Flecanide as a pill in the pocket

[DIB69]

Having just had a reassuring appointment re: my current Afib situation I have been prescribed Flecanide as a PIP for my paroxysmal condition. Has anyone else been prescribed this drug for the same purpose and if so may I ask how successful you've found it?

[BobD Volunteer]

Plenty of people as it is a very common treatment plan. Max 300mg per 24 hour period.

[Lesleyray]

yes, before my second ablation 2023I used flecanide as a PIP and it was very effective, I’ve now been AF free for over a year and my cardiologist has recommended that I go back to PIP if they start up again

[dmac4646]

yes max 300mg in 24 hours but wouldnt take that amount in one go to start with !

[bean_counter27]

The 24 hour maximum Flecainide dosage quoted by other members is general background information only. You should follow the instructions re usage provided by your medical professional as that will apply to your specific circumstances.

[secondtry]

Very infrequent AF, say no more than one short episode every 3 months and I would go with PIP. No harm in trying it but be ready to go onto daily (with your medic's approval) if episodes increase so as not to let AF get the upper hand.

I desperately wanted to just have PIP but had 2 episodes a week and my cardiologist said PIP was too much of a rollercoaster for the heart so I started with 100mgs daily but it had to be increased to 200mgs to stop the AF for 10 yrs. I am reasonably fit and active and haven't any known side effects.

[sdweller in reply to secondtry]

Can I ask... are you still on the Flec after 10 years? And are you taking a beta-blocker like Metoprolol or Diltiazem also? I'm trying to decide on one of the two my doc wants me to take?

[secondtry in reply to sdweller]

Yes still Flec after 11+ years with no BB or CB, as lowish HR and no comorbidities.

[Bhoyo]

Good evening, I have been taking Flecainide and Metropolol as PIP for approx 8 years. Over the years my AF has occurred intermittently. I have taken all or as much as I can preventative measures. I found my tiggers( I believe) to be lack of sleep causing stress( not mental) on body. I still like to be active. Getting to the point( sorry). Over time I now find that have to take the 300mg Flecainide over a period of 24 hrs with 25mg Metropolol each time = 75mg. to have NSR to be achieved. Flecainide and Metropolol cause me a bit if grief (dehydration to max) and occasionally Bradycardia.(Metropolol). Still perseveringly with Flecainide and Metropolol. Not sure what my time limit is for Ablation. All the best and advise I have gleaned from forum over the years invaluable. With medical professionals and forum, I am much more comfortable in managing my AF.

Cheers Cam

[sdweller in reply to Bhoyo]

Can… do you think you might convert back to NSR eventually without the PIP? Or do you think you would have to be cardioverted to get back without the Flec?

[Bhoyo in reply to sdweller]

Good Morning, over the period of time it has gradually taken longer to revert. Early days it was 100mg and a couple of hours. Then 20pmg and a few hours. More recently 300mg and 24hrs. Towards the end of last year, I presented at hospital as I was on to my second day approx(36 hours)and - HR sitting on 100 + After a few hours in A and E, I was offered the option of chemical or Paddles cardioversion. I opted for Paddles and was Zapped with success. I have since had a bout of AF which reverted after 24hrs and 300mg Flecainide.I have not been in AF this year(touch wood). Cheers Cam

[Bhoyo in reply to sdweller]

Further to last long winded reply. I believe I require PIP to revert. I have had 2 x cardioversions in approx 10 years. Prior to both I had taken PIP which had not worked In obtaining NSR . I do not wish to take daily Flec and Metropolol dosage and have attempted to change/ adapt lifestyle to combat bouts of AF. Last year, due to PIP taking longer to assist NSR, I voluntarily on medical advise commenced taking Apixaban. So far this year nil AF. 🙏

[sdweller in reply to Bhoyo]

Here's to wishing for lots of NSR for you!

