Flecainide: I see in these posts that a... - Atrial Fibrillati...

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Flecainide

Summerlily profile image
35 Replies

I see in these posts that a lot of you advise taking Flecainide an hour before meals. Why? The advice by the drug company and my doctor is to take it before, during or after meals. I have been taking it in the middle of my breakfast, should I change?

Do I take Xarelto and Bisoprolol at the same time?

Really greatfully for your comments

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Summerlily profile image
Summerlily
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35 Replies
Bagrat profile image
Bagrat

I have sought advice from different pharmacists on this and all said there are no insruction in their "book of words". The best answer I got was "is it working?" ( I take one an hour before and the second pm with meal) "yes". " That's fine then, don't worry"My personal opinion with no citations or experience is, that if you take it in a higher dose to abort an episode, taking it on an empty stomach would work better. Yes I take my anticoagulant at same time. Bisoprolol usually once a day?

Kennyb1968 profile image
Kennyb1968 in reply toBagrat

Agreed

jeanjeannie50 profile image
jeanjeannie50

My Accord Flecainide Acetate instructions say to take an hour before a meal, so that's what I do and it suits me. I only take it alongside my beta blocker. I'm in the UK and have heard there is a slow release Flecainide tablet in some other countries. Perhaps it's that one that's taken with food, who knows?

You should always take your pills as advised by your doctor and the pill company. Don't worry about what others are doing and you should certainly not listen to the advice of medically untrained people.

Jean

Nan1 profile image
Nan1 in reply tojeanjeannie50

Can I ask what Beta Blocker you take with Flecainide and do you tolerate both well

jeanjeannie50 profile image
jeanjeannie50 in reply toNan1

I take 12.5mg of the beta blocker Metoprolol, which is a quarter of a 50mg tablet. Yes, I think I tolerate them both well.

Summerlily profile image
Summerlily in reply toNan1

I take 1.25 Bisoprolol , okay for me

Summerlily profile image
Summerlily

Thank you all for replyingFor the last 6 months I have been episode free. Started with Afib again on Friday, so of course now I am looking for some answers!

jeanjeannie50 profile image
jeanjeannie50 in reply toSummerlily

Could it have been caused by eating something with artificial additives? Artificial sweeteners were a sure trigger for my attacks of AF.

Summerlily profile image
Summerlily in reply tojeanjeannie50

Thanks Jeanjeanie50.I usually don't eat anything with additives, salt or sugar, but the night before I did have a small portion of baked beans as a treat. Could be that

I know you take some supplements. I take vitamin C and magnesium.

What else do you take?

Thanks for your help and suggestions

jeanjeannie50 profile image
jeanjeannie50 in reply toSummerlily

As well as what you take I have vitamin D in a spray, B12 and also zinc. Sometimes I take a spray of vitamin K2. I avoid any pills that contain Maltodextrin as I believe that's another of my triggers.

mjames1 profile image
mjames1 in reply tojeanjeannie50

Curious which ones? I just drank a ton of Gatorade Zero this week. Uses Sucralose.

Jim

jeanjeannie50 profile image
jeanjeannie50 in reply tomjames1

I've just looked at the ingredients for that! Why on earth would you drink so much and put all those chemicals in your body?

It makes me feel even more that I shouldn't take any supplements at all, just eat them in a natural form.

Jean

mjames1 profile image
mjames1 in reply tojeanjeannie50

lol re Gatorade Zero. I got dehydrated the other day and this hydrates me up quickly. I plan on weaning off. That said, when in afib sports drinks can be useful for quick hydration.

Jim

jeanjeannie50 profile image
jeanjeannie50 in reply tomjames1

Simple answer, don't let yourself become dehydrated. Those chemicals are not useful at all. Hold your hand out while I get my ruler.

mjames1 profile image
mjames1 in reply tojeanjeannie50

LOL. I know.

waveylines profile image
waveylines in reply tojeanjeannie50

Ive read that minerals and vitamins are vastly depleted from veg & fruit due to mas production in comparison to pre war days. So youd have to eat a lot omre or top up woth sypplements. Sad times.......

mjames1 profile image
mjames1

The short answer is to follow the advice of your doctor and the drug company -- take it before, during or after meals.

My ep doctor, drug company (website and package insert), pharmacist and major US hospital websites also say take it before, during or after meals or in short, "with or without food".

Most on this forum from the UK (but not all) have been given different instructions -- empty stomach and a couple have cited their drug inserts. This can be explained because their brand of Flecainide Acetate is different from mine which is Ani Pharmaceuticals. Is the formulation any different, I doubt it. So why the different instructions? Just a guess that maybe the the UK brand was only tested without food and Ani tested it both ways.

FYI Jean mentioned there is a slow release formulation. It is called "controlled release" and comes in CAPSULE form. This is not what I take and is probably not what you're taking unless so marked and in capsules. If it is controlled release then the online instructions say to take it "with a glass of water during or after meals".

If it works for you in the middle of breakfast, I'd continue that way. If it stopped working, I suppose you could try on an empty stomach. But curious, are you only taking it once a day? Flec is usually prescribed twice a day, 12 hours apart. Also, what dose are you taking?

I've taken xarelto an a beta blocker at the same time.

