Flecainide

[PAP48]

I have just joined this forum as I have Paroxysmal Atrial Fibrilation. I’ve been prescribed Flecainide low dose 50mg one at night. Since taking it I feel very tired and lethargic and a bit irritable! Is anyone else on this medication? I’m hoping once my body gets used to it the side effects will wear off!

[jeanjeannie50]

Welcome to the forum and feel free to ask any questions, be aware we always say there's no such thing as a silly one. That is certainly a very low dose of Flecainide and I wouldn't have thought that would make you feel tired, whereas bouts of AF would. Who prescribed that drug for you?

Jean

[PAP48 in reply to jeanjeannie50]

Thank you for your reply and welcome jeanjeannie50. My heart consultant prescribed Flecainide and the dosage. It was my first appointment, and had echocardiogram and ECG before I saw him. I’ll be seeing him again in September to see how things are going, I’ve only been having episodes of AF about every 3/4 months over the past 2/3 years but last one was particularly unpleasant which is why my GP referred me.

[jeanjeannie50 in reply to PAP48]

AF is a hateful condition, but be assured we understand exactly how awful it can make people feel. I have never heard of anyone on such a low dose, some take 1 x 50mg morning and evening. I admire your consultant for cautiously prescribing it for you.

What some people do is just take Flecainide when having an attack of PAF, it's referred to as a pill in the pocket or PIP for short, you may want to ask your consultant about doing that if you feel the drug is making you feel tired. I take 75mg of Flecainide twice daily, it used to be 100mg, but my EP asked me to try and reduce my dose even if it meant upping the dose of the beta-blocker Metoprolol which I take alongside it.

Jean

[PAP48 in reply to jeanjeannie50]

I think the Consultant is looking at the PIP when I see him in September.

[mjames1]

I assume you are taking the tablet and not the sustained release capsule? Also did they give you any new medications to take with it like bisoprolol or diltiazem? Both those meds can cause the fatigue you describe. If not, it could be just getting used to the drug if you just started as we all react differently

That said and if the fatigue doesn't soon go away, I question the need for daily flecainde or even a daily beta blocker for afib episodes months apart. Why feel lousy all the time when you can only feel lousy once every three months for a few hours lol?

So when you speak to your consultant , ask about switching from daily flecainide to taking it as a pill in pocket, only when you're afib. If you take it as a pill in pocket, you should take a beta blocker or calcium channel blocker at the same time or 30 minutes before.

Also, at this point, you should probably be talking to an ep or a well versed cardiologist. Not sure if your consultant fits into those categories.

Jim

[PAP48 in reply to mjames1]

Thanks for your reply Jim. Yes, I am taking the tablet, not the slow release. I'm seeing the Consultant again in September to review the medication as this is all new to me. I will discuss the PIP with him then. He is a reputable cardiologist and I had an echocardiogram and and ECG just before my consultation. I have other health issues, bronchiectasis and asthma which could be the cause of my tiredness too. I'm waiting for a call from my respiratory nurse who is speaking to my chest consultant. If it's not one thing it's another!

[mjames1 in reply to PAP48]

Unfortunately, many doctors, even some good ones, weigh the effectiveness of a drug on the intended results (in your case staying in normal rhythm) rather than weigh the effectiveness in terms of quality of life. It's the old, "the operation was a success but the patient died" syndrome.

For the first forty years of my afib journey, my episodes were infrequent and I was prescribed no drugs at all. Because of that, I lived a perfectly normal life in all respects without having to deal any drug side effects, or limitations in activity. The exception being having to deal with a few afib episodes either through electro cardioversion, or more lately by taking medications at home. Afib was basically a non issue in my life.

If, on the other hand, I had been given a daily beta blocker back then -- as seems to be prescribed to afib patients by some doctors automatically -- or some other drug like Flecainide, the quality of my life for the past forty years would have decreased significantly.

In a general sense, the treatment of afib is more about quality of life than anything else. Something we unfortunately have to gently remind some of our doctors at times before they start writing prescriptions.

Jim

[Kennyb1968]

I'm surprised you are on a regular dose when your AFib is so infrequent ( I'd love a frequency like that😂). When I was in a similar position I was prescribed 200mg of flecainide as a PIP to be taken as and when required. I'd suggest you speak to your cardiologist about a similar approach. As my great mate mjames1 says - why feel lousy all the time when you only need to much less frequent?

[PAP48 in reply to Kennyb1968]

Thank you for your reply Kennyb1968. My cardiologist is going to discuss the PIP option when I have my review in September, but you're all right, why feel lousy all the time when it could be only some of the time!😄

[Shmediac]

Yes, Flecanide keeps me right on the edge of dizzy. Can’t swing my head around too much. Hoping to get off it, had an ablation 5 weeks ago.

[Thomas29 in reply to Shmediac]

Can I ask how you’ve been since your ablation? Do you still have to take full meds for 3 months? I had mine 5 weeks ago too for PAfib … thought I was told all went well I’ve had 2 episodes of AFib in the first 2 weeks so feel perhaps it’s hasn’t been successful. I’ll be gutted if it hasn’t worked as I was so looking forward to getting off my 200mg Flecainide. I’ve actually reduced my dose this week to 50 twice daily… not sure if it is a good idea. I feel I’ve just turned the corner and beginning to feel a bit more normal… felt like I was in snail mode since ablation… not what I was expecting!

[Shmediac]

I was told it’s too early to come off meds. I’m on 100 mg Flecanide twice daily. I feel good after the ablation, was tired a few weeks, but that’s better now. Like you, I have had 2 episodes of afib, in the first 3-4 weeks. Both times it was very hot and humid weather, somehow I think that was a factor. They told me I may have some afib in the first 3 months, not to worry. I feel like it was a success, but too early to tell.Definitely would like to get off some meds though.

[secondtry]

Make sure you take it 3 hrs after eating and then don't eat for one hour. Allow up to 3 months for the body to adjust. Well that worked for me but we are all different.

[PAP48 in reply to secondtry]

Thank you secondtry - that's really helpful. As advised by consultant I take it just before going to bed so about 4 hours after I've eaten and then nothing until the next morning. Very useful to know about the body getting used to it, I wondered if that might be the case.