Adizem Slow Release and Flecainide

[PAP48]

Does anyone take these 2 drugs for blood pressure and Afib? I was on one 50mg Flecainide at night but due to increased episodes my dose has been increased by my Consultant to 50g morning and night with a 100mg pip. He also prescribed me 120mg Adizem slow release which I have been taking in the morning, been on this regime for approx 1 month. Thankfully, I haven't had any Afib episodes for 6 weeks, but since being on this course of medication I feel totally spaced out, no energy and very tired. Just wondering if anyone has any of these side effects or whether maybe my body needs to get used to it. The Adizem has brought my blood pressure down to normal levels which obviously is a good thing. Many thanks for any input.

[mjames1]

Yes, I've been on the Flecainide/ slow release Adizem combo. It's pretty standard, right up there with the Flecainide/bisoprolol combo. Most ep's think Flecainide needs a nodal blocking agent for safety reasons and both Adizem and Bisoprolol function that way.

That was quite a jump in Flecainde and hopefully they have run an ekg a week after the dose increase. If not, I would as, them to as we don't all tolerate that drug well, especially in higher doses. If that checks out, maybe they can go to 50/50 first, which has worked for me. It also could be partly the diltiazem. I got a bit spaced out on Adizem 120 time release and switched to Diltiazem (Adizem) 30mg fast acting tabs which I took every 6 hours. Same dosage but I found the different formulation more tolerable.

Jim

[PAP48 in reply to mjames1]

Thanks for your reply Jim. I'm interested to hear why you think the increase in Flecainide is high and no there was no mention of an ekg. I haven't had one since I was first diagnosed back in May 2022. If my spaced out feeling continues, I'll have to get back to the consultant to see if taking a lower dose twice a day would help. Interestingly my GP wanted to increase the Adizem to 180mg! Thank goodness I declined! Penny

[mjames1 in reply to PAP48]

At least in US, standard protocol is ekg a week or so after any Flecainide dose increase, or if symptons warrant. I didn't feel well after my flecainide was increased from 50 twice a day to 100. Ekg showed Wide QRS and heart block. Dose was reduced back to 50 twice a day. This is a very strong drug that requires monitoring.

[PAP48 in reply to mjames1]

I'm not sure it's the same where I am in the UK. Nothing been mentioned apart from the one I had last May during initial diagnosis. I'll mention it to my GP when I see her, don't know when I'll see Consultant again! Thanks again for your replies. Penny

[mjames1 in reply to PAP48]

Probably more than you want to know, but this is the last sentence of the article's conclusion:

""A 12-lead ECG is required before starting therapy while ECG monitoring is suggested in case of drug adjustments or concomitant therapy with other antiarrhythmic drugs, particularly in the elderly and in patients with hepatic and/or renal dysfunction."

ncbi.nlm.nih.gov/pmc/articl...

[secondtry]

Your Flecainide dosage seems reasonable to me. I was started on 50mg x2 per day and that didn't stop the episodes, so was put on 100mgs x2 per day (which is a medium dose) and that did the trick. However it take take 3 months and other supplements before I felt anything like normal. 10 yrs down the line still taking the same dosage and energy levels good.

[PAP48 in reply to secondtry]

Thank you for your reply secondtry - I'm not sure it's the increase in Flecainide causing the problem, I think it's the Adizem slowing me down. It has reduced my blood pressure dramatically but I do feel I'm living in a fog! Hopefully it will wear off once my body gets used to it.

[mjames1 in reply to secondtry]

No follow up ekg when you dose was increased?

[secondtry in reply to mjames1]

Not that I recall. I do have one annually now though.

[mjames1 in reply to secondtry]

Probably more than you want to know, but here is the last sentence of the conclusion:

ncbi.nlm.nih.gov/pmc/articl...

"A 12-lead ECG is required before starting therapy while ECG monitoring is suggested in case of drug adjustments or concomitant therapy with other antiarrhythmic drugs, particularly in the elderly and in patients with hepatic and/or renal dysfunction."

[bassets]

Tjhat's pretty well what I take now although I have the Adizem at night. When I was first in troduced to Adizem a lovely young registrar took the time to tell me that he had had to take this as an experiment in med school and then was asked to exercise. He found he simply couldn't.

I find the Adizem makes me sleepy and really slows me down, which is why I take it at night. I also have a blood pressure pill in the morning. You will get used to it but the Adizem does affect how you get through your day. I decided it was worth the fatigue to have my heart behave - and of course it's known to be a good idea to take this with flecainide. I tried flecainide at a much higher dose and felt really ill until it was reduced and I went back to the Adizem. I should see if you could take it at night instead? Hope the brain-fog wears off soon

[PAP48 in reply to bassets]

Thank you so much for your reply. Is it the slow release Adizem you take? Taking it at night sounds a good idea. I seem to remember my Consultant telling me to take it in the morning, maybe I need to check that out! Penny

[bassets in reply to PAP48]

I would ask if it's possible to take it lateran as it might allow you to have more energy in the day. I changed to taking mine at night after asking my consultant. Persevere with it as you will probably get used to it eventually. x Helen

[PAP48 in reply to bassets]

Thank you, I will persevere particularly if it makes my heart happy! Last question, when you say you take it at night, just before bed or early evening. I take a 50mg Flecainide at about 9.30pm. Just wondering if taking the two meds together aggravates the 'fogginess'? Penny x

[bassets in reply to PAP48]

I have two alarms, one at 9 am and one at 9pm. I take my meds then, which works for me as I'm really good at forgetting! 🤪

[PAP48 in reply to bassets]

Sounds like a plan!😂

[bassets in reply to PAP48]

🤪

[BaileyC57]

All those meds do make you feel tired! One time I was on Flecainide and metropo and I was tired all the time and a water pill!