Flecainide

[OscarN]

hi everyone. Having been AF free since February I have gone into FAF this morning. I’ve been prescribed Flecainide (1x50mg tablet followed by another an hour later.) I’m. Im not sure whether to take a higher dose and when in the day to take them. Would really welcome any advice. Has this drug helped anyone go back to NSR? How long did it take?

[BobD Volunteer]

Do whatever your doctor has told you within the understanding that the absolute maximum flecainide permitted in any 24 hour period is 300mg. . This is a common treatment.

[OscarN in reply to BobD]

Thank you. When the heart is in AFib does one normally take Flecainide every day ?

[listerines in reply to OscarN]

Speak to your health professionals about this, but know that in general flecainide is prescribed either as a pill in a pocket approach or a prescribed daily to prevent or reduce AFib episodes/ burden (usually taken alongside a beta blocker as well to reduce risk of possible separate arrhythmia that can be triggered by solitary flecainide usage - is rare but can occur)

[OscarN in reply to listerines]

Thank you

[Suesouth in reply to OscarN]

Flecainide never worked as “pill in the pocket” for me, but now take 100mg twice a day!

[mjames1]

Di not take any more Flecainide than your doctor has prescribed. If you're not sure, call the office.

The amount of flecainide you are allowed to take is a clinical judgment by your doctor based on your individual medical history. It's not something found in a medical leaflet, or by googling on the Internet.

Some are allowed 300 mg in 24 hours. Some like myself, are only allowed 150mg. And it sounds like you may only be allowed 100 mg.

Jim

[OscarN in reply to mjames1]

Thank you

[OscarN in reply to mjames1]

I’m going to ask my GP if I can take it daily? my heart felt much better after 100mg earlier today but still not in NSR. So I’m wondering if I take it each day for a while. Thank you for your thoughts. Much appreciated

[BobD Volunteer in reply to OscarN]

Something you MUST discuss with the prescibing doctor which here in UK must be a consultant level ( cardiologist). GPs are not normally able to presribe anti arrhythmic drugs such as flecainide without supervision from cardiology.

[OscarN in reply to BobD]

Thank you

[listerines]

Hello OscarN hope your episode has died down and back to a more normal rhythm. For myself I am prescribed flecainide on a daily basis to control/ reduce my episodes and for the past 2 years or so it has definitely helped (also helps with reducing my ectopic burden as well). Have had 3 ablations as well but still cannot come off the flecainide - definitely discuss options with your cardiologist/ electrophysiologist.

[OscarN in reply to listerines]

Thank you

[Speed]

I’m prescribed by EP to take 1 x 50mg twice a day with PIP of 100mg if slip into AF with 2nd 100mg 2 hrs later if not returned to NSR. Max in rolling 24hrs is 300mg. This was increased to 3x daily when episodes became more frequent but as I’m better in control and episodes less frequent, I’ve dropped back to 2 x daily.

Initially prescribed when diagnosed with A AFlutter in A&E together with a beta blocker, my cardiologist (not EP) was uncomfortable as he didn’t like Flecainide due to associated risks. However, as I’d been on it for several months already he did not take me off. Subsequently agreed with EP to drop beta blocker as it destroyed any enjoyment in exercising as maxed my HR out at about 110bpm.

Restarted after developed AF post 2nd AFlutter ablation. When I reported minor chest discomfort I was immediately referred for an angiogram as I understand Flecainide should not be taken in cases where there are other underlying heart issues. Fortunately all clear and remain on Flecainide which I find very effective as PIP restoring NSR, usually within 8-10 hrs.

As previous comments, any changes should be after consultation with consultant cardiologist, preferably EP (or specialist nurse who will discuss with EP).

[OscarN in reply to Speed]

Thank you so much

[Peony4575]

I have been prescribed Flecainide as a pip but haven’t used it yet . My cardiologist said take 50mg then two hours later another 50mg and if I was still in AF after 24 hours to come into hospital . I would stick exactly to what your cardiologist has told you . Hope it settles soon

[OscarN in reply to Peony4575]

Thank you very much for this

[Sally_Scott]

Hi Oscar. I’m on flecanide 100mg twice daily. I’m a persistent afibber. 3 months ago I dropped the evening dose. Last Monday I was in hospital with high heart rate of 220. I was put on a drip of dijoxin to try to reduce the rate. The following day I had a cardioversion to bring me back into sinus rhythm. I’m now back on the additional evening dose. For me Flecanide works. At least I don’t have to take a beta blocker daily as they make me breathless.

