Just back from appointment with my cardiologist. My holter monitor that I had on last week showed around 10000 atrial ectopics but no atrial fibrillation. That’s a massive amount to have and I felt pretty poorly. He did say that they were all benign and wouldn’t cause any damage. Upshot is I’m now starting regular medication today with a maintenance dose of 50mg flecainide twice a day and 1.25mg bisoprolol once a day.
Am I best to take the flecainide on an empty stomach and the bisoprolol in the evening before bed please. My cardiologist has asked me to touch base with him in a week to give him feedback on whether I have any difficult side effects with the beta blocker and he’ll change it to a calcium channel blocker. I enjoy a round of golf a couple of times a week and am worried that the bisoprolol will give me fatigue etc as others on here have stated. I am going to try it though and fingers crossed I tolerate it ok
Written by
Profound15
To view profiles and participate in discussions please or .
Flecainide is more easily absorbed on an empty stomach so, if it is convenient, do so. Bisoprolol makes some people very fatigued - I'm one of them who was changed from it - others get along fine with it. Your dose is low, so try taking it at night which is what many of us do - I take Nebivolol in the mornings as it has no deadening effects on me.
Best wishes with your drugs and may they give you some relief from those ectopics and keep you playing golf.
Over 6 years on 2 x 100mg Flecainide and beta blockers - first 1.25mg Bisoprolol, then 2.5mg Nebivolol for the last two years. So far, so good.
I’m sure the medication will come with a leaflet saying how you should take your medication. I’m not medically trained therefore cannot really comment on how you should take your medication but I was advised to take the Flecainide on it’s own about an hour before breakfast and similarly, about an hour before dinner. From the comments we get here on the forum, although beta blockers are normally prescribed as a morning dose, some prefer taking it in the evening because they say they sleep though side effects. You are taking the lowest dose of Bisoprolol so hopefully, side effects will be minimal. In my case, when I was prescribed Flecainide I was also taking a calcium channel blocker and after a week or so, there were no noticeable side effects......
Thanks flapjack. My cardio might change to a calcium channel blocker if I get heavy side effects with bisoprolol. I’ve been on pill in the pocket since 2018 so I’m hoping I’ll tolerate the flec ok. What calcium channel blocker are you on please
Diltiazem (Viazem XL). It’s not something I have experienced so far, but it can cause feet/ankles to swell. Try not to condition yourself into thinking that you will have problems with Bisoprolol, it is an effective drug and low doses like 1.25 mg should not be too much of a problem......give your body a chance to adapt.
I have just (yesterday) been changed to 50mg flecainide morning and evening and 2.5 mg bisoprolol evening. The EP was very specific about when I should take it. I have been told I can take an extra bisoprolol tablet ( upto 5mg) if I experience ectopics.I took my first flecainide last night and my heart rate dropped from low 60s to low 50s but I feel fine and will see how I go.
My GPS will offer no help when taking flecainide and bisoprolol together. I think the two drugs are contraindicated, so gps can’t give advice.
Thanks Rhiannonimity1. When did your EP say you had to take the tablets please. I’ve read the advisory note with the tablets and the flec is one hour or so before food.
Hi. He said flecainide 50 mg when I get up and flecainide 50 mg / bisoprolol 2.5 mg when I go to bed.When I picked up the flecainide and read the leaflet - I thought I must make sure I take the flecainide as soon as I wake and not breakfast for an hour but tbh I rarely eat breakfast anyway. My EP didn’t mention food at all .
I take exactly the same dose of medication also to help with ectopics and have no particular side effects. My cardiologist described the amounts as a ‘maintenance’ dose and said he didn’t expect side effects. But obviously we are all different. I have my bisoprolol in the morning as I sleep ok and wanted the maximum benefit during my waking hours when ectopics can be very active. I have had a few holter tests over the years, the worst showing around 20,000 ectopics over a 48 hour period. I think the bisoprolol has ‘taken the edge off’ that burden which is how my doctor described it. It’s not a cure and I think other measures such as diet, relaxation and dietary supplements can also play a part. I take magnesium, avoid alcohol and caffeine, and try to avoid big heavy meals. Not an ideal lifestyle with Christmas coming up, but one I’m used to now, and definitely better for it. In terms of long term use, I’m 10 years plus on bisoprolol and more than 25 years on flecainide and I’m still here! Best of luck
I was told categorically take fiecanide on empty stomach ,ad although I was on 50x2 a day ,little effect.I was taking just before meals and it meant it wasn't absorbed properly so not working as it should.
Try taking biso at night ,as my Dr told me. It helped a lot with tiredness .xx
As my consultant says 1.25mgs of bisoprolol is "nano" amount and so low it shouldn’t affect you at all unless you are ultra sensitive to pills. Good luck.
Agree with the others. I do think the body takes at least a couple of weeks or more to get used to the Biso, so give it a chance before you think it’s not working, or it’s making you feel too bad. My EP explained something about beta-blockers to me once, when I said I was worried that Biso was making me breathless when I started exercising. He said that because the Biso slows the natural heart rate, when your heart starts needing to work hard, like when exercising, there’s a bit of a time-lag which can leave you with a feeling of breathlessness, but it should pass soon when you ‘catch up’. Of course this is just my anecdotal experience; if you get breathless generally, or it persists when you do exercise, you must go back to your practitioner at once. Best of luck in your Flec/Biso journey, it’s been a quality-of-life changer for me.
I take flecainide 150mg twice daily and metoprolol 100mg once daily. Only thing that works for me, any less I get ectopic beats, if I don't take I go into afib very easily. Last three years still good. Before it was many weekly afibs that lasted 8-10 hours. Used pill in the box for 5 years prior and prior to that was controlled with verapamil till it did not work anymore. My BP is now 104/68 HR 67. Very consistent, siting. I am 57 first episode was at 25. Runs in family. HR during exercise will no get above 130, causes some shortness of breath. Daily walking moving around none.
Thanks to everyone who has responded. I really appreciate the support and advice given. This is really a brilliant site with very knowledgeable people.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Third ablation, beta blocker change or something else?
Beta blocker 
Flecainide side effects
