Flecainide pill in the pocket

[AFGran]

I have been given flecainide as a ‘pill in the pocket’ to use when necessary for my paroxysmal AF. I’ve only used it once. The AF stopped immediately, but my blood pressure dropped alarmingly - it’s on the low side normally - and I felt faint and dizzy. I wondered if anyone else had experienced this? And is there another solution?

[mjames1]

I do also do Flecainide PIP but never had that issue, maybe others here have. This would be a good discussion to have with whoever prescribed you the Flecainide, detailing both your symptons and how low your blood pressure dropped. Depending on how your doctor sees things, they may do anything from nothing to changing your PIP dose, to eliminating/modifying other companion medications you may be taking.

For example, I take 50mg Flec, 2x/day and my PIP dose is only an extra 50mg which can be repeated only once, for a full "onboard" dose of 150mg. Some here, take as much of double that as PIP. I also take Diltiazem with it as a nodal blocking agent for safety reasons.

Jim

[estesbubba]

when did you take your blood pressure? AF can cause lower blood pressure while in it but I don’t know if it jumps back right away once in NSR.

[CDreamer]

Hi - yes many people have low BP with AF, sometimes worsened by meds but everyone will have widely fluctuating BP when in AF. I had many years of syncope (fantining) or near syncope when in AF, especially if I stood up - blood pools in the legs - so immediate first aid was to lie with legs higher than head and drink water and electrolyte drink.

My BP was always low but stabilised when I had a pacemaker, didn’t have PM to stabilise BP obviously but it was an added benefit!

Has this happened only when you took Flecainide? If so you should report to your doctors.

Is there a solution to what? Low BP whilst in AF or another med to take? Yes to both but as everyone has different needs, impossible to give an answer.

First thing to ensure is hydration and electrolytes are good so especially in this warm weather, start every day by drinking a glass of water.

[JeanetteH in reply to CDreamer]

Hi Ive been told I need to watch my electrolytes as Im on Sotalol so wondered what electrolyte drink you take ?

[CDreamer in reply to JeanetteH]

I only take pure Coconut water and watch include foods rich in electrolytes in my diet. I would avoid most electrolyte drinks as many will have added sugar or artificial sweeteners. I make my own smoothies - we jokingly call them green sludge because I add spiralina or an algae powder. I take Himalayan Pink Salt to put on my food - I need to take at least 6g salt per day because of low BP. I also take some supplements for bone health which include Magnesium,

You can look on line for electrolyte drinks, plenty to choose from but most are designed for recovery after sports.

You may find this article helpful though targeted at the US population healthline.com/nutrition/el...

[JeanetteH in reply to CDreamer]

Thanks I seem to have missed your reply but started to put salt on my food.May try the spiralina

[secondtry]

Not had that experience, I am on 200mgs Flecainide daily.

How much did you take? Maybe discuss your experience and a lower dose with your cardiologist as that does not sound right.

[Suesouth]

I take 100mg twice a day, but it never worked as PIP

[Speed]

Take 50mg twice daily. Advised to take 100mg as PIP + further 100mg after 2 hours if not resolved after 1st PIP. Max 300 mg in 24 hrs.

Never experienced drop in BP / syncope / pre-syncope after taking (not that I would generally measure BP after episode). My BP is generally high but managed with meds.

[mhoam]

Hi,

I became very dizzy and fainted a number of times when in AF. I found this website very useful

stopfainting.com/

It explains what is happening when you feel faint and how best to avoid the worst of it.

Good Luck

[irene75359]

Yes, I had an early morning dose of flecainide as a PiP and a couple of hours later passed out as the nurse was trying to insert a cannula for chemo. They refused to go ahead (apparently my blood pressure was so low and they didn't have resuscitation equipment nearby!) and gave me two bags of fluids instead. All ended well and I had another chemo slot but if I take a PiP now I always drink lots and lots of fluid too.

[yzmd]

The dosage may have been too high