switch from sotalol (80 mg x2) to bisoprolol and flecanide 50 mg x2

[Anonymouskd]

has anyone made this change? I was on Bisoprolol and Fleca for years then my cardio decided to put me on sotalol, I’m in afib everyday for 24 hours with just 2 days off. Sotalol bothers my stomach and I want to go back to bisoprolol and Fleca now as PIP. With bisoprolol the main drug keeping things under control. Has anyone made this kind of switch back? I could go weeks with no episodes before. They have increased over the years but better than on sotalol, Alsp has a one had a cardiac pulsed field ablation?

[pottypete1]

I switched from Sotolol to Flecainide and Bisporol. However that was 30 years ago. My body didn’t like Sotolol.

Pete

[mjames1]

I'm a little confused. Are you taking 50mg flecainide twice a day or are you taking it as a pill in the pocket? You mention both. Also, if you're always in afib, I don't understand the point of taking an anti-arrhythmic like Flecainide daily. Flecainide is to either keep you out of afib (taken daily) or to convert you from afib to normal rhythm (taken as PIP). Not sure what your doctor is trying to accomplish here.

Jim

[Anonymouskd in reply to mjames1]

no I am lone paroxysmal and convert on my own. My cardio changed me to sotalol to see if it lessened my afib episodes. It hasn’t so I want to return to my previous meds of bisoprolol and flecanide with possibly trying flecanide as a PIP when I go into afib instead of taking all the time. Just want to see if. I can find a more effective method. I am not in persistent afib or permanent

[mjames1 in reply to Anonymouskd]

I got confused because you initially said, "....I’m in afib everyday for 24 hours with just 2 days off."

I read that to mean you're in afib five out of seven days a week, which begs a lot of questions regarding what you are doing. But perhaps I'm still not understanding what is going on.

Jim

[Anonymouskd in reply to mjames1]

sotalol not working. Going to go back to old med protocol of bisoprolol and flecanide 50 mg x 2 which keeps me in SN 1 to 3 weeks at a time. My original question was to anyone who had transitioned from sotalol back. That’s all

[TickityBoo]

I was put onto Sotalol in A&E after my first episode of AFib. Have never seen a cardiologist or EP. Anyway, have rarely felt so unwell. Swollen ankles, could barely walk upstairs, miserable gut symptoms to extent I was scared to leave the house, heart pounding all the time with minimal effort. Begged GP to try something else. I got a lot of push back initially with various GPs refusing to change ‘hospital regime’. After 3 months I finally got an appt with yet another GP who basically said ‘this is ridiculous’ and changed me to Bisoprolol and a PiP immediately. Within 10 days I was probably feeling back to my ‘before’ self. Only problem is my sleep isn’t great but I feel fine otherwise. As far as I know, I haven’t had any episodes since I changed. However, I don’t think I had episodes on Sotalol either, so presumably it was working for the AFib, it just stopped me having any kind of normal life I felt so unwell on it.

[Lilypocket]

Same as Pete. I switched from Solotol to Flec and Bisoprolol with no problems.If you look at one of my previous posts about resting heart rate after an ablation someone went off track and started to chat to someone about their Pulse field ablation which could be of interest to you.

[listerines]

Was on sotalol same dose as yourself for few months but it was like I turned into a zombie and heart rate around mid 40s which made be feel unwell all the time. Switched to FLEC 50mg X 2 and bisoprolol and much more energy and good relief from afib episodes (episodes not as long and intensity not as high). That said have had to increase flecainide to 75mg X 2 to get same effect.Seeing as your episodes are quite frequent perhaps you could discuss with your health professionals an increase in your flecainide dose to see if this gives you better control over afib episodes. Of course discussion re: ablation might also be appropriate. Wishing you good heart stability.

[SingingT]

I have made this switch and feel much better. I still get periods of paroxysmal AF but they are for shorter periods and further apart in time. I can manage this. Hope you find a benefit too.

[Anonymouskd in reply to SingingT]

do you recall the guidelines/protocol you had to follow to switch from sotalol to bisoprolol and flecanide?

[SingingT in reply to Anonymouskd]

As far as I can recall I simply stopped the Sotalol and started the Flecainide (50mg twice each day)the next day. It was a little later that the Bisopralol was added. I only take 1.25mg Bisopralol each day in the morning. It was added to protect me from Atrial flutter which can occur if Flecainide is taken on its own. I don’t tolerate beta blockers very well but I have become used to this low dose. Hope this helps. T

[Anonymouskd in reply to SingingT]

thank you so much for sharing your experience

[Dalmatianangel]

talk to your electrophyiologist. Sotalol works well for me, even after an ablation. Different drugs work for different people.

[jd2004]

I was taking Bisoprolol 10 and Flecainide 2x100 until Covid when frequent af kicked back in. Nothing was working. Cardiologist put me on digoxin. Didn’t work. Put on Sotalol. Was ok but dose wasn’t sustaining nsr. Eventually put back on Bisoprolol 10 and Flecainide 2x 50. So far so good. Only one breakthrough prior to Christmas which I think was food related. Think Covid exacerbated af and when things settled original drug regime was more effective again.

[Mrwoo]

Have pacemaker for 5 years. Sick sinus syndrome and AF and A flutter.Had flutter ablation. I have been prescribed all medication mentioned here and had dreadful side effects to all... But ..the almost latest was Sotolol which seemed to suit better 80mgms twice daily. However I was still very fatigued and weird sensations from resting to activity. It was halved to 40mgms twice daily. Not much improvement. Breathlessness on activity and fatigue continued. Blood pressure very high despite Ramipril slowly increased. Echogram revealed issues with the pumping mechanism of my heart. The two halves not coordinating! Will possibly need a different type of pacemaker very soon and meanwhile I have been taken off Sotolol and replaced with 2.5 mgms of Nebivolol once daily together with 10 mgms Ramipril plus continuing with Apixapam. Symptoms have improved. Blood pressure right down. A first for a long time and a little more energy. Not quite so breathless and strange sensations improved. See consultant in a week re pacemaker. 5 years ago I was sporting fit! I can honestly say I feel a 'bit' like my old self again after 5 years.