What determines the duration of Flecainade post ablation

I am post ablation, I have read many posts that some patients did not take Flecainade post ablation, some took it for a short while and others are still taking it. What are the parameters that determine the duration and dosage of Flecainade.
I only started taking this medication recently, I had an episodes of Afib post ablation, and initially prescribed Metoprol once a day, after the episodes of Afib this has been increased to twice daily with 200mg of Flecaimade. But this combination really knocks me out.

There's no standard on this. It's a judgement call on your EP's part, taking into account your symptoms, how well you tolerate the flecainide, and how well it works for you. And keep in mind there are several choices of drugs. Flecainide isn't the only antiarrhythmic and many people never take it at all. So there are other options available.

I'm surprised by the dosage you're taking. 400 mg per day is the maximum dosage for an adult weighing 154 lbs/70 kg or more. But how much metoprolol are you taking? That's the drug that usually knocks people out. It sure does with me.

Talk to your doc and ask about alternative drugs and perhaps adjusting the dosage.

I'm taking 50mg of metoprolol, and 200mg of Flecainide, prior to the ablation I was taking metoprolol and Eliquis, no issue with either of these, but the Flecainide is posing a problem, over the last four days, I have developed a really bad ticklish cough, which comes on 20 mins after the medication, its very problematic, I struggle to catch my breath, research into the wee hours on Pub Med does correlate Flecainide and dry cough. My Mum died from IPF I have a call into my EP.
I had to go back to the hospital after my ablation and after a few attempts they decided to keep me on 200mg Flecainide, 50mg Metoprolol and Eliquis. I'm hoping he will change the medication, it also makes me so tired with zero energy.
I miss my dance class,

There are other antiarrhythmic drug choices out there if Flecainide is not suitable for you. It took my body two weeks to adjust to it when I first started Flecainide. The worst side effect for me was insomnia.

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Yuxi
There are other antiarrhythmic drug choices out there if Flecainide is not suitable for you. It took my body two weeks to adjust to it when I first started Flecainide. The worst side effect for me was insomnia.

I and quite a few others were given Multaq for a couple of months after our ablations. Before my ablation I had really bad side effects from flecainide.

Call your EP's office and tell them about the side effects. That's a really hefty dose you're taking and could probably be cut in half. And if that doesn't solve the problem, it can be changed to any of several other drugs.

PS- This isn't advice, but if I were in your shoes I would cut the dose in half on my own if they didn't get back to me promptly. There's nothing dangerous about doing that. The worst that can happen is you go into afib, and that's pretty unlikely if you're still taking 100 mg bid.

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Aoife5
I'm taking 50mg of metoprolol, and 200mg of Flecainide, prior to the ablation I was taking metoprolol and Eliquis, no issue with either of these, but the Flecainide is posing a problem, over the last four days, I have developed a really bad ticklish cough, which comes on 20 mins after the medication, its very problematic, I struggle to catch my breath, research into the wee hours on Pub Med does correlate Flecainide and dry cough. ]

Just to clarify, are you taking 50mg of metoprolol, and 200mg of Flecainide twice a day or 25mg of metoprolol, and 100mg of Flecainide twice a day for a total of 50mg of metoprolol, and 200mg of Flecainide per day?

Sorry about delay in response

Flecainide 100mg x 2 daily
Metopropol 25mg x 2 daily
Eliquis 5mg x 2 daily

Thank you for the advise, I had a dizzy spell earlier,

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Aoife5
Sorry about delay in response

Flecainide 100mg x 2 daily
Metopropol 25mg x 2 daily
Eliquis 5mg x 2 daily

Thank goodness. I thought you were taking 200 mg twice daily.

Nevertheless, if it's making you dizzy, it's a problem. You're either taking too much of the flecainide or the metoprolol, and my bet is heavily on the metoprolol. It comes with all the side effects you complain of. Flecainide, not so much.

I agree with Carey, and found that even though I had AF, and was between ablations, my heart wanted to rest near 50 BPM. However, doses of metoprolol higher than 12.5 mg BID often had my heart plodding along at 40 and fewer beats. It made me feel so awful that I had to go to the ER once only to learn that my heart rate was running at 30 BPM, barely enough to keep me alive. I was told to discontinue metoprolol immediately, but to begin taking another ultra-strong anti-arrhythmic drug called Amiodarone. I felt greatly improved as soon as my AF got under control, but my heart rate never went below about 38 after that, and only when I was in deep sleep.

I don't think your Flecainide was the problem. If you heart is largely free of AF at this point and behaving, it might be suppressed too much by even the relatively modest dose of metoprolol you have been taking.