Does anyone take Flecainide once a day? - Atrial Fibrillati...

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Does anyone take Flecainide once a day?

John3333333 profile image
29 Replies

I don't mean PiP, I'm talking about a regular daily dose, such as 1 x 50mg or 100mg. Also, has your cardiologist agreed to it?

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John3333333 profile image
John3333333
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29 Replies
pottypete1 profile image
pottypete1

Yes I have been taking Flecainide for over 30 years.

What do you want to know.

Pete

John3333333 profile image
John3333333 in reply topottypete1

Nearly all my ectopic beats come in the evening. Therefore, I've been considering taking a single dose prior to dinner every day, as I'm not sure if I actually need Flecainide throughout the morning/afternoon. I'm just concerned about the effect this may have on my heart health, other than just being more susceptible to irregular rhythms for half the day.

Has your heart specialist agreed to your single dose, and how has it worked for you?

pottypete1 profile image
pottypete1 in reply toJohn3333333

I take it twice a day 200mg in the morning and 100 mg in the evening.

Flecainide is a very dangerous drug and therefore you should do nothing without instructions from your cardiologist.

Pete

secondtry profile image
secondtry in reply toJohn3333333

My AF episodes were also late afternoon/evening/night and I asked my cardio if I should take 100mgs Flecainide pm and just 50mgs am. He favoured an even dose am & pm, so that is what I have done for 8 years and had no problems.

Elsie1955 profile image
Elsie1955 in reply topottypete1

PETE! Have I been looking for someone like you! My cardiologist got it in his head that flecainide would be a killer or some crap and though I've been on it for 7 years without incidence he said "over time..." Apparently this isn't a one size fits all! You're here and well as can be! Please tell me how you're doing? I was prescribed 100 mg 2x daily.

pottypete1 profile image
pottypete1 in reply toElsie1955

Hello Elsie

I have taken 2 x 100mg for as long as I can remember.

Even though I have had 7 ablations anyI am really stable my EP (who is a very well respected expert) agrees with me on continuing to take this medicine .

We are however all different and for some it obviously does have side effects.

Pete

CDreamer profile image
CDreamer

Treat with extreme caution and consult your cardiologist. Even at low doses you need to be monitored with regular ECGs, echo etc as Flec can cause other arrythmias. Many are prescribed a beta blocker alongside Flec. I took 200mg daily some years ago and developed other arrythmias and AF broke through anyway.

mjames1 profile image
mjames1

Of course consult with your doctor, but what you propose sounds reasonable.

I have at times varied my flec dose to kick in during those times I was most prone to afib, including dosing like you propose.

Now I'm on 25mg, twice a day, a not often prescribed dose, but one that works for me.

And yes, Flec should be monitored, but the toxicity problems come from too high a dose, not cutting down.

Jim

Deb86290 profile image
Deb86290

yes I do 150mg and have done for a year now. My new cardiologist however is not ok with it and wants me off it by January when I have an ablation assessment. He says that at 61 I am too young to take it as it can have serious repercussions further down the line.

Hope this helps.

pottypete1 profile image
pottypete1 in reply toDeb86290

I have taken Flecainide for over 30 years and am now 75. I am not aware of any “serious repercussions”.

Pete

Deb86290 profile image
Deb86290 in reply topottypete1

This medicine can cause changes in your heart rhythm, such as conditions called PR, QRS, or QT prolongation. It may cause fainting or serious side effects in some patients.

tunybgur profile image
tunybgur in reply toDeb86290

It's not recommended for people with a long Qt interval as it could cause Torsade-de-pointes, however I'm not aware that it can induce a prolongation of the Qt interval.

Suesouth profile image
Suesouth

I take 50mg twice a day along with rivaroxoban, Bisoprolol, candesartan and bumetadine, I can also take 100 mg when I go into AF

Cricket24 profile image
Cricket24

interesting , I would like a bit more detail on the comments “dangerous drug” and “repercussions down the line “.

I have been taking 100mg twice daily since I was 62 on recommendation of my cardiologist - bit concerned now.

Many thanks

jeanjeannie50 profile image
jeanjeannie50 in reply toCricket24

The last words from my EP when I last saw him about 6 years ago were to try my best to reduce my dose of flecainide from 2 x 100mg daily. I sensed he didn't like the drug. He had tried me on Sotalol instead but that didn't prevent my AF.

CDreamer profile image
CDreamer in reply toCricket24

See my post below.

Although it has it’s dangers, if you are well monitored and tolerate it and do well on it and haven’t had any reactions, you have to consider what would be the alternatives because all the other drug alternatives are more toxic, have potentially worse affects which leaves you with ablation, mini-maze, pacemaker or not treating.

