Flecanide reduction

[Georgeedgar]

Hi everyone, currently on 2x100mg flecanide, and 1.25 bisoporal,2 episodes of afib slept 2020 would like to taper off flecanide, any suggestions.Im in sinus at the moment.

[Hidden]

I take the same Flecainide as you but 1.5 Nebivolol. No episodes since March. Asked EP about changing dose but was told if it ain’t broke don’t change it.

[Georgeedgar in reply to Hidden]

Yeah I understand the reasoning,but as I'm 61 years old I don't want to be drinking in the last chance saloon to soon.But also with covid not the time to be tweaking meds incase of hospitalization.thanks for the reply.

[Hidden in reply to Georgeedgar]

I’m 77 and have got my life back. I was having episodes for two days then they would stop for a day then another two days so took matters into my own hands and upped to 100!!

[Finvola]

Perhaps I am reading your post wrongly but if you have had only 2 episodes of AF, then 200mg of Flecainide daily seems very high? If you have had no AF since Sept then the Flec may be working.

I take the same dose and several years ago tried to reduce - it needs to be done very slowly -but I failed because I need the 200mg to keep my heart steady. My EP advised me to forget about it and, like Hylda says, leave it alone.

Best advice is to talk to your cardiologist who knows the background of your AF, frequency of episodes, etc. If you do decide to reduce, go down in small steps - I tried steps of 25mg using a pill cutter. Stay at the lower dose for a couple of weeks before reducing again. Best wishes - hope it works.

[Georgeedgar in reply to Finvola]

Thanks for the reply,I did forget to add that I have been a afib sufferer for 5 years now and changed to flecanide in may,previously episodes 2/3 a year treated with various beta blockers, I have had one episode 4 weeks ago which I got back myself with oral loading of flecanide, so far so good always prefer sinus as I like to cycle and walk.

[irene75359]

I am assuming that an EP prescribed that dosage, did you have more episodes before? I was taking 100mg flecainide and 1.25mg bisoprolol daily and was having an episode every 2-3 months. I was unhappy with the number of drugs I was taking given how sporadic my episodes were, and with my GP's approval I stopped the flecainide and eventually the bisoprolol and now only take them as a PiP.

Oddly, my episodes have decreased, since last October I have had only two, and both times were over in a couple of hours after taking the PiP. I am fortunate as my GP really knows his stuff and is so knowledgable and supportive, I don't think I would have stopped without any input. However, my anticoagulants are a must, as are my blood pressure tablets.

[Georgeedgar in reply to irene75359]

Well done Irene,that's exactly what I would like to achieve but it's a little more trickier at the moment with the pandemic, ie hospitalization etc,but certainly my long term aim.

[secondtry]

With just 2/3 AF episodes a year, I would have expected the medics to have started you on a lower dose of x2 50mgs Flecainide. I started on the lower dose but then had 9 episodes in a month and went onto x2 100mgs. My cardiologist, despite my concerns, is like your EP and says if all is well stay on that dose.

Two more points, I am using this episode free time to make as many lifestyle changes as I can identify to give me the best chance of reducing the Flecainide without recurring AF, once the Covid pressure on hospitals eases in case something goes wrong. If you do decide to reduce Flec, I have read here that you should reduce the first 100mgs particularly slowly; by that I would suggest 12.5mg steps for 3 months. Good luck and keep us informed.

[Georgeedgar in reply to secondtry]

Personally the worst trigger point for me was alcohol, I use to enjoy a drink but now I'm teatotal because I enjoy being kept in sinus more.

[Thomas45]

Surely the fact that you only have a few episodes is a sign that the Flecainide is working. Why would you want to want more episodes by reducing Flecainide dosage?

[Georgeedgar in reply to Thomas45]

Yes I agree,but I would like to find if I could manage on less as I would like a bit of leeway for adjustment increase later in life if possible, I realise everybodys afib is unique to themselves and can't understand why I was administered quite a heavy starting dose!

[Georgeedgar]

Thanks for the advice,I think that tapering off advice is the way I would go,I realise everybody is unique and individual but my long term goal would be PIP and rivoxaban ,I am waiting for an ablation but that's on hold at the moment, Its all a bit of trial and error and nothing set in stone.but better to be glass half full attitude, (water that is).

[cbsrbpm]

I go with the 'if it ain't broke don't fix it' I started reducing my 2x 100 mg by 50mg and after week or so went back into AF, so now seriously regretting this as my heart is still playing up nin and out of sinus and HR been in the 80's ever since. was always in the 60's before.

[Georgeedgar in reply to cbsrbpm]

Sorry to hear that your out of sinus,but don't you think reducing by 50mg was a bit drastic, the advice coming out seems to be 12.5 at steady intervals.

[cbsrbpm in reply to Georgeedgar]

I know it was daft of me really but I was doing so well, false sense of security 😞