Reduce Flecanide?

[Maymuna]

Hi, after regular worsening AF and then a stroke, I've been on 100mg Flecanide morning and evening plus Apixoban. Its been nearly 1.5 years now since the stroke and everything is good with barely a heart flutter. I'm wondering if I could self reduce the flec to 50mg twice daily? Reason being I have very achy legs which I think is due to the meds. Would this be a sensible move or will I be threatening what's working well so far? Anyone who's done this before ?

[meadfoot]

I would ask for an appointment with my cardiologist first. My GP will not interfere with my cardiologists planned medication regime for me so I would not choose to self reduce. It may be ok but I wouldn't risk it without proper input.

I have been taking flecainide for ten years and have changed doses at times during various heart issues but always in discussion with my cardiologist. Best wishes.

[bean_counter27]

I've reduced my flecainide twice and both times returned to my original dose after several weeks because of palpitations and one episode of AF. However doing so was done in consultation with my cardiologist. I plan I trying again at some stage... but I've never had a stroke and my episodes are not lengthy or a major burden. I.e low risk IMO.You should discuss with your doctor.

[Vonnegut]

As we know, we are all different but I now take 50mg am and 100mg pm at my suggestion after I’d remained AF free after forgetting the first 100mg pill of the day. It works fine for me and I haven’t taken an anticoagulant for ages as they gave me constipation after the first one came with the opposite so that I had to stop taking it very soon after starting on it, which apparently happens with lots of people. The EP who originally prescribed the Flecainide for me to take as a PIP, told me that unless an episode of AF went on for a long time with a very fast heart rate, which mine never did, I was not “at risk of stroke”. I had been fit and healthy before the PAF arrived with chronic fatigue following a virus when I couldn’t get an appointment at our surgery, but I was well into my 70s and have made it to 81 and fortunately have my slightly younger husband to help me through.

[secondtry in reply to Vonnegut]

May I ask, what was your medic's reaction to your report on constipation and attribution to ACs? I started them 12 months ago and constipation has become more of a problem recently.

[Vonnegut in reply to secondtry]

Well my surgery docs didn’t seem interested but when I had an investigation which showed my hiatus hernia, I could see that my stomach still hadn’t emptied over 5 hours after I had last eaten! You are told not to eat for 4 hours before the appointment but there was a delay that day and fortunately, I had a good book with me! I guess my surgery must have received that information. Sadly, the Flecainide that has put an end to AF episodes for me also messes up my digestion a little (along with the fatigue I acquired with the PAF after a virus). They are apparently “rare” side effects “. You really need a good sense of humour (as well as this supportive forum) to cope .

[secondtry in reply to Vonnegut]

Thanks, GSOH need for most days at present!

[ForensicFairy in reply to secondtry]

I routinely take psyllium husk in capsule form. This was on the advice from my gastroenterologist. It works like a charm.

[secondtry]

On balance having read posts here over the years and my own experience, I would say don't rock the boat.

[ForensicFairy in reply to secondtry]

Same. I recently had a reduction in my beta blocker and all hell broke loose. Had to go straight back up to the previous dose.

[FitnessGotFibbed]

I used flecainide to stabilize my heart for a couple years after 1.5 year of afib episodes. Then tapered and stopped. I should note that I also eliminated my primary trigger (athletic training) entirely.

The 1st couple times I didn't take the tablet, beast returned. So, the 3rd time I reduced the dose slightly for several weeks. If heart was unhappy, gave it a normal dose for the night, continued the taper when heart was happy again. My boat was rocked only ever so gently. Over time got to 0mg.

The flecainide pills I have are scored, breakable but need strong fingers. Made the process easier to do.

Let doc know the plan ahead of time too.

[Maymuna]

Thanks so much everyone, I really appreciate your thoughts and I'll wait to discuss with cardiologist first

[Redactrice]

I'm starting to taper down now, six and a half months after my first ablation. This is the third attempt -- it has not gone well previously.

My prescribed dose is 100mg twice a day. Previously, cutting back to 50mg 2x/day put me back into AF. I've modified that to 50mg in the morning and 100mg at night (since the current pattern is AF breakthroughs overnight), following a helpful hint from Vonnegut (thank you). Next step is to go down to 50mg at night. We'll see.

The last time I had a follow-up with a cardiologst, at 90 days post-ablation, he said breezily, "Since you're now in NSR some of the time [previously I had been in persistent AF for over a year], you can stop all the drugs." Really??? This was only a phone call and he was a registrar, not fully qualified. I'd had enough ups and downs post-ablation that I was sceptical of the advice. And so it proved.