How long does flecainide take to adjust the heart not to go into af ?

[mjm1971]

I’ve taken my 1st doses of flecainide today

100mg at 8am and 100mg at 6pm

I’ve been in af since 2pm today

Should that 1st dose have stopped that or does this drug take a few days to actually sort the heart etc .

[rosyG]

I think you need to talk to your doctor about dose and whether you need to vary it when AF starts.

[Hidden]

I have tried taking 50mg of flecainide daily morning and evening several times and it has never succeeded in preventing episodes so I would have to take a further 2 when an episode started in which case they always stop within a couple of hours but I now just use it in this PIP way though must admit episodes are occurring more frequently and it’s troubling to hear that you have found that twice the dose has failed for you ! The EP who finally got in touch well over three years since my diagnosis said there was another drug that might work better but he doesn’t propose to be in contact again until it will be almost four years since my diagnosis!!! Good luck with finding what works for you as we know how different we all are!

[BobD Volunteer]

Give it time. The use in PIP varies a lot according to the whim of the EP. Back along when I first started my AF journey I was told by the original cardiologist to take 300mg in one hit and no more for 24 hours and that often worked in a short time. Once I met my EP he switched me to propafanone 150 mg twice daily. That didn't work either so went ablation route.

[mjm1971]

They haven’t told me to use as PIP I’m 200mg daily . by the sounds of it this drug is used as a PiP so it should have stopped me going into Af as I took 100mg at 8am and went into AF at around 2pm Back to my EP it is lol

[Deacon-L in reply to mjm1971]

Hi, getting the dosage and timing of flecainide right can take a bit of trial and error. As I have PAF, my consultant prescribed Flecainide 100mg to use as a PIP. After a bit of trial and error, the further advice I was given was that it can help to take a 2nd dose an hour or so after the 1st dose if there was no beneficial response from the first dose and for me that made a difference. He reckoned that the first 2 doses closer together and taken as soon as possible after onset was more likely to get it under control and in the therapeutic zone (NB max daily dose is 300mg a day).

It could be helpful to you to have a discussion with your medical advisor about the possible benefit of taking the first 2 doses closer together, rather than evenly phased through 24 hours?

I hope that helps and works for you🤞

[Singwell]

If you've only recently started taking it then it will take a while for the dose to work, that my experience. When I first transferred from bisoprolol to Flecainide I had two runs of AF and then a blissful 3 months without. I chose to stay in a lower dose of 50mg X 2 although I could've tried 100 X t as I continued to get AF runs about once every two months. For those, on advice of EP and under guidance of GP (this was during height of first lockdown), I took extra PIP. Like BobD I've gone the ablation route. Flecainide doesn't suit all of us so that's something to consider too. Maybe try for a few more days?

[Sfhmgusa]

Hi, I think the simple answer is that yes it should have worked if it was going to.

Flecainide use and effectiveness seems to vary from person to person and ( for me) episode to episode . In my case in 2 hours it sometimes worked , but as my af got more frequent it worked less well and I went the ablation route.

I would check with your doctor because it may be that a large single dose ( never more than 300mg) right as the af starts may work,

Steve

[katiefforde]

When I first started taking flec about 7 months ago, 50 mg twice a day, I had more episodes but they were much shorter. But, (I hardly dare write this) they stopped and I haven't had an episode since before Christmas. I've done the things that would have definitely set me off before so I'm very pleased. But it wasn't immediate. It probably took a fortnight for the episodes to stop. Katie

[secondtry]

If you have only had very occasional AF episodes, I would expect that dose would stop your AF (if its the drug for you) after it has had chance to build up - say 48hrs after taking the first 100mgs. Create your own track record with a diary to be able to summarise and advise your medics when you consult.

[mjm1971]

once again thanks to all for the responses .

i find it astounding at how different it is for us , even with the science behind medication its still one thing works for one and yet not another

[BobD Volunteer in reply to mjm1971]

As I have said many times before AF is a long journey but you have some great travelling companions here so buckle up and try to enjoy the ride. Flecainide may not be the route for you but trial and error is the only way till you try ablation and that doesn't work for everybody. either .

Life is still good though and far better than the alternative.

[mjm1971 in reply to BobD]

Totally agree Bob , I genuinely ( may sound depressing ) find this AF fascinating and the more I learn the more I want to find out . I don't mean find out for my own benefit as I get no symptoms ( a bit tired ) when in AF . I just find it intriguing to hear all the different things others have been through in regards what works for one doesn't work for others etc . so many options for us all but we all have the same condition . I've not heard of any condition like this where there are so many variants of treatments and lifestyle changes that work for one but not the other . yet we all have the same condition all be it part time or fulltime . Apologise if some ( probably all ) of my questions are repeats of others .thanks for the info so far and here's to a long / VERY LONG journey .

