Flecainide update

[Andyb7612]

Hi guys again ...just a quick question to anyone using flecainide. I've just started my new flecainide treatment on it a day and a half 3 tablets in basically .. I've still felt the odd palpatation but it never develops to anything lasting a few seconds and feels not a strong as before ...is this normal as ive only just started the treatment or should I feel nothing at all which means do i need a stronger dose...or does it take a few days to take full effect sorry for all the questions but I'm still new to it all, I'm on 50mg twice a day thanks andy

[Paulbounce]

Hi Andy,

I can only talk from my own experence with flec. I found it fine and it ticked all the boxes. It's likely your cardio might increase the dose to 100mg twice a day when your body adusts. 50mg is a 'starter' dose. May I suggest you also take a small amount of beta blocker alongside - it should stop flutter too. Maybe 1.25 of bis.

I am not a medic so am just giving something to discuss with your doctor - no more.Just something to have a natter with your doctor about.

Cheers Andy

[Andyb7612 in reply to Paulbounce]

Hey Paul cheers for that mate yeah I'm on 1.25 my of bisoprolol as well I guess I will just have to see how it goes , I just didn't know if it takes a few days to take full effect or it is supposed to be at full effect from the first tablet...cheers again for your advice mate take care . .

[Paulbounce in reply to Andyb7612]

Hi Andy.

As far as I'm aware it should kick in pretty quick. However take it on an empty stomach ie before you eat or about 4 hours after food. As I say I'm not a medic - for me though I would adjust my meal times to make sure I take the dose at least an hour before eating.

Paul

[saulger in reply to Andyb7612]

Andy, I was on 50mg x 2 + 1.25mg Bisoprolol, same as you, but was still getting AF episodes.I am low resting HR (53 BPM) and low BP, and my flare ups are mainly due to exercise.

So, I now go for PIP (Pill In Pocket) and take 100mg FL + 1.25 Bis, two hours before exercising and I'm good for 24 hours and more and can go for days with the heart feeling normal, if I don't exert myself.

[betsea in reply to Andyb7612]

In my experience the effects of Flecanide is fast acting and can be used as a pill in the pocket for that reason.

[Guitar335]

I found it took a few days to get into my system and settle down

I don’t bother with the empty stomach thing when taking and seems ok

[Singwell]

Takes 3 full days to really take effect and up to a couple of weeks for your system to adjust re potential side effects. I'm saying 3 fay's because they tell you it takes 3 days to get it out of your system. I'd definitely give it a bit more time to do its job - it's a hefty drug.

[Respondicus]

At one point and I must add in desperation I was taking up to 400mg daily, that led to problems with vision, I back it down to 300mg daily and that seems OK, I have a pacemaker and have had cardio ablation that has helped reduce the severity of my AF, but now I'm in AF a lot more but with reduced symptoms, seeing doc in a few weeks, my ablation was in December last year and it can tske upto 12 months for this to settle down.. I had been on bisoprolol but that gave me really bad heart rates, between 40 and over 200 jumping up and down, at times unable to even get out of bed. My pacemaker seems to stop my heart dropping under 40 now, as it was pausing for up to 9 seconds, took me a while to get used to flecainide but it definately works, give it some time I'm sure you wil benefit

[Singwell]

Re food- I find I can eat an hour afterwards but I'm on the lowest dose. Its going to vary between individuals but we all agree - don't have with food.

[Chrissy7 in reply to Singwell]

Hi Sing I’mBack in hospital

They want me to stay a few days and try flec. I’m terrified

Do you have side effects?

[Singwell in reply to Chrissy7]

Personally no, not on the lowest dose, which is 50mg X 2. In fact I now take 75mg a day by cutting up one of my pills. And I know others here do the same. It is an effective anti arrhythmic in my experience and it might help with the dizziness I think you've spoken about. For me it never stopped the AF altogether. Be aware if you take extra PiP when needed (as I do, preferring to stay on a lower maintenance dose), that you can get 'reversion pauses' when you convert to NSR. Not very nice. I don't miss those at all post ablation. No AF for a month now. Pleased. Hope this works out for you whole your waiting for ablation

[Singwell in reply to Chrissy7]

And what others say here about taking it away from food is also important. I take mine 1 hour before food and not less than 1.5 hours after. I recall feeling a bit dizzy and headachy when I first started taking it but I've always thought I had asymptomatic COVID at that time anyway.

[Chrissy7 in reply to Singwell]

Hi Singwell after 24 hours of being in ER with HR of 40-190 and back I felt exhausted from no sleep (ever try to rest in a hospital?) and chose to come home and increase diltiazem (my electrophysiologists other suggestion) as you know i've been on a low dose and honestly think it may not be doing anything since I took it yesterday and then took more - before going on a speeding trip to ER, I just can't explain how horrible I feel when my HR goes crazy and it was All over the place all evening and up until around 2 am.They didn't want to give me more Diltiazem as they did last time because it was going to low and were afraid it would drop lower. that's why I can't understand why he wants me to increase my dose...

