Flecainide Dosage

Per Kardia, slipped into aFib about 9 pm this evening with, maybe, some ectopics. 72 bpm. Long 12 hr day, hot humid, with outdoor chores in early a.m. and again in late afternoon-early evening. Sandwiched 18 holes of golf in between. Did my best to stay hydrated. Fella in our golf group had a hole in one! He bought the beer and I had about 2 to 3 fingers worth of a glass to celebrate. First beer I've had in 15 years or so. Maybe a coincidence that I went into aFib. I weigh about 166 lbs, I am prescribed Flecainide 75 mg/2x and Eliquis 5m/2x. I took an extra 75 mg with my evening dose of Flecainide bringing me to 225 mg for the day which is, I think, ok for my weight. Assuming I am still in aFib, I was wondering if tomorrow I should double my morning dose again to a total of 150 mg and then do 75 mg in the evening for another 24 hour total of 225 mg of Flecainide. Don't want to flirt with the 300 mg max doseage. Just wondering if this sounds like a plan? If so, would it be ok to do the same adjusted dosage for several days? Suppose I could try to get a call in to my EP and maybe fax over a Kardia but don't think he's in on Fridays. Don't feel this is an emergency. Last episode about 6 months ago lasted about 6 hours or so with one adjusted Flecainide dose. Thanks.

It’s 300mg in a 24 hour period. You may need to time it so you don’t go over the 300. I hope you self convert. Stay hydrated!

I had things off on my EKG with flec. I can still take it but not a ton. I would check with EP before upping it. Our center has an after hours where we can ring the EP on call. (a fellow). My QRS was high but there was another part of the EKG as well that was off/ high/low or whatever. I asked my EP monday about it but can't remember specifics on that. Anyway- before upping I'd give a call. JMO.

Coming from someone that has used Flecainide frequently, and took too much having an adverse reaction, I would Titrate up slowly, and be conscious of side effects, then back off if you need to. 75mg every 8 hours makes more sense for someone worried about getting too much. Tolerance is dependent upon the person, lookout for signs of cardiac depreciation: Feeling faint, shortness of breath, weakness, lightheadedness. Monitor your pulse for irregularity or weakness.

With that stuff the smaller the dose the better....never assume what you need....let your body tell you....if anything err on the side of small NOT BIG.....or nothing if you can.



Edited 1 time(s). Last edit at 07/15/2022 10:24AM by vanlith.

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The Anti-Fib
Tolerance is dependent upon the person, lookout for signs of cardiac depreciation: Feeling faint, shortness of breath, weakness, lightheadedness. Monitor your pulse for irregularity or weakness.

Agree--whenever your dose of Flecainide is raised, monitor your symptoms. I didn't realize that it was Flecainide causing my symptoms for a while as my PCP had also started me on a new medication at the same time as the raise of my Flecainide dose and I thought the symptoms were coming from the new medication. But, yes, I had all the symptoms mentioned above and they came from Flecainide.

I had a 3 day ICU stay after a flecainide overdose from taking too much. 24 heart rate. Flecainide is not a drug to experiment with. It has a black box warning for a reason.

Returned to NSR about 1 am Friday morning. So about 4 hours in aFib and whatever. Don’t know if the extra 75 mg of Flecainide helped or not. But thanks to everyone for your thoughts and advice. Flecainide sure has its “drawbacks. Makes me wonder if I should even be on it despite not experiencing the side effects mentioned. My EP hasn’t suggested anything else. Thanks again.

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Mark
Makes me wonder if I should even be on it despite not experiencing the side effects mentioned.

Mostly the side-effects come with higher doses. My EP kept raising the dose whenever I started getting break throughs, and that is when the problems came. I was fine with low doses and 75 mg twice a day is a pretty low dose.

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Mark
Returned to NSR about 1 am Friday morning. So about 4 hours in aFib and whatever. Don’t know if the extra 75 mg of Flecainide helped or not. But thanks to everyone for your thoughts and advice. Flecainide sure has its “drawbacks. Makes me wonder if I should even be on it despite not experiencing the side effects mentioned. My EP hasn’t suggested anything else. Thanks again.