[dangalf]

Yes was prescribed it as pill in the pocket for paroxysmal afib. Same dosage. Worked for me. Although it does take a couple of hours to kick in I find.

[sdweller in reply to dangalf]

Are you taking Metropolol or Diltiazem with the Flec when you need take it?

[dangalf in reply to sdweller]

No, just flec

[H48007]

I take it pip 100mg wait an hour if no change another 100mg . I do find it can take a couple of hours to settle. I am due a second ablation.

[Joolivia]

I have it as a PIP too and used it once and it worked

I have BAF and my plan is when it comes on I take my calcium blocker first for two days with blood thinner too then if this doesn’t revert me I take flecanide

Had two af episodes last year and one I needed flecanide which worked so quickly

[Ppiman]

Yes - I took it just the once (50mg) as I didn't like the heavy thumping feeling I got on that day. My specialist assured me all was well, but my AF has not been symptomatic enough for me to resume. I have something called LBBB which also put me off taking the PIP - Dr Google, eh?!

It is very commonly used and I suspect you will benefit from it. It really depends upon the severity with which you feel the AF symptoms, I think.

Steve

[Vonnegut]

I was and it worked brilliantly at stopping episodes of AF in a few hours. As episodes increased it was suggested I take it regularly 100 mg morning and evening so that on the very rare occasions I still had an episode (when I must have caught covid with no other symptoms but a positive test) I could take 100 mg as a PiP. Now I take 50 mg first and 100mg in the evening and recently, when I ran out of both, my heart remained in normal sinus rhythm for two and a half days without them which was very encouraging. Hope it works for you too!

[Lenlec]

I take 200mg of flecanide as soon as possible when af starts.

[lizzieloo2]

Yes, I was prescribed 200mg Flecainide PIP with a follow up of 100mg if it hadn't worked after 1 hour by my first cardiologist(EP). I never took this as was worried about taking it. Was then transferred to a new EP (much nicer person altogether) who dropped the dose to 100mg PIP followed by another 100mg after an hour if necessary. I avoided taking any for years until the episodes became more frequent and finally took the plunge. I had no ill effects but, like others, found it took much longer than 1 hour to settle the symptoms. Only once did I take 2 tablets and when this did nothing, I called an ambulance. About an hour later, the symptoms subsided and I cancelled the ambulance and never took 2 again. My new EP said he didn't want me on Flecainide for too long as he said it could kill me! I eventually opted for an ablation after about 10 years when the episodes started coming every week. I had the ablation in August 2023 and although I still get episodes, they have improved considerably. My EP told me not to take Flecainide immediately after the ablation so I haven't taken it for nearly 2 years. Now, when I get an episode, I drink at least a pint of fluid (orange squash) and this brings me back into NSR within 2-3 hours so just as quick as the Flecainide.

[ian16527 in reply to lizzieloo2]

I found that not to take it immediately but wait 2 hours then take 100mg. It would then take another 2 hours to resolve. If I took it straight away it would not resolve and could take up to 13 hours and another 50mg.

I had to go on to 100mg twice daily as I was getting attacks every day which took 4 days to stop them until I had an ablation

[sdweller in reply to ian16527]

Since you started it every day has it worked? Do you take Diltiazem or metropolol aslo?

[ian16527 in reply to sdweller]

I am now off Flecainide just after 18 months, after an ablation in May 2023, although the EP wanted to reduce it from 100mg to 50mg straight away , he said continue for 3 months until review. Due to the NHS waiting this was 6 months later, then the last appointment was a year later when they said stop it.

It worked for the 6 weeks prior to the ablation, and did work as a PIP, but only if taken after 2 hours into the attack. Never worked if I took it straight away.

I have taken Bisoprolol from 5mg when I was fisrt diagnosed in 2012, then had the dose up and down and still on 2.5mg now as well as apixaban. I did try a CCB but cant remember the name, but it made me feel much worse than the Bisoprolol

Only thing the Flec did was make me feel awful for the first month