Taking Flecainide 50g twice a day with Apixaban 5mg Twice a day and Soltalol 40mg twice a day

[RagdollRagdoll]

I have been getting AFIB 30% of the time when i was wearing a 14 day heart monitor.I was already taking Apixaban 5mg and Soltalol 40mg twice a day. I had Pulmonary embolisms in March 2023 from a DVT in my lungs. I am 52 years old and had good fitness until the DVT struck. I had been drinking red wine around 3 small glasses a night whilst on the monitor. My plans to to get rid of alcohol are in place.

I am scared to take the Flecainide without asking some questions first. Can all of these medicines be taken together and are there side-effects.

Kind Regards

Andrew 😞

[Paulbounce]

Hi Ragdoll.

I see you are newish to the forum - welcome.

How to answer your question? I am not a doctor and I think it's most important to follow your medic's advice. However I'll put a copy and paste below.

Have a lovely weekend.

Paul

Apixaban (a blood thinner) and Sotalol (a beta-blocker with anti-arrhythmic properties) are medications commonly used to manage atrial fibrillation (AFib). Flecainide is another anti-arrhythmic medication that is sometimes prescribed to help maintain a normal heart rhythm.

However, the combination of medications can have different effects on individuals. Your doctor will consider various factors such as your medical history, current health status, and potential drug interactions.

[RagdollRagdoll in reply to Paulbounce]

Thank you greatly for your reply it's much appreciated.Kind Regards Andrew

[mjames1]

Even though their anti-arrhythmic functions overlap, Soltalol and Flecainide are sometimes used together although it doesn't seem a common combination from my experience on these forums. Since Soltalol alone didn't work, why not ask your doctor if you can just switch to Flecainide which is usually taken with a nodal blocking agent such as bisoprolol, metoprolol or diltiazem, rather than keeping the Soltalol and adding on. At this point, you ideally should be talking to an electrophysiologist (ep) or a cardiologist well versed in afib and not a GP.

Jim

[RagdollRagdoll in reply to mjames1]

Thank you Jim your kind response is very much appreciated.I am under a Intervention Cardiologist.Kind Regards Andrew

[mjames1 in reply to RagdollRagdoll]

All the best with the combination, but if you end up with too many side effects, I'd drop the Soltalol before the Flecainide. Flecainide has shown itself to be a more effective anti-arrythmic per studies and anecdotals in the forums. Again, if me, I'd question the combination all together, but I tend to be a minimalist when it comes to medications, meaning often experimenting under the supervision of my doctor to find the most benefit with the least amount of medications.

Jim

[Finvola]

Welcome to the forum Ragdoll.

Sotalol is a beta blocker with anti-arrhythmic properties - some people are fine on it but I had frequent runs of tachycardia at around 160 bpm so I was switched to Flecainide by my EP.

Flecainide is a powerful anti-arrhythmic drug, prescribed to patients who have a normal heart structure. It can cause other arrhythmias such as Atrial Flutter and is usually taken with a beta blocker to lower heart rate.

Apixaban is your anticoagulant and is the mainstay of stroke prevention. The only side effect I've had from it is that cuts take longer to stop seeping. It can be prescribed with beta blockers and anti-arrhythmics.

Have you been prescribed Flecainide or are you considering asking for it? By the way, that's a good call with stopping wine - I had to do that too.

The only interaction I can find is with Sotalol and Flecainide and the warning on the site I use is that your cardiologist should monitor if you have been prescribed both of them to take together. If you google 'drug interaction checker' you can fiind a site where you can enter the names of the drugs you wish to use and get a report on the known side effects of combining them.

[RagdollRagdoll in reply to Finvola]

Thank you for your reply it's been very helpful and reassuring.Yes I have been percribed Flecainide(have not collected them yet)and I'm already taking Soltalol 40g twice a day.Kind Regards Andrew

[Finvola in reply to RagdollRagdoll]

Best wishes with it Andrew - it has been a real friend for me over the last ten years.

[Paulbounce in reply to Finvola]

Finvola wrote

Flecainide is a powerful anti-arrhythmic drug, prescribed to patients who have a normal heart structure. It can cause other arrhythmias such as Atrial Flutter

No more true words spoken. It caused flutter for me. However, that wa my fault as I took over the recommended dose as told by my cardio. Flec can be very effecitive though.

Paul

[doodle68]

Hello Ragdoll, I wasn’t allowed to be prescribed Flecainide until I had an echocardiogram to check my heart function also I was told to book an ECG a week after starting taking it to check for QT issues , both wise measures .

[RagdollRagdoll in reply to doodle68]

Thank you I have had both types of Eco done but i will book an ECG with my GP in a week or so.

[LoveRowing]

I was on anticoagulant, beta blocker and Flecainide. I was prescribed the first 2 by GP and the flec by my cardiologist. Once the flec had controlled my AF I was taken off the beta blocker as this was causing my symptoms to remain while in NSR. After very long and frequent episodes which were not controlled at all without flec I am now AF free for 10 weeks. Alcohol is a definite trigger for me so cutting that out has probably reduced my AF burden. Hope you find your magic combination of meds soon, we are all very different so it’s a bit of trial and error to find what works

[RagdollRagdoll in reply to LoveRowing]

Thank you your feedback it is very reassuring. Kind Regards Andrew

[Sacstate in reply to RagdollRagdoll]

Hi RagdollRagdoll,

I have been taking 50 mg Flecainide twice daily and metoprolol for a couple years with great results, very little AFib activity only seconds long at that. However, if even a sip of alcohol is a major trigger for you as it was for me and I dare say for many others, seems like your first move is to eliminate those three glasses daily and see what happens.

[RagdollRagdoll in reply to Sacstate]

Thank you for all of this kind feedback is vital and very reassuring.Thank you and yes the 3 glasses have gone also.Kind Regards Andrew

[ozziebob]

You have had comments from members with direct experience of these medications and I can only direct you to the interactions checker on drugs.com, which gives information which might help you in formulating the questions you are intending to ask your medical team.

drugs.com/interactions-chec...

Good luck.