CDreamer profile image
CDreamer

Quote:- This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Immediate Repercussions and down the line:- can cause long QT interval, Flutter and other arrythmias - which is why first dose must be administered under medical supervision - although it seems these days to happen rarely.

healthline.com/health/drugs...

In my case long QT interval and worsening of neurological condition. I took Flec as PIP initially (300mg), then daily at 100mg x 2bd for 2 years aged 58 with extra 100mg if AF broke through.

I now have a resynchronisation pacemaker.

Electricblue1 profile image
Electricblue1

hi, it’s worrying what people are saying about flecainide, I’m on 50 mg twice a day, I tried to come off my evening dose but my body experienced to many side effects. I am now concerned that long term flecainide might cause me more harm than good .

PAP48 profile image
PAP48

I take one 50mg Flecainide before bedtime, usually about 9.30pm. Only been on it about 3 months and due to see Consultant this month. I think he prescribed it to be taken at night because my episodes of Afib were most usually during the night. So far so good, I'll wait and see what he says. He was also talking about using it as a PIP. So far, I haven't noticed any side effects but then 50 mg is a low dose.

wilsond profile image
wilsond

you have to have an even dose am and pm so it wouldnt work to just take 1 dose. It is a volatile but usually effective drug IF taken exactly as prescribed.

The dose is spread evenly when taken on a daily dosage to ensure correct responses prior to af epidsodes (prevention)

PIP dose is different.

Deb86290 profile image
Deb86290 in reply towilsond

That is interesting. I only take one dose of 150mg in the morning. I will have to ask the cardiologist about this. I have only ever had two episodes of AF in the last five years and am really not sure any of it is necessary.

wilsond profile image
wilsond in reply toDeb86290

yes ,worth checking Id say. X

DKBX profile image
DKBX

100mg morning and evening plus metoprolol succinate in the morning. So far, so good … knock on wood.

tunybgur profile image
tunybgur

I believe it is supposed to be taken twice a day to maintain effective blood serum levels, its half life is relatively short.

I have been taking 100mg am and 50mg pm for five years, no AF since, works very well and I've been tried on most other drugs.

ozziebob profile image
ozziebob in reply totunybgur

So you aren't taking a beta blocker at all?

That would definitely go against others on the Forum who say that for safety reasons you need to take both. Was a beta blocker never mentioned when you received your prescription?

Just asking because I'm about to start Flecainide and Bisoprolol as PIPs, and I need all possible insight into how to best use these 2 potentially dangerous drugs.

Bob

tunybgur profile image
tunybgur in reply toozziebob

Hi Bob,

I was not prescribed a beta blocker after my heart attack 10 years ago because my resting heart rate was only about 50 (always had been low, I was very fit). Several weeks later I started having short tachycardia attacks, periods of 160-180 bpm, and I was tried on 1.25 mg of bisoprolol which stopped the tachy attacks but dropped my HR to 45 and my BP to 100/60.

About 3 years later I developed AF and after several months treatment I was eventually tried on flecainide which immediately fixed it, effectively gave me my life back!

I was never told to change any other meds, I am also taking a calcium channel blocker (amlodipine 5mg) and for the last year I have been halving my beta blocker (quite tricky as the pill is very tiny) to try and get my heart rate back up a bit as I occasionally feel a bit faint after a hot bath or period in the sauna or steam room at the gym, this normally drops your BP sometimes quite a lot, but I value the therapy highly so look to control it.

My HR hasn't increased so it's still about 46 but my BP is around 125/65.

My underlying concern is balancing the blood supply to the rest of my body, brain and other vital organs etc. against looking after the pump! At 74 I start getting concerned about dementia etc.

I know the cardiologists main concern is reducing the strain on the heart in order to prevent it failing but I do worry about the long term effects of reduction of oxygenated blood to the rest of the body.

Good luck

ozziebob profile image
ozziebob in reply totunybgur

tunybgur,

Thanks for your helpful reply.

However, I'm a bit confused when you wrote you have been halving your beta blocker? Does that mean you continued taking 1.25mg of Bisoprolol ever since you started it for your tachycardia? and which you are now halving?

You don't mention any other beta blocker to which your "halving" could refer. And Amlodipine is a calcium channel blocker.

Bob

tunybgur profile image
tunybgur in reply toozziebob

Hi Bob,

The only beta blocker I have ever taken is bisoprolol 1.25mg and I am now halving it as I am concerned about the effect of limiting the blood supply to the rest of my body as I get older....no point in having a working heart if my brain is half dead imo.

I'm not aware flecainide and beta blockers are mutually dependant.

Sorry if I wasn't clear....it's all about quality of life rather than just preserving life for its own sake, but that's another discussion.

Snowgirl65 profile image
Snowgirl65

I was on Flecainide for many years, prescribed by my EP.

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