To flec or not to Flec ?

[Trout7]

Hello Again.

I posted a few weeks back about the effects i had from Dronedarone....difficulty breathing. I decided not to take another tablet and made an appointment with my GP who was happy that i didn't take any more. My doctor contacted my Cardiologist and we have waited almost three weeks for a reply. During that time i have been taking 200mg of flecainide when an episode started. The tablets seemed to work for around 18 hours then my Afib would kick in again and i had to wait until 24 hours or thereabouts was up so i could take another two.

My cardiologist suggested i take amiodarone but after reading and hearing about the side effects i decided i wasn't taking these tablets. I spoke with my GP today who has suggested i come off the flecainide , almost like a reset or take 100mg twice a day.

Would it be safe to do a reset or better to try 100mg twice daily instead ? I reckon he is thinking the 200mg of flec im taking daily at the onset could be causing my problem to worsen.

[mjames1]

Given your story, , sounds like you should be on daily Flecainide and not wait for an episode to start before taking it, which is called PIP.

Daily Flecainide is dosed every 12 hours so there are no gaps. What worked for me was 50 mg twice a day. Some take 100 mg twice a day. The rule of thumb is not to take more than 300 mg in 24 hours, but not everyone is allowed that much.

We can't advise you how much it takes so you should speak to your doctor.

Jim

[Trout7 in reply to mjames1]

Thanks for Reply Jim.

I have previously been on 50 mg twice a day and that didn't work so they upped it to 100mg twice a day and that didn't work either but I'm willing to give it another chance. Ive read that stopping flec instantly can cause problems.

[bean_counter27 in reply to Trout7]

I started on 50mg twice daily, which was upped to 100mg and then to 150mg 5 years ago. I still have several episodes a year but that doesn't mean it's not working. The question is what would be happening if I wasn't taking flecainide?

I went for 4 months earlier this year without an episode so I tried reducing dose to 100mg (with my cardiologist's approval) but had an increase in palpitations and an AF episode so went back to 150mg. Coincidence? I'll give it a few months and try again to see what happens.

Also, since being on flecainide the episodes I have are sometimes measured in minutes or only a few hours. Early in my diagnosis my episodes were seemingly always 12 - 16 hours.

I have no doubt flecainide combined with Metoprolol works at reducing the frequency and duration of my episodes. Its failure to eliminate episodes altogether doesn't mean it's not working, at least not for me. However that's just my experience and we're all different.

[Thomas45 in reply to Trout7]

I took Flecainide daily for about 13 years. It reduced my AF to one or two ten-minute episodes each year. I started on 50ng x 2 a day, and over the next two years it was raised to 159mg x 2 a year. I took no other medication for AF except an anticoagulant.After about 13 years I was found to be in persistent, though asymptomatic, AF and was told to just stop the Flecainide. Not over a period, not Wednesday myself off Flecainide, but just to stop. So I didn't taken any more. Nothing untoward happened. I am now in my 7th year of persistent AF, which I now consider to be permanent. It causes no problems.

[wilsond in reply to Trout7]

It certainly did to me but we are all different x

[Denise-]

I take 50g x twice daily. It mostly keeps af at bay. If I do have an episode my consultant told me to take extra 50 g. It works for me, in fact I was signed off 2 years ago. I can of course go back if anything changes. I average 4 episodes a year. Hope this helps.

[OceanPaddler]

Hi, are you taking a medication for rate control eg Bisoprolol or Diltiazem? I have been told Flecainide pill in the pocket can be taken alone if using it occasionally ( say once a month). However, if it being taken daily we also need rate control. When I started daily Flecainide it triggered AF and also atrial flutter. In retrospect I think my Diltiazem dose was very low. Hope you find solution. The unpredictability of AF is so difficult.

[Trout7 in reply to OceanPaddler]

Hi OP ,

I was on Bisoprolol but they have now stopped that and im on flec and Apixaban.

[OceanPaddler in reply to Trout7]

It is interesting how different people have different medications. Hoping you find a solution.

[Trout7 in reply to OceanPaddler]

Thank you.

[Tapanac]

I was better on 50 x 2, but if that doesn’t work you perhaps go back to what you were on 100 x 2. Personally I found taking regularly twice a day kept my afib tachycardia in check better than PIP

It was even better after my pacemaker

All the best

[Ppiman]

If you search fr a study titled "low dose amiodarone side effects" you will uncover some genuinely useful information. Individual anecdotal reports, however interesting to read, and certainly useful for discussion with a specialist, can never replace high quality studies and an experienced doctor's advice to an individual since each medical history will be different.

I was close to being given amiodarone but in the end my ablation solved the atrial flutter. I would not have been happy to take it, to be honest, because of what I have read here, but with supervision it seems it can be a very safe and uniquely useful cardiac drug without many of the potential issues of other anti-arrhythmic drugs.

Steve

[wilsond]

I found it much better being on a daily maintenance dose of 100mg a.m and 100mg p.m instead of the big whack of 200 which was becoming more frequently needed.Nice and steady now,still on after my successful ablation .

Well worth a try xx

[Finder31]

no don’t go onto amiodarone as it gave me hyperthyroidism it can cause other problems with your lungs also you need to keep out of the sun may be you should consider a rate control drug like diltizam