Flecainide PIP info please

[sunlovah]

Diagnosed first episode March 2023 after exercising with shingles( unknowingly)- had four episodes since waking in AF, (also had Gastric probs during this time) Cardioverted back each time.

Currently on Ablation list and awaiting tests to see if I can take Flecainide PIP, intolerant to Beta, Blockers, Adizem lowered heart rate too much. Taking thinners only.

Please what can I potentially expect on Flecainide, after taking will it write off the whole day if I 'flip out' or can it revert quick? Side effects? EP advised to be sitting down when I take it as could cause dizziness when reverting back., yes? You know the usual. Be interested to hear experiences (hopefully positive) .

M y system is not too tolerant of some meds, any info would be helpful.

[TracyAdmin Partner]

You can download the pdf copy of our 'Flecainide' patient information sheet direct from the AF Association webpage: api.heartrhythmalliance.org...

Kind regards

TracyAdmin

information sheet

[sunlovah in reply to TracyAdmin]

Thank you.

[BobD Volunteer]

Mot anti -arrythmic drugs need a structurally sound heart but propafanone is an alternative to flecainide though not normally used as PIP.

[sunlovah in reply to BobD]

Is there a reason why Propafanone it is not as well favored do you know?

[BobD Volunteer in reply to sunlovah]

No idea. My EP switched me from flec to propafanone when I first met him in 2004/5. It does have some beta blocking function so does not need bisoprolol as does flec.

[Hidden]

I take Flecainide as a PiP. 200mgs has thus far stopped my AFib in about an hour. I do experience quite intense though very brief sensations of nausea and light headedness when my heart is converting back to NSR.

Like you, I am very sensitive to medication in general, and I do tend to feel pretty rubbish for some hours afterwards and usually end up lying down for some time. I'm not entirely sure if that's due to the AFib or Flecainide but I've tried taking a small daily dose of Flecainide and it makes me feel tired and pretty rubbish generally so it's likely that it's contributing to my feeling the need to hit the prone zone for the rest of the day after taking a larger PiP dose. It's worth it though, to me, for stopping the AFib which is very unpleasant. I'm retired so it's not a huge inconvenience to need to rest up.

[sunlovah in reply to Hidden]

Do you take a Beta blocker /Calcium channel blocker at the same time as a PIP? Thanks

[Hidden in reply to sunlovah]

I take 10mgs of Propranolol (a very mild/low dose beta blocker) just to settle my HR initially but my normal HR is quite low so anything stronger will bring my HR down too much. My heart is structurally sound so I think a CCB is only necessary if taking a daily dose of Flec?

[sunlovah in reply to Hidden]

My rate is good- on the low side. I think that's why BB's wipe me out. I will ask about Propranolol, you only take that when you go into AF not daily?

[Hidden in reply to sunlovah]

Yes, as a PiP. My HR only goes up to 130ish at the onset of an episode but starts to come down into the 90s pretty quickly. My normal resting HR is in the 50s and will go below 45 during the night. I can't tolerate Bisoprolol, which is the usual BB of choice for AFib it seems like. Even the lowest dose competely flattens me.

I should say that no doctor suggested Propranolol to me. I've had it in the past for mild anxiety and I had some left so tried one during an AFib episode and it did the trick so I asked to be prescribed it. It seems to act quicker than Bisoprolol and not stay in the my system so long. which is exactly what I need. I don't need a beta blocker kicking in after an hour or more, by which time the Flec has done its job and the episode has stopped.

[Vonnegut]

I started taking Flecainide as a PIP and it worked fine at ending episodes of AF within a few hours. As episodes increased I was advised to take it regularly and I haven’t had an episode for over a year now. It might have increased the fatigue that began around the same time after shingles hit with the pain before the rash and I was unable to get an appointment at my surgery when an antiviral would have prevented all this! Hope it works well for you too. The lowest dose of Bisoprolol was too much for me to take like you with the beta blocker you were given but we are all different.

[sunlovah in reply to Vonnegut]

Do you need to take a Beta blocker /Calcium channel blocker at the same time as a PIP? Read somewhere that it is needed at the same time.... Thanks

[Vonnegut in reply to sunlovah]

I don’t as the lowest dose of Bisoprolol brought my heart rate down too low. When at first I just took Flecainide as a PIP I was advised to take a Bisoprolol if my heart rate was over 140 twenty minutes after taking the Flecainide which hardly ever happened. We are all different and I hope you find what works for you.