[ian16527]

I found it worked better if I waited 2 hours after the attack started, 100mg PIP then it would revert in 2-3 hours usually.

[lizzieloo2]

I took 100mg Flecainide as a PIP before my ablation in August. My EP said he didn't want me to take this for any longer than necessary. I had to take 100mg and then another 100mg after an hour if it hadn't worked. If it persisted then after another hour, I could take another. I resisted taking Flecainide for years and then finally succumbed without any problems but I only ever took 2 on one occasion. This didn't seem to have any effect and so I called an ambulance after another hour but the AF stopped while waiting so I cancelled. Once I had the ablation, my EP told me not to take it unless absolutely necessary so it seems it differs for everyone depending on other issues I suppose. Good luck with it all

[OscarN in reply to lizzieloo2]

Thank you.

[OscarN in reply to lizzieloo2]

how long had you been in AFib before taking the Flecainide?

[lizzieloo2 in reply to OscarN]

I was diagnosed with paroxysmal AF about 10 years ago and after the first few episodes, they were roughly 9 months to a year apart. So I never took the Flecainide for years until the episodes became more frequent, every couple of months. Once I decided to start taking the Flecainide and knew it didn't make me feel ill, I would take it as soon as I realised I was in AF which only ever comes on at night and wakes me up.

[FSsimmer]

Hope you are soon feeling better. I take 50 mg in the morning and 50 mg evening following my Ablation. Unfortunately my Ablation did not work so I am in Persistent Afib, have been for over 2 years. I also take Bisprolol 7.5mg daily and Edoxaban. I am fortunate as I am practically symptom free, but in relation to the medication always follow the Drs advice. I must admit that I have no side effects or problems taking any of my meds

[Dollcollector]

I took 300mg as a pip and it worked in half an hour. I tried taking just 150 thenext time l went into afib and that didn't work. I have never taken it daily.

[OscarN in reply to Dollcollector]

That’s really helpful. Thank you.

[OscarN in reply to Dollcollector]

Wow. Half an hour! I’m so envious of that. Did you have any side effects to the 300mg? I’m wishing I’d been prescribed that larger dose vs the 100mg I was told to take. I did feel better for a few hours but didn’t revert.

[Dollcollector in reply to OscarN]

It stopped my heart and started it again in n.s.r. the same as a cardioversion. Not a pleasant experience. That is why l took less the next time as l was nervous of taking it. I seem to be very sensitive to drugs and often have the worst side effects. I went to hospital to take the 1st lot as advised. My partner saw me flatlined on the monitor. As l was taking a dose the next time l was in a.fib at home , l thought l should reduce it. Other people might be O.K. with a large dose.

[OscarN in reply to Dollcollector]

I won’t up my dose until spoken to my cardio but now I’m wondering if Flecainide only works at the first onset of an attack? And taking a higher dose later isn’t effective. Does anyone have any experience of taking Flecainide a few days or weeks into an AFib eposde?

[Dollcollector in reply to OscarN]

When l used to take a pill waited to see if l reverted by myself, which l did sometimes. I wouldn't leave it more than 4 or 5 days as l used to have a pulse rate of 150b.p.m. to 250 b.p.m plus a box of frogs in my chest and was incapable of doing anything.

[Dollcollector in reply to OscarN]

I think you need a high dose for it to work as a pip.

[OscarN in reply to Dollcollector]

Yes that’s seems to me what people are saying too. Thank you.

[Camelia23]

Hi. Good that you've been AF free since February. I was prescribed flecainide in Feb 2020 as a PIP. 50mg. I found it worked for me in about 3 to 4 hours but I was reluctant to take it at first and sometimes I reverted to NSR naturally. I'm waiting for a referral to cardiologist but think it might be a while yet.

[OscarN in reply to Camelia23]

Thank you. Pleased 50 worked for you.