Saw cardiologist yesterday who found it odd that I couldn't exercise "hard" -- so I tried it (stupid I know) --but I tried it (fast walking half hour with a pulling pup and then swam for one hour quite fast for some of it ) and then felt the exhaustion etc, creeping up so should have listened to it...it is definitely a warning.

Electrophysiologist and I agreed that should I need to come back to ER with HR issues, I will agree to the flec and stay in 3 days for the obstervation. here it's the weekend and honestly they are short staffed as it is.. I will take my chances with Diltiazem.

I remember when it made your HR spike however, trying to remember (and did re read your post) but do you think the diltiazem causing HR to spike was because you were on too high a dose? (180 I think vs 120 now?)

thanks as always, (I came home exhausted)

one year wait for an ablation.

[Singwell in reply to Chrissy7]

The Flecainide didn't make my HR spike. The Diltiazem made my BP drop after a longish run of AF. The issue was the Diltiazem not the Flecainide. I do hope you'll be OK. I know hospitals are horrible but if my HR was jumping around like that I'd be in like a shot if I couldn't stabilise it.

[Chrissy7 in reply to Singwell]

I’m stabile and back home. It was insane. I’m a chicken .. did not want to try flec just yet.. heard horrible side effects …

[Chrissy7 in reply to Singwell]

Understand.. I know people who say they are exhausted on flec….

[tunybgur]

I started on 2x50, it worked within a few hours of first dose and I was fine for about 3 years.

I then started having the odd AF attack slowly becoming more frequent.

Dose was increased to 100mg in the morning and 50mg in the evening, this has kept me AF free for the last 2 years.

I always take 1 hour before of after food.

I avoid all the normal triggers, caffeine, too much alcohol, vigorous exercise (although moderate exercise is essential), cold and flu medicines, liquorice for me, and stress etc.

I also take 1.25mg bisoprolol.

Good luck.

[Andyb7612 in reply to tunybgur]

Hi there sorry for the late reply ..i meant to ask hiwniftennwere you getting afib episodes before starting the flecainaide ? Thanks andy

[Andyb7612 in reply to Andyb7612]

Sorry for the jibberish half way through the message my phone is playing up...I meant how often were you getting afib episodes before you started the flecainide

[tunybgur in reply to Andyb7612]

Hi Andy,I was pretty much in permanent AF, I had a heart attack in 2012 which was the start of my cardio problems. I think the scar tissue affects the electrical pathways.

I had cardioversion which worked for about 2 months, then had a stressful personal episode which put me back into AF. Started Flec just after and have been pretty well AF free since apart from the dose adjustment couple of years back.

I no longer have any heart problems, reasonable fitness, I play 3 rounds of golf every week and go to the gym, walk a lot etc, at 74 I'm happy with my fitness but take nothing for granted.

Good luck

[Andyb7612 in reply to tunybgur]

Thanks for the reply there , and we'll done with your fitness , I hope im as fit as you at 74 all the best

[manabouttown]

Hi Andy, I'm on the sme dose as you of Flecainide- 1 tab 50mg twice a day.I'm also on a blood thinner Rivaroxaban as well. Fro what I remember it does take a week or so to really take effect. Take it on an empty stomach and don't eat for an hour or so afterwards.I take mine at t 9am and again at 9pm.

[stoneyrosed]

Hi Andy, It took me about 3-4 weeks for my body to get used to it, when it did it was absolutely fine.

[SuziElley]

Give it time to get into your system. I found it took a week or two to really feel the benefits.

[Cos56]

HiI’ve been on 50 mg twice a day along with metoprolol 25 mg in am and 12.5 in the evening, of course with Eliquis. I think the treatment of choice is both the Flecainide with a beta blocker which is what I’ve been prescribed. The beta blocker had stopped working by itself.

I felt the effects, meaning no blips or anything , right away. Into it further along, 3 months now, I can feel it wants to go into a palpitation,but doesn’t.

I love it!it’s changed my life.

Good luck to you❤️

[Andyb7612 in reply to Cos56]

Hi there that's good news for you...I've just had a chat with the arrhythmia nurse and she said because I've only been on it for 2 days its far to early to make a judgement yet and it can take a week more two to fully take effect before everything settles down.. she's gonna organise another holder monitor anyway just to be sure...cheers andy

[ChadL]

Hi Andy,I've been on Flec for a little over a year. It took me a couple of months to get into the swing of using. I take 100mg twice a day with 12.5mg Metoprolol.. if I don't take the Metoprolol my heart will start to race about an hour after taking. I've found taking the meds with food cuts down on the side effects.. i do get some breakthroughs however just accelerated heart rate after exercise or when my electrolytes are off balance.

All the best,

Gabby

[Flyer2820]

Hi Andyb7612.It can take up to a month or so to completely kick in. I had my dose of Flechanide upped from 100mg twice a day to 100mg three times a day and it took almost a month before it stopped my af completely. So yes you have done well to be as good as you are up to now. It may improve in time. I hope it does for you. I am af free however now as I had a successful ablation on 5th November 2019.

Good luck for the future.

Regards Flyer.