem. Did it take you a while to adjust to taking it every day? It makes me feel weak physically and much less alert.. Therefore, making me leery to ask for a larger dose. But maybe I would get used to it. I will check with the doctor. Thank you so much for responding.

sanotrader1 profile image
sanotrader1

Hi Tux ,

So that's not all I take I'm on 200 mg of MetoprololXL per day and 240 mg Verapamil XL per day. I was only taking metoprolol 50 mg per day and had only a few bouts of afib every few months until it decided to go full blown with my heartrate jumping around from 130 to 180ish for days then I went to ER spent two days in Hospital . But this mix has kept my heart rate in the high 50's to 70's and in sinus rhythm . Oh almost forgot on Eliquis 2x a day

I'm 53 about 239 lbs 6'

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