Hello everyone. I started with AF about 28 months ago. It was under control until July this year. I was taking 50mg Flecainide am and pm and Bisopralol once a day. 4 weeks ago my Flecainide was increased to 100mg and still 50mg at night. I was taken to hospital 2 weeks ago as my HR was between 120 and 150 for 10 hours but eventually went back into normal rhythm on its own. The consultant sad that should it happen again I can take another flecainide as a pip. I've been in AF again since 11.30am. The consultant didn't say how long to wait before taking my pip. How long do you all wait?
Thank you for any advice.
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NEONBUTTERFLY22
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We cant advise on taking medicine, but I know that the maximum Flecainide you can take in 24hrs is 300mg. I have heard of people taking that one dose all at once, but don't think I'd do that. When did you take your last tablet? From what I can recall I took a second dose on the advice of my GP about 6hrs later after the first 100mg.
Hi. Thank you for your response. I took my last 100mg at 11.30am. I never thought to ask my cardiologist how long I should wait before I took my PIP. I'm due my night time one at about 11.00pm. I just wondered how long you all wait before taking your PIP.
Realy do not understand why you have been told, 200mg as everybody else is told 300mg as you will see from the answers you have been given. When I took it soley as PIP it was 300mg in one hit.
Although we cannot advise on medication, we can convey information which we have heard from specialists provided members understand that they must consult their Doctor before making any changes to their prescribed medication. I belong to an AF Support Group and I have lost count of the number of times this question has been asked. At least 5 different EP/Cardiologists have said that if Flecainide is used only as Pill in the Pocket then it is more effective if the maximum permissible daily dose of 300 mg is taken as one single dose. If the dose is gradually increased over the 24 hour period it significantly reduces it’s effectiveness. Under no circumstances must anyone take more than 300 mg of Flecainide in any 24 hour period unless it has been prescribed by a Doctor which is most unlikely……
Regarding when to take, I was advised to wait around 20 minutes from the start of the episode and if I had not gone back into rhythm, take the full dose…..
It’s the Surrey Arrhythmia Support Group (Surrey ASG) which pre Coronavirus met monthly at Epsom Hospital. It was set up by rosyG who is also a member of this forum. Meetings are now held via Zoom but because of obvious pressures on the medics, they are not so regular and I believe the next one is scheduled for Wednesday 6 October. Members of this forum are notified about 2 weeks in advance and subject to availability, are welcomed to join. It’s been a lifeline for many, including me and is free.
My cardiologist. Said to take my normal 100mg am and my usual 50mg at night and take 59mg as a pill in the pocket. But she said not to rake more than 200mg in a 24 hour period. She just didn't say how long I have to wait after AF starts before I take the pip.
I will share what I was told just so it is another view on what different EP's can suggest and in no way am I suggesting it would be right for you. During a holiday I was taken into A& E with AF and when I left I was given a PIP and told me in future to take a 100mg Flecainide 30 mins from AF onset ( I knew exactly when it would start ) and if that didn't work take another 100mg an hour later, that worked well for awhile .It became ineffective so was told in future to take the maximum of 300mg in one go and that worked 4 out of 6 times from memory, then I had an ablation. I was on Sotalol as my main medication at the time. I am now on Dronedarone but still have my 300mg maximum in one go PIP instruction in place but never more within 24 hours. I do remember initially being asked my weight 80kg and 5'7" male so slightly overweight although stocky, so they said the 300mg in 24 hours would be ok.
I believe the reason why many medics recommend the full dose is because it creates a similar effect on the heart as a cardioversion but without the enormous jolt. Flecainide is a potent drug and can have serious consequences which is why folk must follow their Doctors instructions.
Instructions to me only! When I start an episode I take 200mg immediately and it always (touch wood) resolves in less than two hours. I don't take flecainide on a regular basis.
I have had a few short sessions of AF in the days following my ablation in June. Like you, I was on 2 x 50mg flec. together with the bisoprolol. I found that taking an extra 50mg as soon as the AF started stopped it again within 15 - 20 minutes. Of course, that could be coincidence.
Then after three weeks, I went into a bout of tachycardia with AF mixed in at intervals, all at a rate around 140bpm. The extra flecainide didn't have any effect at that time. After 53 hours of that, I gave in and phoned for help on 111. They referred the call to a paramedic who then sent for an ambulance for me. Sadly, the attentions of the doctors in A&E did not result in any change, despite intravenous metaprolol, fluids, extra bisoprolol. The only advantage to me was a continuous monitoring on a 3 lead ECG, with occasional 12 lead ECG for the records. I self converted, after 16 hours on a trolley in the resuscitation section of A&E. Not very nice. They then sent me home.
My advice would be only to call for help if you are at your wit's end and can't cope any longer. YMMV of course.
That sounds very simular to my recent experience. I was there for hours being monitored. They also took my bloods and the repeated them as one of the results was abnormal. They then came back and told me that I had, had a heart attack.!!!!! When the cardiologist came down to see me she advised I hadn't had a heart attack and that whatever had shown in my bloods was common in people with AF because the heart in under such strain and that its the same result in the blood for people that havdehad a heart attack. Talk about almost scaring me into having one. My heart went back into normal rhythm after 15 hours. She also advised that unless I felt I couldn't cope or it wasn't going back on its own that it's OK to stay at home. I'm glad you're doing OK now
Instructions from my cardiologist 2 weeks ago (appreciate this was just to me and we’re all in different situations / on different meds) was to take 100mg flecanide pip immediately and not to wait. I’m on 1.25mg bisoprolol per day. I only take flecanide as a pip. Mine takes around 5 hours to resolve. Between 12 - 40+ hours if I don’t take my pip. I’ve tried to wait it out without meds or leave it as long as I can bear - hence quite firm instructions from my cardiologist last visit to take it as soon as possible.
Thank you so much everyone for taking the time out of your day to reply. My heart went back into normal rhythm after 16 hours (just as I was about to take my pip) the support that you all over is amazing and kept me calm. It's so good to be in touch with other people that understand because they have the same experiences. Thank you and have a great Bank Holiday 😊
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