I take Flecainide and Metoprolol & have been told by various pharmacists and told by different cardiologists & been told by my electrophysiologist:
Take them together, with food
Take them separately 6 hours apart, with food
Take them together on an empty stomach
Take them separately 6 hours apart, without food
Take on an empty stomach or take with food.
Take the metoprolol with food.
You get the idea!
Would anyone like to ring in on this? I really think no one really knows, because everyone is different, but I want to maximize my meds working (somehow I think doing it “right” will keep me out of the Emergency Room).
I do have another worry/question, but I’ll have to post it separately one of these days.
Thank you!!!!
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Doggiemomma
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The only thing I know - from experience - is that if you take Flecainide on a full stomach it may make you very nauseous so I always took my 12 hourly doses at 6am and 6pm - about an hour before eating.
I only took Beta Blocker for a very short time and I think I took at night? It always zonked me out SO much it was the only time of day I could take it!
My thoughts are, no pharmacist, that it is important to take your meds regularly and as directed on the instruction leaflet. It is important to take Beta Blocker as a companion drug to prevent chances of other arrhythmias which Flecainide can cause. That doesn’t mean to say you need to take them together - at the same time of day.
Given your information I would- take the Flecainide on an empty stomach, leave a few hours before eating and take the Metoprolol after or with a meal.
PS - I am assuming this is a daily dose regime and not using as a PIP.
It probably makes no difference, but I would follow what your prescribing doctor said which I assume is your EP. If you do experience stomach upset, then I would take with food.
Personally I took Flec and Diltiazem together, usually on an empty stomach, but that was simply because of the time of day I took them.
You may hear that the Flecainide insert says to take in a specific way in regard to food. That may be true with the UK insert, but the insert in the United States says with or without food, to the best of my recollection. Check your insert.
Surely Flecainide without food - those were my instructions and what was on the leaflet.
In order to avoid the possibility of food affecting the absorption of the drug, flecainide should be taken on an empty stomach or one hour before food.
Is this yet another difference between advice given in US v UK and if so why?
Why? Well, the manufacturers are probably different and so are the regulatory bodies. If it says with or without food, the FDA most probably tested it both ways and found no significant differences. No idea what that process is in the UK.
I got mixed messages re flecainide too and for a while tried (and failed) to keep 12 hours apart and an hour before food ( we eat at 6pm) Pharmacist said with or without food and now take as I start to eat!Last pharmacy review I asked again. Pharmacist said "is it working?" When I said "yes" he said "well don't worry about it then".
Never had nausea as a result and can't take beta blockers
This is based on UK advice , given to my Mother whom took this combination.She was told to take the Flecainide without food . As others have said this was to help absorption of the Flecainide.
I know this because she'd get nauseous when she tried taking it with food in the morning.
She was told to leave at least two hours between her dose of Flecainide and Metoprolol.
The reason for this was if they are taken at exactly the same time there is more risk of a low heart rate (bradycardia ), especially at night when your heart rate lowers during sleep , which may increase the chance of you waking up feeling dizzy or woozy.
I take 100mgs Flecainide twice a day, always 3 hrs after food and then don't eat for an hour after that. Zero problems and no AF for 11 yrs save 2 v short episodes.
Why not read the information leaflet that comes in the pack with the drugs?! I did that and early on was thanked by a friend’s doctor who along with my friend, had failed to do that, and thus led to her taking twice the dose of anticoagulant that she should have been on which led to internal bleeding and a very dangerous experience requiring a blood transfusion that went wrong! I take my Flecainide either on “an empty stomach” or “an hour before eating” and roughly 12 hours apart to cover the whole day as I was told to do by the EP who originally prescribed it. It works for me but as we all know, we are all different.
I have been taking Flecainide now for 12 years. I was also taking Metroprolol. It did not matter whether I took it with food or not. I had no adverse effects. I originally took it early in the morning, but I got tired of waking, just to take a pill! I now take it whenever I wake up. I then take my second dose around eleven pm before bed. I also take Simvastatin at this time.
Regarding Metoprolol. I started taking Flecainide 50mg twice daily, along with 25mg Metoprolol. I seemed to have problems with dizziness, so my doc reduced the Metoprolol to half of a 25mg tablet daily. After about five years, I started having monthly episodes of Afib. My Doc raised my Flecaide to 100mg twice a day. I still kept having episodes, when a new Cardiologist after I moved, told me he thought the problem was being caused by the Metoprolol. He told me to stop taking it entirely. For about a week, it was a roller coaster ride, Afib along with Tachycardia, but it eventually subsided. I had NO problems after that. I have had no episodes since. My Doctor here in Germany recently reduced the Flecainide back to 50mg twice daily. I have been Afib free for five years.
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Conflicting advice
Conflicting views and useless comments!
Seeking info on side affect of medication 
Bleeding on anticoagulants - interesting snippet of info