Jim

Summerlily profile image
Summerlily

My Flec is in capsule form, after reading what you said I have looked more closely at the box for the first time, it says 'libération prolongée' so there you go!I take 150 mg a day

Now I understand, thank you!

mjames1 profile image
mjames1 in reply toSummerlily

Then it sounds like you are on controlled release flecainide and accounts for your once a day dosing. So as to food again, online sources say "with a glass of water during or after a meal" so you're fine taking it during breakfast -- and in your case you may not be good taking it on an empty stomach although "after a meal" is a big vague. Does it mean you can take on an empty stomach or just take it right after a meal? I don't know. The instruction "with or without food" seems clearer. What does your package insert say?

Curious, do you also take flecainide tablets as a PIP when you go into afib?

Also, you mention that you were doing well until an afib episode Friday. An episode here or there may be expected but if the frequency starts increasing then time to talk to your doctor about a higher dose of your controlled release flec or possibly switching to twice a day dosing of the fast acting tabs.

Jim

Summerlily profile image
Summerlily in reply tomjames1

All very interesting Jim, thanksI don't take anything as a pip.

First my cardiologist told me to take Amiodarone, which people on this forum thought was a bit odd as it does not work immediately. Then last time he told me to take a double dose of bisoprolol, which I think is odd as when I have an Afib episode my blood pressure plummets and I certainly don't want it helped to go lower

I am seeing a different cardiologist in two weeks time in a different hospital so want to ask him a lot of questions

Sally_Scott profile image
Sally_Scott

I take ,y morning one before food but my evening one 12 hours after 1st dose which is always 3 hours after food. Am I doing this wrong?

Singwell profile image
Singwell in reply toSally_Scott

It looks as though Summerlily takes a prolonged release form in a capsule. Usually pills like that are taken with food to assist with slow release absorption. If you're on a normal tablet form then it seems the advice is to take without food, to assist absorption. So taking 3 hours after food I'd say is fine for that 2nd dose.

Summerlily profile image
Summerlily

Yes, that's correct, until mjames mentioned it I didn't know there were two types of Flec, but I am taking the slow release one so take it with food

wilsond profile image
wilsond

I have to take it on an empty stomach as otherwise do not absorb enough of the medication. I'm not sure if it's the same for everyone as some feel nauseated if not taken with food.

SuziElley profile image
SuziElley

Thé instructions that come with my Flecainide say to take it an hour before eating so that’s what I do.

Afibflipper profile image
Afibflipper

On the patient leaflet it says in bold letters under how to take Flecainide -Swallow tablets WHOLE with WATER on EMPTY STOMACH or 1 HOUR BEFORE FOOD It also states on the box to keep tablets in original packaging and also in box

I would imagine it’s effectiveness deplete when out of its blister and in light

I don’t like this because I have a box that says AM & PM so have to store this on top other wise I’d forget as I’m on so much

I take my bisoprolol and apixaban at same time

Hope this helps you

Summerlily profile image
Summerlily in reply toAfibflipper

This is different for the slow release capsules

Afibflipper profile image
Afibflipper in reply toSummerlily

Oh ok, thanks I didn’t know they did a capsule - I only just started it and they’re the tablets

tunybgur profile image
tunybgur in reply toAfibflipper

Agreed, that's the same instructions with my flec.....I don't know why, I guess the absorption into the bloodstream is affected, but it's very clear!

ChadL profile image
ChadL

I take my Flec and Metoprolol with food, I've found if I don't the side effects are horrific about an hour after.. I also take Magnesium 2x a day, since I started taking i've not had any episodes.. took me a while to figure what works for me .. ☺️

Gilli54 profile image
Gilli54

My doctor just says consistency is the key. Also I take levothyroxine in the mix which has to be taken at least an hour before food. So I take them all together and it seems to work for me. Levo , flecainide snd bisoprolol. I take my second tablet 12 hours later with my warfarin at the same time . It’s better than having alarms going off all day for different tablets.

Jmc43 profile image
Jmc43 in reply toGilli54

If you don’t mind me asking, what does of magnesium do you take twice a day?

Gilli54 profile image
Gilli54 in reply toJmc43

Hi. I don’t take magnesium as a stand alone supplement. I do take Vitamin D and calcium. The Osteocare calcium supplement also contains magnesium. And one or two other things. I take it three different ways. Just to ring the changes! The liquid, the chewable tablet and the one in water. I always have a bit of cheese alongside too. 😊I take it with breakfast and try and fit in another dose at dinner.

Gilli54 profile image
Gilli54 in reply toJmc43

This is the chewable tablet formulation. I also eat things like kefir for vitamin K2. And I eat all veggies. I self check my warfarin and am pretty good at keeping in range. I take the supplement as my levels of calcium were low. I try to keep up vitamin K to ensure it gets to the right place and always take it with calcium rich foods. Hopefully this will help direct it to the right place. Thank

Nutritional Information Average per 2 tablet % NRV*Vitamin D (as D3 400 IU)

10 µg

200

Calcium

800 mg

100

Magnesium

300 mg

80

Zinc

10 mg

100

Copper

1000 µg

100

Manganese

0.5 mg

25

Selenium

50 µg

91

Boron

0.6 mg

--

Summerlily profile image
Summerlily

It seems that most people on this forum take the twice a day Flecinide.I have been prescribed the slow release once a day one, I wonder why.

Perhaps my cardiologist didn't trust my memory!

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