I am prescribed Flecainide Acetate 50mg bd for AF.
US websites do not generally put any limitations on how to take the pills ...but UK ones often do ...and my pharmacist always puts a label on the box saying "Take on an empty stomach, ...1 hour before a meal or 2 hours after a meal".
Because this means that this pill is separated from the others I take at breakfast (ramipril, apixaban, diltiazem), it means I often forget to take the flecainide.
So I'm wondering about the empty stomach limitation. Does anyone know whether it's important (UK) or not (US)?
Written by
timetabler
To view profiles and participate in discussions please or .
I couldn’t tell you why US & UK have different advice only personal experience and what my doctor told me. Take on empty stomach for 2 reasons - first and most important is absorption and bioavailability is much better on an empty stomach & second I only once took soon after eating and boy did I regret it. I felt extremely nauseous for some hours afterwards and instead of being effective within 1 hour, it took about 3 hours. I should expand and say that was taking 300mg as a PIP & not a daily dose.
I have taken Flecainide 200mgs for years. I always wait 3 hrs after lunch and then another one hour before I eat again. Took it early a couple of times made me nauseous. I would advise following this routine as even if no side effects felt, it may affect the efficacy of the drug, which in turn could contribute to an AF episode starting.
I’m in the UK. I take 50mg Flecainide twice a day. In the event of an AF episode, if it does not resolve within the hour, I take increasing amounts of Flecainide every 2 hours (max 300mg in 24 hrs) until it resolves. Rare to take more than 150 mg as PIP.
For a long time, I was not aware of the advice to avoid taking with food and so took with other meds around breakfast time. I’m not aware of any side effects during this time nor any changes now that I am taking as advised. Also not aware of any direct impact on efficacy. However, I had a 2nd ablation for AFlutter Nov 21 and developed AFib shortly after. Episodes of AF have steadily declined in frequency from weekly soon after Ablation to it now (Sept 22) being 8 weeks since last episode (🤞). It would be some time over the last 9 mths that I have switched to avoiding taking with food. I cannot directly identify a correlation between switching and the longer breaks. It’s possible the switch has helped but also could just be an underlying improvement over time.
Also, I think I’ve seen a reference to avoid taking with milk, and so the blanket advice to avoid food MAY actually just relate to milk products. Note this is just my observation.
Edit: Have just found that the Australian patient leaflet says milk can effect absorption and hence why you should avoid taking with food.
have been on 50mg Flecainide for several years and take it in morning when I wake up (without regard to timing until breakfast) and at bedtime …well after dinner…Was never advised to take with time lag til eating…NO difference in effectiveness or symptoms!
I take Flec 100mg on waking 6.30am then breakfast about 9am. Second dose 100mg with first mouthful of my evening meal 6pm.
Asked several pharmacists inc. one at hospital, all said itdoes not mention before food in their "bigbook of words".
When I had meds review with pharmacist one year, I asked again. He said Does it work?" "yes" don't worry about it then.
I have a feeling ( no citations, sorry) that used as a Pill in pocket it might be more effective on empty stomach but will be absorbed in spite of food in due course.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
PIP and Flecainide 
Flecainide and dreams
Premature atrial contractions - flecainide?
Flecainide
AF and Stomach Issue
