Does anyone take Flecainide 25 mg twice per day?

[John3333333]

I know that the min dose is 50 mg X 2 daily but I was just curious if anyone split their pills?

[BobD Volunteer]

I doubt that a dose that low could have any affect on your AF so why would you?

[dizzielizzie1 in reply to BobD]

Hi Bob, this isn't a reply to John 3333's question, but I didn't know where else to make this general comment. I'm pleased that the current users of this site are a kind , helpful bunch of people. A few months back there were people on here who were really bitching about each other and I was really quite shocked. We're supposed to be here to help each other, after all. I'm glad that the forum has reverted back to what it was.

[Palpman]

Probably people under 55kg or children.

[Singwell in reply to Palpman]

I'm around 54 kilos so that might be why I do well on 75 a day.

[mjames1 in reply to Singwell]

Weight is always a possibility but in my case 25/25 worked with my weight between 72 and 75 kg during that period.

Jim

[mjames1]

I take 25mg bid (twice a day).

Started at 50mg bid and later increased to 100mg bid, but I did not tolerate the higher dose well. Then kept decreasing until I got to 25mg bid.

Before I started the flecainide I got to the point where I was in and out of a fib three times a week. Except for one or two very short episodes when I had Covid, I've been in normal sinus rhythm for about five months now on the 25mg dose.

And as a bonus, because I was on such a low dose of Flecainide, my ep allowed me to stop taking Diltiazen as a nodal blocker.

In my unprofessional opinion, most patients are overdosed or under-dosed, because doctors do not take the time and effort to tailor a medication regimen to a specific patient. While it was my idea to reduce the dose, I feel lucky that my ep supported the process.

Jim

[John3333333 in reply to mjames1]

I've been taking 25 mg twice daily for 4 weeks. I certainly notice a few more ectopics (maybe the odd couplet and triplet, too), but all perfectly manageable. I also take 1.25 mg Bisoprolol daily, and feel like the combination is currently right for me.

[mjames1 in reply to John3333333]

Glad that combo is working. If I get too many ectopics, I will add another 25mg to settle things down, as afib often follows ectopics with me.

Jim

[secondtry in reply to mjames1]

I agree Jim, it is up to us to push the medics to adjust the dose or do it ourselves. I had to push to have my Flecainide increased to stop the AF.

Just one small point you may want to put in the mix, my cardio does not favour variable doses (eg upping following ectopics or more pm than am). He puts more store on getting the heart stable with a constant dose sufficient that it doesn't need to be varied........trial and error needed!

[mjames1 in reply to secondtry]

Agreed, trial and error.

I find the variable dose very effective. Not much different conceptually from using a PIP dose when you go into afib. You're just doing it prophylactically.

Like many here, My body sometimes signals me in advance when it about going to afib. Why wait for it to go into afib before taking extra flec?

And the other "tweak" I have used maybe 3-4 times in 5 months is to take a little extra flec in anticipation of an afib episode. One example is the dehydrating bowel prep for a colonoscopy. Looking back, I should've up my flecwhen I had Covid and I might have stsyed in NSR.

You could argue maybe I need more daily flec, but I only take the extra 25mg dose maybe twice a month. So why take all the extra Flecainide on a daily basis? Not to mention if I take any more flec than 50/50 I will have to go back on daily diltiazem.

And the bottom line is that both my ep and myself are happy with the results.

Jim

[Singwell in reply to mjames1]

Agreed. If that maintenance dose works for you as an individual then it's doing the job. I'm 5 months post ablation. Come September I'm cutting down my morning dose to 25. Been on 75 a day for over a year abd prefer it.

[jwsonoma]

I have always split my Flec in 1/2. I bought a 4 way pill splitter and split my Bisoprolol into 1/4s.I checked prices and found it was cheaper to get double the dose and split it. I explained it to my Doc so he wrote the RX. For the Flec I try to use the split pill in a day AM - PM so the daily dose is correct it just may be off a little between AM and PM if the split isn't even. I split 150mg not 50. It's been + 5 years.

[mjames1 in reply to jwsonoma]

The 50mg Flec I get is small, round, no score in the middle and on the soft side. So even with a sharp pill cutter, getting a good split is difficult. I generally only get one good half and have a container full of broken pieces and dust from the other half. In your case, with 75/75 makes sense to ignore the small variance, but at 25/25 I want to make sure I'm getting the whole 25

Jim

[Singwell]

I split my evening dose and am planning in due course to split the morning one too. I said to me EP - suppose you'd say that's ridiculous! No, he said, you're small. Try it, do it if it works for you.

Couple more people here who do it. We aren't all statistical norms...

[willec49]

I split the 100mg. tab and take 50 twice daily.

[TM93]

If it works for you, there’s no problem with it in my view. I was prescribed 25 mg Metoprolol twice a day but discovered 25 mg is all I need. It works. Doctors often are “underinformed” about medications. Pharmacists seem to know more, at least in the US. In the US there is too much reliance on pharmaceutical representatives and you know what that leads to.

[AussieHeart]

Such a great question … and here’s another reason to halve it … too low HR. My mum is 90 and has SVT. She was put on 25mg Metropolol twice daily to take with her BP meds but it dropped her HR so low she couldn’t function! And yet her cardiologist doesn’t want to change anything! Interestingly I dropped my Flec to 25mg twice daily and now take it nighttime ONLY with 1.25mg Bisoprosolol but it’s not as effective so thinking of taking half again in the mornings as Singwell is planning to see if that helps. My EP said I could play around with dose while he monitors me via implantable loop recorder as ablation is next step (booked Sept 13) but I’m thinking of cancelling that surgery as feel EP hasn’t provided enough info on my condition eg: currently looking at length of pauses which in his words could be caused by these meds and not my arrhythmia ! I feel like a Guinea pig!!!

[Cityplan]

I used to take Flecainade 50mg every 12 hours , i.e. twice per day. It was after discussion with my cardiologist last December that I began to take a reduced dose of 25mg twice per day.