How to taper off Flecainide?

I've been on 100 mgs of Flecainide twice a day since December 2012. For the last 6 months I have been AF symptom free and would slowly like to get off this drug since it is so bad for one's health. I don't think it is doing much to prevent my AF attacks anyway. I was continuing to have episodes while on Flecainide every couple weeks until I came to this website where Jackie and others helped me understand how to use the right supplements, eat a low sodium, no processed food diet. I am ever so grateful!

I know Jackie says it is critical to come off Flecainide very slowly, but I'm not sure how to cut the pills to do this. How do you mark them? How much do I slice off each time and at what intervals of time do I stay at a given level? Do I start with the morning or evening pills first? I would guess I'd take some off the evening pill, for example, and then stay at that level for several days or a week and then take the same amount off the morning pill and stay at that level for a week, and then reduce them, going back and forth between evening and morning to keep them equal.

Thanks for your help on this.
Nancy M.

Nancy,

There are many methods for reducing your doses. Some people shave off small bits of the pill, increasing the amount shaved off until nothing is left. Some split it into smaller pieces, taking 7/8 of a pill, then 3/4, then 5/8 and so on. This works well if the pill is large, but not so well for tiny pills. I think my favorite method is dissolve the pill in 8 teaspoons of water and consume 7 t. of the solution and step down the same as splitting the pill into pieces. This method is probably the most accurate and easy to control.

As far as time between steps, slower is usually better.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon



Edited 1 time(s). Last edit at 11/06/2012 02:25AM by lisa s.

Lisa,

Have you tried this method of dissolving the Flecainide in water? Does it stay in solution? I would think the Flecainide might sink to the bottom???

Thanks,
Nancy M.

Hello Nancy. would you not shake it up real good before measuring out your dose? Just a thought.

PeggyM

Hi, Nancy,

Sorry it took so long to see your post. We lost power last night (ironic that we just went through Sandy with nary a flicker ;-)

I have no personal experience with Flec, but I have (out of curiosity) dissolved all sorts of pills (meds and supps) in water, to test both time and completeness of dissolution. Oil-based caps, notwithstanding, if it wont dissolve in water, chances are your body won't be absorbing it. Some of that may be fillers that won't make any difference.

Have you tried the Flec to see how completely it does dissolve? If it doesn't do a very good job, do as Peggy suggested, and put it in a container with a cap and shake before measuring. Using this method, it certainly won't be less absorbable than a whole pill.

lisa
__________________________

So much of medicine is looking solely down the wrong end of the gun barrel, and that is really a pity for all of us---Shannon

Nancy, I have instructions from my EP to reduce slowly over time. I was taking 300mg daily for a couple weeks. His instructions were...(My pills are 150mg that can be split and I took 2 times a day=300mg daily.)

(1) Take 75mg 3 times daily for 2 weeks
(2) Take 75 mg 2 times daily for 2 weeks

That's as far as he said, but I will do the same reduction below 75 2 times daily to get to zero or until afib is back. He said to make adjustments very slowly.

..ron

Ron,

I am amazed that your doctor would have you jump down from 300 mgs to 225 mgs in one big leap like that!! And then down to 150 after that!! Wow! Are you doing okay so far?

I find that doctors don't have a clue as to how to reduce medication. One doctor told me to just stop taking 50 mgs. of Metoprolol and I did. That was a mistake! I was jittery for weeks and felt awful. But I am in that 25% group of very sensitive people who are poor excreters, according to my chiropractor. So I plan on taking my taper much slower than yours.

Good luck to you and thanks for your help.

Nancy M.

Nancy, So far, 10 days into flec reduction, I feel fine. I am pretty tolerent to meds and don't notice many complications on any except the pradaxa I took for 13 months.

Anyway, I will check with my local safeway tomorrow and see what they say. Thanks for calling my attention to it.

..ron

Nancy - My single experience in weaning off flecainide was from 150 mg twice a day down to zero. I started by halving the whole tablet and taking only 3/4 of one dose... left the other dose as is..... did that for about 10 days... and then tried another 3/4 dose for the remaining daily dose... I did this gradual downsizing for at least six weeks until both doses were negligible.... I had a rebound effect even with that precaution...so went back on just 50 mg daily which held nicely until I had the ablation. (this was advised by my Integrative MD at the time) as a precaution. Everyone is undoubtedly different in response to drugs and clearance of drugs through the detox pathways so while I advise weaning off very slowl as a precaution, others may be able to wean down more rapidly. My rebound experience was very uncomfortable.

As for the pill reduction, I used a single-edge razor blade and just approximated half and then half again. Nothing very scientific.

I wish you well with your experiment.

Jackie

Jackie, When you had ablation, did you stop just prior, or did you have to stop long enough for the drug to be completely out of your system ?

Jackie,

What were the symptons of your rebound experience?

If you are taking a beta blocker, which you should be if taking Flec, and you want to reduce that med as well, I was told to decrease the one med,wait a few days, then reduce the other. Never reduce both at once or afib problems might result.

Ron and Wes - I was on only on the 50 mg of flecainide no beta blocker and stopped that about a week prior to ablation... whatever they said to do. I was concerned I would lapse back into AF, but did not.

The rebound effect was one of the nastiest AF events I'd ever had. Fortunately, it self-converted and my heart settled down again immediately. In hindsight, I should have extended the weaning-off period longer and really done heroics for upping the supplements at the same time. Undoubtedly, my electrolyte stores were not optimal and I definitely was not thinking about the potassium-to-sodium ratio back then. We know so much more now.

Tom C gives good advice about not weaning down on both meds at once... this would extend the period of time involved but would definitely serve to allow for a successful transition if that is going to be possible at all. Each person will undoubtedly be different and much will depend on the stored electrolyte reserve.

Jackie

Concerning the razorblade metod for reducing pill size, walmart and most drugstores sell nifty little easy to use devices called pillcutters. Typically they cost around a dollar, sometimes even less. While tapering off metroprolol, i cut the 50 mg pills in half, then cut those halfpills in half again to use a quarter dose.

PeggyM

Peggy - I have one of the cutters but I find I like the razor blade better. It probably depends on the tablet, itself.
Jackie

Thanks, everyone, for your help. Will let you know how it goes. I intend to do this very slowly. My cardiologist is against me doing this as he thinks I'll just have to go back on it. We'll see. I sure don't want to go back into afib again.

Nancy M.