Flecanide

Hi all. Been in a fib now for 48h. Feel ok heart rate is about 75. Normally 55. I take 2.5mg bisooprolol as a pip
A friend of mine is the same Age as me 49 and he takes flecanide as a pip. He swears by it. He’s offers me some to try. What should I do ?
Go a and e or sit it out ?

Hi LenLec, Best never to share medications - a common medical warning. Depending on your medical history and Rx you might be taking could cause serious problems. In the case of Flecanide, my cardiologist requires I take my first dose in the office, so I can be monitored for adverse effects, both very serious and not. So my take is it would not be a wise idea. I hope that helps.

Jeff

Depending on your medical history flecainide could be dangerous for you. Get an appointment with a doctor and find out if you can take it. Also, are you taking an anticoagulant? If not, there's another reason to see a doctor. You probably should be.

Agreed with all above. Don't share. Extreme caution.

1st time I took flec (on drs orders) I sat in hospital emergency waiting room and informed the staff exactly what I was doing.

Might have been a waste of a day and overly cautious.

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My name is (name)
I have been in AFIB since (date)
At the advice of my Dr, (name) at 10:00 AM on (date) (today) I took a (amount) mg dose of Flecainide. I also took (amount) mg of Metoprolol Succinate at 8:00 AM earlier today.
I also take 5mg of Eliquis 2X daily.
(list other drugs and amounts)
No other medicines or supplements are in my system.
Along with heart rhythm issues, it may be possible that a blood clot moved from my heart and into my lungs or brain due to the use of these prescriptions.
I have insurance with (company) and request that all life saving measures be conducted if I am unable to respond for myself. My insurance information is printed behind this sheet.
My emergency contact is (name and number)
My attorney is (name and number). He can provide medical directives if needed.

Flecainide Toxicity: Although I did not take a ‘toxic’ dose. This information is presented to save time should it be necessary:
The mainstay of medical therapy has been the use of high-dose sodium bicarbonate to offset the cardiotoxic effects of the drug by inducing a high-dose sodium load along with serum alkalinization. This therapy alone has been shown to rescue patients from even life-threatening overdose
Flecainide overdose may cause potentially fatal arrhythmia, myocardial depression, and ventricular dyssynchrony. Hypertonic sodium bicarbonate is the mainstay of medical therapy, though there may be a role for other antiarrhythmics and intravenous fat emulsion. In the failure of initial medical therapy, consideration should be given to the early use of venoarterial ECMO, which can provide life-saving hemodynamic support and promote natural drug clearance.

My doctor wants me to take either Dofetilide or Tikosyn, I am in AF and have been since the last of Nov., they said I would have to spend 3 days in the Hospital I am told those two drugs are the same. I had asked about Flecimide and was told the drug was similar to the drug which I was taking and that was Propafenone. I had quit taking Propafenone as it wasn't helping me, they don't think Flecimide would help me, I asked If I did take the drug what would be the dose, I was told 25mg twice a day. So as of now I am not going to take any drug, I think I will try Flec. but not right now, just in case I have a problem with it, I don't want to go anywhere near a hospital for a while.

Liz

Dofetilide is the generic name for Tikosyn, so yeah, they're the same drug.

Flecainide and proprafenone are in the same class of drugs and have the same mechanism of action. So if proprafenone wasn't working for you then flecainide almost certainly won't either. It would most likely be a waste of time trying it.

Your choices now would be Multaq, Tikosyn, sotalol, or amiodarone. Tikosyn is the only one that requires a hospital stay, but since you've been in AF 5 months now, they'll probably have to cardiovert you after starting one of those drugs. Multaq is very tame and has few side effects, but it's also the "weakest" of the bunch so may not be effective for you considering that you're persistent and have been for 5 months. Personally, I would go for the Tikosyn.

Carey what about AV node blockers before Flec - do you have a preference?

Most EPs prefer metoprolol with diltiazem as a second choice if beta blockers aren't a good choice. Personally, I despise all beta blockers because they suck the life right out of me. Some people aren't affected by them much, but I'm one of the unlucky ones who is.

