Flecainide

[ChadL]

Good day all, looking for some feedback. I have been on 100mg of Flecainide 2x a day since I was diagnosed with tachycardia in 2021. My heart rate is now in the 40's... my cardiologist is lowering my Flec dose to 50mg 2x a day.... has anyone had any adverse side effects from taking less of the med?? TIA, gabby

[jeanjeannie50]

Hi ChadLWhen I took Flecainide I reduced my twice daily 100mg of Flec to 50 mg with no problems whatsoever. With your heart rate in the 40's I think the lower dose may suit you well.Jean

[ChadL in reply to jeanjeannie50]

Thank you! That is so reassuring. 🙏🏽 I was glad for the reduced dose, but flashbacks of when I started on Fleck was starting to fill my mind.. ❤️

[ChadL in reply to jeanjeannie50]

I'm starting tonight so fingers crossed!! 🤞🏽

[jeanjeannie50 in reply to ChadL]

You'll be fine and it's always better to be on a lower dose of Flec if you can, especially if it's taking your pulse down so low as 40's. Normal heart rate is considered to be 60-100bpm.

Jean

[ChadL in reply to jeanjeannie50]

so far all good. few episodes of the 40's HR last night, but to be expected at rest..my cardiologist ordered a holter monitor, im getting that hooked up tomorrow. 🙏🏽

[Redactrice in reply to jeanjeannie50]

Perfect timing -- you answered the question I was just going to ask in a new post. I'm going in the opposite direction: doubling flecainide to 100mg following a phone call with cardiologist today (because I'm in persistent AF; cardioversion back in Feb. failed after three days, now waiting for next step). I had forgotten to ask him on the phone: if 100mg causes any unwelcome side effects, how easily can I drop back down to 50mg? It sounds as if you simply halved your dose. Yes, if my heart rate drops into the 40s, I will go back down to the lower dose.

[OzJames]

I’ve done 2 reductions. As my normal HR in sinus is 60-65 and when in AF 80-90 at rest I found when first went onto both 100mg Flecainide and 25mg metoprolol my HR at rest went as low as 38-45. We found reducing it to 50mg Flecainide and 12.5mg metoprolol still had me high 40’s to just over 50 at rest. This is after I was back in NSR. He eventually took me off both then 4 months later back in AF then cardioversion followed and so he adjusted again and am now on 20mg Flecainide twice a day and around 10.5mg metoprolol twice a day which is equivalent to around 1mg of bisoprolol.

We are all different and what keeps me feeling good and out of AF may not be right for others

[ChadL in reply to OzJames]

Hi Oz, when I was first put on Flec and metoprolol my HR was hitting 38 as well, was a scary time! I was then put on the 100 Flec and 1/2 a Metoprolol 2x a day... that worked until a few month ago when I started having the low HR issues. I'm am hopeful this new dose gets rid of some of the dizziness and awful feeling 🙏🏽

[Peacockmumma]

interesting. I started on 50 and was increased to 100 as my episodes increased. ..been on that for a good year I think. My resting heart is 47-53 think it was 51-53 when I was on 50mg

My episodes seems to have stopped at the moment…coincidentally am now on anticoagulant and also blood pressure tablets…wasn’t that high but you know what doctors are like,they like to hit targets lol

Recently I have been doing everything I shouldn’t…..drinking alochol(not excessively.l.socially at meals as friends are visiting) have still carried on weight training, not walking as much as I should but still active…drinking 2 cups of caffeine a day..previously none….not drinking as much water.

Really weird. All the triggers I thought I had….? Afib is certainly weird.

Long May this continue tho…not complaining at all.

[ChadL in reply to Peacockmumma]

Hello! Glad your episodes are greatly reduced and you are able to carry on life as normal! I partake a few drinks and limit myself to one cup of coffee in the morning. I was a 3-4 cup before my tachycardia episodes... I made sure to ask the cardiologist in the ER if I could drink coffee before I was discharged! May you continue episode free 🙏🏽❤️

[Peacockmumma in reply to ChadL]

Thank you . May just be a fluke but who knows . Good luck..I’m sure you will be fine

[AfibSufferer]

A few months after having an Ablation I started trying to reduce my Flecainide dose (I'd been on 100-150mg/day for about 5 years). After a couple of weeks I started getting lots of PVCs (premature ventricular contractions). So I restored the original flecainide dose and they went away. I went through a couple of cycles of this, before deciding to stick with the lower dose and see what hapened. The PVCs came back but then gradually reduced over the next month or so. Eventually I eliminated Flecainide altogether, but it took a year. Now been off Flecainide for 5 months. Still get some PVCs if I have a cold or after vaccination, but not really a problem.

[ChadL in reply to AfibSufferer]

Hello, I was so glad for this reduced dose. I too am hoping with some time I can slowly get myself off these drugs. In the 3 years, the side effects has not bred the most pleasant.

[Kent2007]

I used to be on 2x 100mg flecainide and 2.5mg bisoprolol. I've gradually reduced to just 2 x 50mg flecainide, without any obvious adverse effect. I still get the occasional bout of AF. When this happens, I reckon I have the 'headroom' to take another 50 or 100mg flecainide as a PIP. This seems to work well, as my periods in AF are usually less than an hour. But, we are all different!