[BobD Volunteer in reply to mjm1971]

I think there is more and more a thought growing that AF may actually be a symptom rather than a condition.

There is no doubt that it can be acquired (over exercise by endurance athletes and fast jet fighter pilots) but also that some type of genetic influence may be at work. If you heart is a particular shape you may be more likely to develop AF and even by modern life which is why life style changes seem to work so well for some people.

It is also important to remember that in general terms treatment of AF is still new. Thirty years ago it was considered a natural part of aging and something to be endured and it was really only after the link to stroke was well known that doctors started treating it. Even after my 16 year journey I still know **** all.

[wilsond]

As above it does take a few days for effect. I have been on several regimes with flec. Began with 50 x2 a day with option of taking 100 in response to any breakthrough AF. Worked ok until I had a very long run of lots of activity. So upped to 150x2 a day.Nothing of note for 7 months

GP and I had a chat yesterday about reducing the daily dose. As he said ,at max dose you have nowhere to go if you do get breakthrough.

So will go for that. Speak to your EP and see how you go. If you are on daily dose that should keep you mostly on track,but I think it isn't always effective for everyone.

Hope it kicks in soon xx

[Tryfan]

Think the common thread is we are all different. Whilst I'm not qualified to pass any real judgement on doses. What I will suggest is to do some gentle breathing exercises. Google it look on this site for box breathing.What I do know that the anxiety we all suffer when in Afib is like a feedback loop making it more and more difficult to break.

The more I read and practise breathing the more I'm convinced of its ethical provenance. Best wishes.

[Palpman]

If you are a heavy person then 150mg x 2 would be given by your EP.

I was on 50mg x 2 but the arrhythmia persisted. My weight was 95kg so the doc upped it to 100mg and that worked immediately.

[mjm1971 in reply to Palpman]

I'm 93kg and 5ft 11inches , I'm on 200mg a day

[Thomas45]

I took Flecainide for 12 years. The starting dose was 50mg X 2 a day. Over time that had some effect on reducing episodes but when I saw the consultant he upped it to 100mg X 2 a day. That reduced episodes significantly but I still had them from time to time. After 2 years of starting them he put me on the maximum of 150mg X 2 a day. For the next ten years I had one or two short (20 minutes) episodes a year. After the total of 12 years I was found to be in persistent asymptomatic AF, which I've agreed with medics is now permanent asymptomatic AF. I think your dose should be a decision between your consultant and you.There is no standard body, so I can't advise what dose anyone should take , ( and am not medically qualified). See how Flecainide affects your AF, keep a diary of episodes, and if they continue to be bad after, say 3 months, get back to your consultant.

I hope you soon have an improvement from Flecainide.

[mjm1971 in reply to Thomas45]

thanks Thomas

[Flyer2820]

Hi mjm1971The simple answer is, How long is a piece of string. I found it took almost a month to totally kick in. On 200mg of flechanide per day I still had episodes of af. When I upped the dose to 300mg per day it took almost a month to stop the af. As others I have now had an ablation and have been af free for 1 year and 7 months. No longer needing flechanide. As af is hereditary my younger brother has started with af episodes. He has had a pacemaker fitted because his heart was stopping for as much as 5.5 seconds. He is awaiting an ablation.

Hope this helps.

Good luck.

Regards Flyer.

[Snookersteve]

Hope the Flecainide soon does the trick for you and gets you back into sinus rhythm.

If you can't get back into sinus then a possibility may be to have a cardioversion. My EP put me on Flecainide for 2 weeks before a cardioversion (2 x 50mg daily) as it helps the cardioversion work. If you need a cardioversion then you may have to take an anticoagulant for a few weeks (but not permanently as you are still young with no other risk factors). Steve

[momist]

We're all different! I'm new to flec as well, so I'll not say more . . .

[djmnet]

Flecainide doesn't work for everyone. I tried it for several months (100 twice a day) and it did nothing to keep my afib down.

[tunybgur]

We're all different, but Flec worked for me within an hour or so of the first dose.

I was initially prescribed 100mg/day 4 years ago.

A few years ago I started getting the odd AF attack and I am now on 150mg/day.

Been continuously AF free now for 1 year after dosage increase.

Good luck