Amio to Flec

Hello everyone,

I've been on Amiodarone for a few months (200mg/day) due to it converted me in the hospital last May after a violent week of Afib. I found a new EP who was willing to prescribe me Flecainide PIP to try and then take daily if necessary. I know Amio has a long half life but the EP said I could use the PIP after a 3 week washout of Amio. My EP prescribed 300mg at the start of an event. I've read somewhere on here about folks chewing it and maybe taking less mg to kick back into NSR (George?).

Also I'm not sure what to do if I go into Afib before the 3 week washout as I don't want to go back on Amio. I've had no side effects and it's been very successful but I know enough now that I want to move off of it. It's been 10 days off so far. Could I try a smaller amount of Flec sooner than the 3 weeks if necessary?

Thanks
Bob

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BobsBeat
I've read somewhere on here about folks chewing it and maybe taking less mg to kick back into NSR (George?).

Yes, that is what I do, I always chew it to make it take effect faster. It isn't a great taste, but I don't care.

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BobsBeat
It's been 10 days off so far. Could I try a smaller amount of Flec sooner than the 3 weeks if necessary?

Not a question for any of us. You could possibly be playing with fire. You'd need the EP to approve this. Flec doesn't have the side effects of amio, but it not a med to be trifled with. I've successfully used it on demand, relatively infrequently for the most part for about 17 years.

For others' benefit, Susan suggests that I always note that the max dose for someone under 154#'s (70 kg) is 200 mg/day. She was prescribed too much with very negative consequences.

If you're going to switch to using a PIP, you're going to have to get used to the idea of being in afib and just living with it for a while. That might happen in the next couple of weeks, so just be mentally prepared for it. Did your EP give you metoprolol or another beta blocker to slow the rate down if you do go into afib? If not, you might want to call back and ask for something to have on hand. A rate control drug probably won't stop the afib but it will make it a lot more tolerable.

I agree with everything George said. For sure no one here is going to tell you it's okay to use flecainide early. You've got to get through the washout before you take any flec unless your EP says otherwise.

George how many mgs when you take(chew) Flec?

Thanks Carey. Yes I will wait the washout period. Yes the EP prescribed Metoprolol Tartrate to be taken with Flec as a requirement. In the past I took the extended release but right now I'm not on any rate reducer because my resting HR is low 60's.

Thanks all!

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BobsBeat
George how many mgs when you take(chew) Flec?

I take 300 mg (three 100 mg tablets).

I have read that the longer you are in Afib, the more your heart gets used to it, and the longer you are in NSR, the same. I have a friend whose EP put him on Amio for 3 months and after the wash out, his AF never returned! Maybe you'll be so lucky! Hang in there! Try to think positive. Meditate to relax. The stress of worrying about going into AF used to bering it on for me.

I use Flec as a PIP and I only take 150 mg (I weigh 128lb) and I have only needed to use it once in the last six months and it worked like a charm. I swallowed it so it took 3 hours to kick in. I did smash half of it and mixed with apple sauce to try to mimic George's technique, but even with applesauce it tastes terrible!

Thanks Lani, appreciate the input!

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LaniB

I use Flec as a PIP and I only take 150 mg (I weigh 128lb) and I have only needed to use it once in the last six months and it worked like a charm. I swallowed it so it took 3 hours to kick in. I did smash half of it and mixed with apple sauce to try to mimic George's technique, but even with applesauce it tastes terrible!

LaniB
What were the circumstances for you to take Flec PIP... meaning how long were you in AF before taking it? And do you only take it if bpm is high? My cardio prescribed Flec as PIP and instructed me to wait in AF to see if converted on its own for 15min but that was only if bpm were >100. I've had a couple AF episodes recently that lasted a few min with 70-80 bpm so I didn't take one but honestly those few minutes terrified me!

Am I the only person here who cannot tolerate metorprolol, propanalol? Horrific nightmares and lethargy at 12.5 mg, used prn for times when I had PACs and the few incidences of AFIB, all of which were with RSR and frighteningly fast. When I needed to go on some BP med this year, I was switched to losartan which isn’t great, but works with fewer (for me) side effects. But it doesn’t seem to affect the PACs.