[ChadL in reply to Kent2007]

Hello there! We are definitely all different! I've been telling my cardiologist for a while I don't feel good on the 100 Flec 2x a day, and the last visit he was trying to put me on a higher dose of meds! I'm barely functioning on the dose now! Thank goodness I was adamant about not taking anything more.

[Pommerania78 in reply to Kent2007]

How long have you been on Flecainide? Thanks.

[Maymuna]

Hi I too was reduced to 50 twice a day from 100 as the heart monitor hadn't shown anything going on. However I continued having AF episodes once a week so they put it back to 100 twice a day. It took a while to settle down (I posted on here out of frustration) but thankfully now it has been going really well with AF only once in last 19 days and very mild. So you don't know till you try and you have to give it a week or so to settle down again. Then see what happens and go back up if it affects your AF too much.

[ChadL in reply to Maymuna]

Hi Maymuna, glad you are feeling better! I figure it would take a few days to feel any side effects of the reduced dose.. if any 🤞🏽hopeful there's none

[paulalex1313]

I believe that a medication regime is a combination of the individual patient’s situation and the preferred regime by the cardiologist based on experience, or ideas.

I have had three ablation procedures. After the third, I was discharged in 2016 and since then I have had no symptoms, other than a couple of short episodes of ectopics. My cardio specialist told me to maintain a medication regime of 100mg Flecainide twice a day and to keep Metoprolol as a pill in the pocket, in case of a tachycardia attack, which happened only twice many years ago prior to 2016.

My pulse rate it normal and it has never been suggested I should reduce my dosage of Flecainide.

I suggest you consult your cardiologist if you are worried about your situation, particularly in view of a heart rate of 40bpm, which is very slow, unless you are an elite athlete. Good luck!

[secondtry in reply to paulalex1313]

Thanks interesting re Metoprolol as my cardiologist thinks I don't need it a a PIP just in case. Peace of Mind makes me think I will challenge him on that one as now having almost daily AF or Flutter.

[Pommerania78 in reply to secondtry]

It's good to hear from you. Your thoughts and comments have helped me and I hope you get to feeling better.

[mike1961]

Flecainide doesn't lower the HR by very much at all in my experience/to my knowledge. If I have tachycardia at 130bpm (happens for a minute or two a few times per year) 200mg extra Flecainide (pill in the pocket approach) wouldn't drop the rate at all. Even BBs or CCBs wouldn't make much difference - hence why tachycardia is known as being harder to medicate for than AF (the rate of which is fairly easy to reduce with either BBs or CCBs). Not sure why your tachycardia is reduced to in the 40s by Flecainide ? ! Happy to be educated here !

[ChadL in reply to mike1961]

Hi Mike, I was surprise yesterday when he said he was lowering the Flec and not my Metoprolol. I have occasional tachycardia issues, like yours only lasting a few minutes sometimes. I am hopeful the lower dose of Flec trick.. so far so good this morning, will see how the week goes.

[Vonnegut]

Tachycardia is a fast heart rate rather than a fast and irregular heart rate - atrial fibrillation - which is what Flecainide is for. I have paroxysmal atrial fibrillation and taking the dose you are on has virtually put an end to my episodes. You need a drug that reduces your heart rate like Bisoprolol ( and a perhaps a more knowledgable doctor!)

[Pommerania78 in reply to Vonnegut]

How long have you been on Flecainide, and how long did it take for it to end the Afib (virtually)? Thanks.

[Vonnegut in reply to Pommerania78]

As I have written, since taking 100mg twice daily, I have not had an episode for 15 months when I must have caught covid with no other symptoms but a short episode ended after a few hours with an extra pill, and for around a year or so before that since my dose was increased from 50mg twice daily when I still got occasional breakthrough episodes.

[Garaidh]

Hi Gabby. Hope you're doing OK today.

I had very similar situation. Long story short, I now take a total of 100mg Flec a day, and I get on much better at that level of dose.

I was cleared up to 300 by the EP and was taking 200 but did notice my pulse was down to same level as yours, 40 or so.

My only caution would be to titrate your dose down over a week or more. Afib isn't great with sudden changes! I bought a tablet splitter as 50mg is the smallest dose pill we can get here in Scotland. I cut from 200 - 175 - 150 etc.

I now take Bisoprolol 1.25 in the morning to avoid slow heart at night, and Flec as 25mg noon & 6pm, and 50mg at bedtime. That gives me a slightly higher level of Flec overnight... it was almost always during the night I'd go into Afib.

My resting pulse is now a bit higher (it tends to be slow naturally) in the low 50s so that's much better I think.

Good luck!

[ChadL in reply to Garaidh]

Hi Garaidh, I was able to cut my 100mg Flec for the 50mg. So far today pulse steady in the 50's.. will see over next few days as I get used to the lower dose what happens.

[ChadL]

Thank you everyone for all the responses. You have no idea how each response made me hopeful and less anxious! I wish continued health and healing for everyone. Gabby ❤️❤️