I was diagnosed with AF in April after 4 years of episodes ( 2-7 hours long) that were never captured on ECG. I was given Flecainide 50mg pill in the pocket when I have an episode. Despite losing 10% of my body weight, avoiding big meals especially late and cutting out alcohol, I just had my longest episode yet at 14 hours, which I rode out at home and it has just ended. The point is, I took the Flecainide for the first time at around midnight with no effect whatsoever! Can’t help wondering if it made it longer than usual but probably not. Has anyone had this happen to them? When the cardiologist prescribed them I really believed it would stop an episode! 🤯
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Joeyy06
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If you're not on daily Flecainide, 50mg is a very low PIP dose. My PIP dose was between 100 and 200 mg. Some are authorized to take up to 300 mg. So it's very possible it didn't work because of the low-dose.
To be clear, do not take more Flecainide than your doctor says...because there may be a good reason why you are only authorized to take 50 mg. On the other hand, you should let your doctor know that the PIP dose did not work.
Hopefully you're seeing a cardiologist or ideally an ep (electrophysiologist). At least in the United States GPs are not very well-versed with Flecainde and how to use it.
it says take 50mg once a day so maybe GP prescribed wrongly
As written , that is not a PIP (as needed) prescription, but rather a daily preventative dose. As a daily preventative dose, it's still on the low side, as the usual starting dose is 50mg bid (twice a day) and sometimes 100mg bid.
Also, often you take both a daily preventative dose, as well as a PIP dose on top of it, should you have an episode.
I would definitely seek clarification from both your GP and cardiologist.
How much flecaainide were you told to take as a pill in pocket. 50mg would normally be a daily maintenance dose. Most people using PIP would take a minimum of 100mg at the onset of an event with a maximun 24 hour does of 300mg.
That said, AF is almost always a progressive condition.
Seriously if it says once a day it is maintenance dose. PIP would say "Take 100 (or200) Mg at start of AF . No more than 300mg in any 24hour period.) I suggest you discuss with your EP.
My cardiologist gave me 50mg as a Pip. He said to ignore the once a day thing on the instructions as the pharmacist system couldn’t cope with PIP idea. The first time I took it, it didn’t work. I reverted in the morning which is what usually happens. When I told him about it, he said if it doesn’t work, take another 50mg in an hour. I haven’t had one since then so can’t report back on that.
I suffer from af, and an attack usually requires an a&e visit. I take 50 mg twice a day and carry 200mg as a pill in the pocket. After taking the pip, it can take up to 4 hours before there are any relief of any symptoms, and up to 12 hours before my heart rate drops. We are all different and react differently to drugs. My advice, speak to your cardiologist and mention your concerns as he can do something about it for you. Good luck
Joey my Cardiologist never gave me an amount as PIP so like you it didn't work. Since discussing with hime i had the option of going 100mg straight away then if nothing happens another 100mg 2 hours later. Be careful do not self prescribe.
I've since chatted to him and am now on maintenance dose of 20mg twice a day plus 10mg Metoprolol twice a day. Any more and my HR drops too much. Right now i feel great been clear since end January and HR is between 55-60 most times at rest. I did also check my bloods last year and was found to be deficient in CoQ10 and low in Vit D and Magnesium. I've been supplementing with both and feel good. I cleared the Supps with Cardiologist before i started. I believe to tackle AF it is a combo of things we have to do. If you can moderate exercise daily helps with both the heart and mind!
Sorry to hear about you long episode. Dose you took is not enough to stop it. PIP dose is 150-200 mg . But be careful , to take it you heart need to be structurally healthy.
Flecainide didn't work for me. You can still get episodes whilst on anti arrythmics. Mine still lasted up to 36 hours so I finally had an ablation this year
Your dose of 50mg Flecainide is way too low.The standard dose in A&E is 300mg -ie 6 tablets plus a beta blocker like Metoprolol or Bisoprolol to lower the heart rate.I would also advuise you to get a Kardia device to be able to record an ECG whilst you're having an AF episode.
Flecanide works well for most people but for me, it made my AF worse and actually ended up with a life changing reaction. Please discuss how it affected you with your cardiologist…..
Hi , I have had AF for 15 years, occasional like you but has got regular in recent years, originally I was given Flecainide as a twice a day tablet , but like you it did not stop episodes and effected my libido (possibly) . I reverted to taking when an episode goes on I consider too long. I recommend drinking water , trying deep breathing, and eating a banana or two , once it has started . My episodes can last 8 - 16 hours once 24 hours. Yes it feels uncomfortable and slightly worrying, after around the 12 - 15 hour mark I may take one Flecainide then on an empty stomach , I also carry on with life , in fact I go to gym and play golf and found ( be careful ) that it often stops when exercising . I think it might that getting the heart to beat slightly faster with episode it then reverts to normal as it should . So in conclusion I am not certain if Flecianide works definitely or whether just the passage of time , but often the heart returns to normal after taking at that time period and on empty stomach . Good advice from below regarding doctors advice on dosage , but you could ask if possible to increase dosage during an episode . I have written in other places regarding my usages of different methods of controlling my AF which is helping me , Good Luck my friend !
When I was first prescribed Flecainide, by an EP who we consulted privately after the lowest dose of Bisoprolol proved too much for me to take daily, it was for 100mg to be taken as a pip- rather than just 50mg which might explain why it didn’t work for you! Now that I take 100mg twice daily, I have not had an episode for several years and only one breakthrough episode around the time I must have been infected with covid with no other symptoms but a positive test and that was ended with an extra 100mg thus reaching the maximum daily dose for the one and only time. Good luck!
You should probably start thinking about an ablation before you start having afib that doesnt self correct. You also need to see an electrophysiologist (EP). With that said, 50mg flecainide is ok if you are having occasional short bouts of afib, but for proper titration you need a higher and more regular dose. I had no issues with flecainide and take every day.
hey Joey what do you think sets of your AF. Mine was lack of sleep and stress. Was on flecinide for two years @50 bid I no longer take flec..Do all the research you can on fib and causes. Sounds like you are building up to events. Make sure you are getting enough oxygen while you sleep. And find ways to cut stress. I have not had an afib event for almost 2yrs now. I feel myself getting close at times but I know what sets me off. Good luck
Reading down the thread there definitely seems to be a confusion about whether the dose is a maintenance dose or PiP. Prior to my ablation I took 50 mg X 2 a day and could take up to 300 altogether across 24 hours if AF broke through. I never in fact needed more than 200 across 24 hours.The dosage is a variable thing in the sense that dependent on your BMI, age and ability to absorption the medication (pretty much any really- not just Flecainide) your system will need and tolerate different amounts. The guideline for Flecainide in the UK is minimum dose of 50mg and 300 max across 24 hours. So it's possible you need to find a new sweet spot that works for you.
Currently post ablation I still get occasional outbreaks and if they're troublesome and don't resolve on their own I find 50mg is sufficient. I'm.68 and 52 kilos.
Great idea to contact your cardiologist for proper guidance.
Agree with all comments. I'm on a daily, preventative dose, of flecainide 50mg twice daily. Literally just had an AFib episode and have taken 100mg on top of my daily dose and almost gone! Possibly discuss this with your cardiologist. Best of luck
I had pill in the pocket for 4 years but then started to have episodes every few days went on to 50mg twice daily which slowed them down to once a month and was told to take another 100mg if episode started works well but still have episodes regularly about once a month but only last around 2 hours so to me they work well. Mine always happen during the night.
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