Glad you're back in NSR.

ALL the antiarrhythmics have drawbacks, and flecainide isn't the worst of them. It's a proven, inexpensive drug with a good safety profile compared to most of the other antiarrhythmics. So that's why your EP hasn't suggested something else. But you could ask them about Multaq. It's widely considered the safest antiarrhythmic, and also the mildest with few side effects. The drawbacks are it's not sufficiently effective for many people and it's expensive. But it sounds like it might work for you, so ask your EP about it. Can't hurt to try it.

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Mark
Returned to NSR about 1 am Friday morning. So about 4 hours in aFib and whatever. Don’t know if the extra 75 mg of Flecainide helped or not. But thanks to everyone for your thoughts and advice. Flecainide sure has its “drawbacks. Makes me wonder if I should even be on it despite not experiencing the side effects mentioned.

My 2 cents as someone who has used flecainide on-demand to convert for nearly 18 years. First, highly likely the extra 75 mg of flec was the agent for your conversion. I agree with Daisy that 75x2 is a modest dose. Lastly, from the little I know of your situation, the 75/x2 is likely the agent keeping you in NSR.

What is your weight? The closer you are to 154#'s (70kg) - I assume you weigh more, the more I'd be concerned about pushing 300 mg.

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Carey

Returned to NSR about 1 am Friday morning. So about 4 hours in aFib and whatever. Don’t know if the extra 75 mg of Flecainide helped or not. But thanks to everyone for your thoughts and advice. Flecainide sure has its “drawbacks. Makes me wonder if I should even be on it despite not experiencing the side effects mentioned. My EP hasn’t suggested anything else. Thanks again.

Glad you're back in NSR.

ALL the antiarrhythmics have drawbacks, and flecainide isn't the worst of them. It's a proven, inexpensive drug with a good safety profile compared to most of the other antiarrhythmics. So that's why your EP hasn't suggested something else. But you could ask them about Multaq. It's widely considered the safest antiarrhythmic, and also the mildest with few side effects. The drawbacks are it's not sufficiently effective for many people and it's expensive. But it sounds like it might work for you, so ask your EP about it. Can't hurt to try it.

I’ll bring up the Multaq at my next EP appt. From reading posts, it seems that, sooner or later, meds lose their effectiveness. I agree that the Flecainide is probably what keeps me in NSR. If Flecainide loses its effectiveness would Multaq be a good backup? Thanks.

Multaq was the first anti arythmic drug I tried; a total bust. Not affective at all. Severe side affects, blurred vision, burning skin and eyes, I could barely think, elevated blood pressure, etc. three days of it and I was done. Switched to flecainide 50 bid and worked like a charm, until it didn’t. Started to have breakthroughs at one year. I tried increasing dose to 75 bid and experienced severe side affects, no side affects except mild tiredness at initial 50. There is no way to know before hand how you will react or whether affective, you just have to try. Apparently I am very sensitive to these drugs, but that’s just me others experience will very.

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Mark
I’ll bring up the Multaq at my next EP appt. From reading posts, it seems that, sooner or later, meds lose their effectiveness. I agree that the Flecainide is probably what keeps me in NSR. If Flecainide loses its effectiveness would Multaq be a good backup? Thanks.

As others have said, response is very individual. I moved from Flecainide 150 mg x 2 (after a serious side-effect from Flecainide), to Multaq 400 mg x 2. Multaq is pretty effective at keeping me in NSR (a short break through about every couple of weeks. Initially it gave me bothersome gastric side-effects but those have passed since I became strict about taking it with a full meal that includes protein and fat. It is expensive though. When I was switched to Multaq, it was not on my Medicare part D drug plan so I am getting it from Canada.

Multaq gave me marathon vomiting of acid GERD. Flecainide gave me insomnia. I would stay up until 5am hopefully to sleep. That started me on the road of benzo sleeping rx.