TY

Hello Afibbers. I’m new here and new to AFib. I’m 71 and was recently diagnosed with AFlutter in March for which I had an ablation April 17. Before the ablation I was on 180mg of Diltiazem and 2.5 mg of Bystolic. I’ve been on Bystolic for 10 years for HBP. Only beta blocker I can tolerate. When I had the atrial ablation for flutter the EP was able to easily induce AFib. So as a result I was told to stop Diltiazem, stay on the Bystolic and they added Flecainide 100mg 2x/day. Cardiologist reduced my Flecainide the other day to 50mg 2x per day. He was willing to stop it altogether thinking I didn’t really need it but being anxious about all this I asked if we could reduce the dose and see if it reduced some of the symptoms I was having that I think were side affects of the Flecainide. My Bp and HR are fine with the Bystolic. No AFib thus far. However I’m having some shortness of breath at night which wakes me up and keeps disturbing my sleep. It’s my understanding that Flecainide can cause SOB like this. Wondering if others here have experienced sob with Flecainide and if so does it go away in time? I’ve only been on Flecainide for 10 days. If it doesn’t then thinking I should stop the Flecainide as my cardiologist offered and have a “Pill in a Pocket”. Any thoughts for a new guy here???
Thanks much.

I would stop the flecainide just like he suggested. If you go back into AF or AFL, no big deal. They restart you on something else and cardiovert you.

He said I could stop, but didn’t say if I can stop cold turkey or if I have to taper. Only been on it 10 days. Can I just stop being as hoe I am on 50mg 2x per day

Yes, you can stop cold turkey. Flecainide does not require tapering. Very few drugs do.

Ok thanks. Does Flecanaide cause insomnia? I’ve read various “opinions” on this.

I've never heard of flecainide causing insomnia, but lots of drugs have lots of different side effects in different people.

Let's focus on your other thread, okay? Having two threads going with this one not actually about you is too confusing.

Quote
Pokey
Ok thanks. Does Flecanaide cause insomnia? I’ve read various “opinions” on this.

On September 4, 2004 I started Flecainide. I had slept like a baby once my head touched my pillow before starting Flecainide. Once starting Flecainide I could not sleep. I would stay up until 4-5am trying sleep hypnosis CDs, biofeedback and other desperate tricks. I was told not sleeping could trigger AF so I was prescribed a benzo for sleep. In 2019 when I stopped Flecainide and the benzo, I started to sleep like a baby again without drugs— until a month after my ablation when my PVCs started. Now I can fall asleep pretty easily (unlike while on flecainide) however I wake up 4-8 times a night when my PVCs are violent. Two nights ago my PVCs were extremely violent so at 3am I broke down after remaining awake and rummaged through all my old meds until I found the former benzo Rx bottle with a few pills remaining. I took a half. I slept 5 hours until a phone call woke me up from a sound sleep. My PVCs are a freak show now but I won’t take a benzo. It’s going to be a long night.

So yes, for me it caused insomnia. Drugs.com lists it as a side effect.

My limited history with Flec after my Jan. ablation is: Two months of 100 mg 2x day. No issues of any kind, good sleep and no afib, no SOB feeling 100% normal. Then pill in a pocket because some afib returned. Four times I have taken 200 mg when afib kicked in during the night. It took maybe 15 mins. to get back to sleep, with a little SOB, but that's from the afib, not the Flec. I am highly symptomatic so it's my heart jumping around that makes it a bit more difficult to get to sleep. Then waking a couple of house later with no afib on all four occasions.

Not happy with the returning afib since the ablation was almost four months ago.

I have dropped from 100 2x/day to 50mg 2x/day. I think I can tolerate that OK. Hopefully I can drop it altogether down the road soon

Question: does flecanaide affect BP, thats is, lower it?? MY BP has been running lower than usual

It can, but only by a little. Nowhere near as much as your Bystolic does.

How about causing major fatigue. I’ve been on 2.5mg Bystolic for 10 years and I’m acclimated to it. When I developed flutter they had me on diltiazem and my usual dose of Bystolic and not to fatigued. They dropped the diltiazem. Now I’m on Bystolic & Flecainide. IT seems I’m much more fatigued with Flecainide added to the mix.



Edited 1 time(s). Last edit at 05/01/2020 09:37PM by Pokey.