[bikergurl in reply to sunlovah]

I only take my PIP when I have an onset of Afib. 300mg Flecanide, 25mg metoprolol, which is a beta blocker.

[Singwell in reply to sunlovah]

I was told OK to take solo as PiP but if Flecainide is taken regularly it's safer with a partner drug such as a betablocker or calcium channel blocker. My opinion is that I was put on regular meds needlessly and wish I'd been taught to use PiP from.the get go.

[secondtry]

I have Lone PAF and my cardiologist favoured daily Flecainide rather than PIP, which he likened to a roller coaster for the heart. Also because my pulse and blood pressure were lowish he did not give me any other drug. We are all different, so you need that frank discussion with your trusted medic, but the above has worked for me for 11 years, given that I have made lifestyle changes to deal with gastric and other negative stuff.

[sunlovah in reply to secondtry]

Will have that chat after test to check heart if it's a go or not. Thanks for reply

[bikergurl]

My experience is that I revert back to NSR within 60-90 minutes. I typically feel a little “ wiped out”, but am able to function normally. Hope this helps.

[sunlovah in reply to bikergurl]

Thanks for reply. How much/often do you take and do you need to take a Beater blocker as well? Thanks

[AustinElliot]

I take Flecainide as a PIP. So far its been hit and miss.

But I have had no side affects, no dizziness, nausea or anything else

I was advised that the first time I took it I should be in the ER, that was 5k. Yikes. I was prescribed 50 mg, which did not work to convert me. I converted about 8 hours, which my normal is 8-12 hours.

The next time I took it (50mg) converted in 2.5 hours. (accidentally took second 50)

The next time took 50 + 50 +50, I ended up going to sleep and converting in the morning.

Finally took 100 + 100 and converted 2.5 hours

My plan for the next time is to try 150 mg +50 mg + 50mg + 50 mg. or maybe go straight to 200 mg. My EP was not particular helpful. Basically said take the lowest dose that is affective.

Good luck!

[sunlovah in reply to AustinElliot]

How far apart do you take them? I did ask if I need to be in A & E first time as a rooky, they said 'no'. Looks like it a bit trial and error..

Thanks

[AustinElliot in reply to sunlovah]

Yeah, I think it was a waste of money. The only thing I got out of the visit was that 50 mg was a ultra low dose for PIP.

I usually wait 1 hour.

When i queried my EP about the low dose, he was vague. The ER Doctor was hesitant to give me the 50 mg, as everything he read said 200/300 as PIP. The ER also gave me 10 mg liquid Diltiazem twice and then gave me the 50 mg Flec. Reading between the lines, it seems they want to identify the lowest dose that is affective. This is fine, but the EP never said anything.

[sunlovah in reply to AustinElliot]

Do you take Diltiazem every time you go into AF as well, with the Flec PIP?

[AustinElliot in reply to sunlovah]

I take daily 180 mg time release Diltiazem. I don't really know what my HR was before I was prescribed it. My HR now is in the mid 50/60s resting. So its fine.

I originally thought that it was dropping my HR too low, as sometimes it gets down to 45/42 while sleeping. And I thought some of my anxiety was from that, but after about 3 month on it, I guess I adjusted to it. Now I have been on it about 10 months, and feel pretty good.

[Singwell]

I was on the lowest dose of Flecainide daily for 3 years and did use extra PiP on advice when AF broke through. So on occasion I might have taken 150mgs within a 4 hour period. And yes, I did sometimes get a reversion pause - it's not nice. Lie flat as soon as you can and just hang in - it'll be over in 30 seconds. But alarming the first time to feel the room spinning. So I'd say, as a PiP not to take it if alone in the house. I am very sensitive to meds and often need a half dose only compared with what others need. I was lucky to have a good EP who said - if it works for you, then that is fine.

[sunlovah in reply to Singwell]

That's sounds scary. I'm quite often alone in the house.

EP said...take one 50mg then if no sinus rhythm, take another 50 mg half an hour later, then another half an hour later etc up to 300mg. Are you still on them now?

[Singwell in reply to sunlovah]

No, currently off all heart meds but have used Flecainide as PiP since coming off. 50mg with no problems and Sinus rhythm within 30 mins. There are others here who take much higher doses (up to 300) as PiP successfully.