PIP Flecainide not working. Take two? Three?

[MvTries]

Hello,

Been lurking here for a long time, but never posted. Got diagnosed with paroxysmal afib a few years ago after an attack that put me in the emergency room for a while.

Since then under control with Flecainide 150 slow release and Metropole. Occasional (2-3 a year) mild episode that goes away by its own.

Got 50 mg Flecainide instant release with 25 mg Metropol as PIP. Got an atack 24 hrs ago and took it. Brought it down but did not reach NST. Came back to high rates (120 bpm, pressure 90/80) overnight. Am now considering doubling or tripling this dose as a second attempt. Am nowhere near any medical facilities atm and can't get there either for days.

Am on Apixaban/Eliquis 2x5mg.

Anyone has experience with this PPI combo/dosage?

Thx,

Marcel.

[Hidden]

Hello Marcel, whilst I appreciate your dilemma, I and most others here, are not medically trained therefore for reasons I’m sure will understand, we are unable to advise on medication. However, we can make sure that you are aware that maximum dose in any 24 period for Flecainide is 300mgs but given you take other medication, even this dose may not be suitable for you. As difficult as it might be, you really should discuss this with your medics, most drugs used to control AF are very potent and one can have an impact on the other which is why you need professional advice…….

[Paulbounce]

Welcome to the forum.

I'm not going to give advice on what you should / or not do. However it's worth talking to your doctor about taking instant release flex as a PIP. The slow release is useless as a PIP IMO - I had experience of it when traveling. I took a chance and 'speeded' it up (there is a way - and no I won't tell you how) but I don't recommend it to anyone. Stick with your doctors advice. Looking back it turned out to be the right call but I wouldn't do it again - these drugs are not sweets.

300 mg is the max you can take in 24 hours - take more and you risk serious repercussions.

Good luck Marcel.

Paul

[irene75359]

Like you, I had 2/3 episodes a year and took 200mg flecainide with 1.25mg bisoprolol as a PiP which worked every time within a couple of hours. However, the flecainide wasn't slow release and I took that amount after checking with and under the supervision of my doctor. Would really be worth calling your doctor for advice.

[Sfhmgusa]

too much flecainide can be really dangerous so whatever you do make sure you have spoken to your doctor or medical advisor and got their recommendation in writing and in a form that is clear to you. I know that many on the forum (Including me pre ablation) took more than 50 mg of Flec as PIP but it must be with the knowledge and input from your medics, we are all different when it comes to meds

[Buffafly]

Hi, it sounds as though you have got PIP instructions as you have 50mg Flecainide dose as well as slow release. Perhaps you have got the instructions written down somewhere? As others have said, too much Flecainide is much more dangerous than controlled AF.

[MvTries]

Thank you everybody. I have amended my original post to show that the PIP I was given was indeed instant release. I know I should consult my doctor and all that, but that was not possible given the circumstances. So I went ahead and took 3 pills of 50mg each (150 mg total). Got rid of the AFIB in less ten 10 min. Shockingly effective! These are no candies for sure......

Will talk to my cardiologist when I am back in civilization to adapt my PIP strategy. Feels that 100 mg is enough, but not the 50 he prescribed. Reason I went ahead at my own peril was that my BP had dropped to 80/60, at 3 times my normal BPM and I was close to fainting the whole time (in a situation where that would be extremely inconvenient).

Again thank you everybody. This forum is great.

[Cookie24]

I found this article about such a situation. I plan to ask my EP about this strategy.

mdedge.com/familymedicine/a...

[Pollywaffle10]

As previously stated, Flecainide/Metoprolol is a good combination to control PAF. But enough/not enough/too much can be tricky to work out. My cardiologist EP told me never to take extra tablets as the dose is calculated by body mass/age etc. I am over 80 have been taking it for years, rarely get episodes, and also take small dose of Eliquis. Best advice is to phone hospital or Dr for advice before taking extra medication.