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Paxlovid and Flecainide

Sacstate profile image
10 Replies

With Covid cases rising since Thanksgiving here in the US, the latest medical advice is “vaccinate, then, when testing positive with Covid, take Paxlovid within 5 days of onset of symptoms.” I tested positive with Covid last July, and I was quickly contacted by an advising physician who stated that I could not take Paxlovid because of my taking Flecainide. I’m 76 and take 50 mg Flecainide twice daily plus 25 mg metoprolol for my PAF. Although I was pretty much bed ridden at home with the Covid, and it took ten days to finally test negative, I did fine and recovered fully. I don’t know if taking Paxlovid would have made the symptoms easier or not, but I did later email my cardiologist who advised that I could definitely stop the Flecainide long enough to take Paxlovid if ever I needed that for another bout with Covid. He didn’t elaborate on how long I would have to remain off the Flecainide to treat a Covid case with Paxlovid, but it seems kind of freaky to have to choose between AFib treatment and Covid treatment. We have friends and acquaintances who have taken Paxlovid and cruised through Covid infections rapidly and with mild symptoms. Have any of you had any experience with this Flecainide versus Paxlovid issue?

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Sacstate
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10 Replies
Palpman profile image
Palpman

I have no personal experience with this drug but in the UK GPs would not prescibe Paxlovid if you are on Flecainide.

Sacstate profile image
Sacstate in reply to Palpman

Thanks for your reply, Palpman. Yes, for sure, here too Paxlovid is not prescribed for those taking Flecainide. My concern is that Paxlovid seems to be a very effective treatment for Covid, and my cardiologist advises that it is okay to stop Flecainide while taking Paxlovid in a Covid emergency. That makes it seem to me like a coin toss whether to protect from worse Covid symptoms or from atrial fibrillation. I just wondered if anybody has heard of this or actually stopped Flecainide while taking Paxlovid.

Singwell profile image
Singwell in reply to Sacstate

We're generally told that if we stop taking Flecainide we're protected for 3 days so maybe a quick burst of the Paxlovid would work in the future? How long is the treatment?

Sacstate profile image
Sacstate in reply to Singwell

thanks for your reply, Singwell. It looks like you have to take the Paxlovid for five days as emergency treatment for Covid. That means NOT taking Flecainide for at least those five days, which has to be an open invitation for AFib to return in force. If I ever test positive for Covid in the future (which, fingers crossed, I won’t), I’ll immediately email my cardiologist for detailed advice on this matter.

Chasemenow profile image
Chasemenow in reply to Sacstate

I had Covid and was very sick. my Dr also said I could not take Paxlovid. I was sick for at least 2 weeks. I had every system listed for Covid.

Sacstate profile image
Sacstate in reply to Chasemenow

Thanks, Chasemenow. Yeah, I had Covid in July and got pretty sick, too, though I have had much, much worse flu over the years in the past. Because of that, and because I am fully vaccinated and boosted, I am inclined to forego the Paxlovid and keep taking Flecainide if I were ever to test positive again.

secondtry profile image
secondtry

There apparently are alternatives to Paxlovid for Covid, if I was you I would keep taking the Flecainide and look at covid19criticalcare.com/ and check with your medics before taking any alternative.

Sacstate profile image
Sacstate in reply to secondtry

thanks for your reply, secondtry. I appreciate the very interesting and informative link you shared. Of course, I don’t have Covid and take every reasonable precaution to avoid it, but want to be prepared with a good plan regarding medications since it is spreading rapidly here again.

Poochmom profile image
Poochmom in reply to Sacstate

as Secondtry said, I have all the protocol from critical care advisors on hand. I had Covid last January, started the protocol immediately and was over Covid in three days and it never got me bedridden. And I didn’t have any AFib. But I only take Flec as. PIP.

Sacstate profile image
Sacstate in reply to Poochmom

…the outcome from the way you treated Covid is certainly a strong recommendation for Critical Care Advisors. Thanks, Poochmom!

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