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Anyone experienced differences between Flecainide brands?

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malex57
malex57

I have had Paroxsysmol AF for 12 years and experienced most medications, e.g. Sotalol, Propanalol, Amiodarone, Bisoprolol and finally, a few years ago, Flecainide (2x50mg per day). 2 months ago I relapsed into significant AF which settled only moderately after a few hours. I increased my dose to 2x100mg per day, which made no difference to the symptoms. It occurred to me that I had very recently been prescribed a differrent brand (Brand B) from the Brand A ones prescribed previously. My GP thought it was worth trying Brand A to check if my symptoms improved. My local Pharmacy had a few Brand A "off-cuts," but was unable to obtain any more. I have since learnt that Brand A have discontinued production. My AF quickly went into remission and a number of side effects kicked in. I reduced my dose back to 2x50mg per day gradually, over several days and my AF has remained under control. I run out of Brand A brand in a few days, so will be able to confirm a brand issue when I restart taking Flecainide marketed by Brand B. In the meantime I would be grateful for any professional advice or patient experience relating to the above topic. Thanks in anticipation.

0 likes, 13 replies

13 Replies

  • peter52762
    peter52762 malex57

    Posted

    Malex, I take bisoprolol, whether this is helping I do not know. My symptons are so infrequent and generally last for only an 1 hour. I am still in the process, by elimination, of determining what causes these episodes. My last episode happened when working in the garden ( digging ). I thought that exercise was good for you. This occured in March and the hospital put me on Bisoprolol, so only a couple of months use. I will keep you posted. Peter.
    • malex57
      malex57 peter52762

      Posted

      Hi Peter52762, thanks for your reply. I was on Bisoprolol for quite a few years, and like you had the odd relapse into AF. I have found that AF is variable and therefore a prescribed dose of medication occasionaly doesn't cope. But don't knock it, Bisoprolol is a well tried and safe medication with few side effects. Stick with it as long as possible. Others like Amiodorone or Flecainide are less so. My ex-GP called them "dirty drugs." I trust your episodes of AF remain infrequent. Best wishes.
    • maggie34838
      maggie34838 peter52762

      Posted

      Hi Peter,

      Interested to know how you're going on Bisoprolol - I started on 2.5mg a month ago but it very rapidly had to be increased to 10mg at the moment - all with no effect on my AF episodes which have increased in frequency and severity. Today I was started on Digoxin to see if that would help. Exercise triggers my AF but I also am now woken by episodes. It seems the condition usually gets worse for most people so interested to know how you are going? Maggie

    • peter52762
      peter52762 maggie34838

      Posted

      Maggie,

      I think I am one of the lucky ones, I have only had 2 episodes this year. The first was in March, when I was prescribed Bisoprolol 2.5mg and my second was this month.

      I believe this was triggered by eating white bread when I went out for a meal.

      I have changed my diet I now try and eat only brown wholemeal or granary bread. I have lost 2 stone in weight and reguarly walk out in the morning to get my paper.

      Like you I used to have episodes during the night, I believe this was due to what I was eating and drinking.

      Different people different bodies.

      I hope this might help, keep well and think positive.

      Regards,

      Peter.

    • maggie34838
      maggie34838 peter52762

      Posted

      Am envious Peter!

      - just coming out of AF/palpitations as I type - still quivering!

      Interested in the diet angle - could you tell me more please? What are you linking it to - gluten? and is there some research you've read regarding this? I have cut out all alcohol and caffeine - do drink some decaf coffee hoping this is OK.

      Many thanks for your support, it helps to know there are others who have experienced similar symptoms and have improved, even if they are on the other side of the world! (I live In New Zealand). Regards Maggie

    • john84040
      john84040 maggie34838

      Posted

      Hi maggie, i take 2.5 mg of bisoprolol daily and 300mg flecinide daily..

        ive cut out wheat and also gone on a competley gluten free diet this has vastley reduced my episides of AF. I like you cut out alcholol but ive realised it was the wheat in the beer that was triggering AF. i know have cider or a couple of glasses of red wine with no episode

       i also realised even decaf and cheese were also triggering my AF. Also keeping my self hydrated also helps. You can buy electrolite capsules  that youdisolve in water, if you feel run down  ie. exersise these will help you with dehydration.

      i have also had prolbems when changing to different brands of meds. at the moment the brands a working fine , i sorted with my pharmacy to give me the same brands that iknow are fine. unfortunatley my pharmacy has informed me the the bisoprolol brand that works fine for me will not be available.i will have to see how i go with the new brand and if it doesnt work im going to my gp and ask him to slightly up my dossage. ive read the active ingredient is the same in all the brands but within a 20% margin. If true im thinking  it could be the 20% less thats making the difference.

      hope this helps, thanks,

      John.

       

       

  • derek76
    derek76 malex57

    Posted

    I used to take Securon SR a version of verapamil for my BP. After a few years when doctors had to prescribe generic versions of drugs I started to get ones from different makers and found that my BP was not so well controlled during a two month spell while taking them. Naturally my GP and local pharmacist denied that there could be any difference.

    I then started to go to a big Boots branch who always had Securon but who I normally avoid due to their queing system to hand in a prescription and again later to collect it as they seem incapable of doing anything while you wait.  Soon Boots also started to to give out generic versions.

    I wrote to the maker of one of the generic ones and they sent a courier to collect samples to check. Not sure if they actually did as they repled by return that they were to specification.

    Being a dogged person who never gives up his bone I contacted the MHRA ( Medicines and Healthcare Products Regulatory Agency) They asked for samples and I sent some from two makers. After a long time back came the reply that they conformed to specification.

     

    • malex57
      malex57 derek76

      Posted

      Hi Derek76, many thanks for your very helpful reply. I will follow your example and send some samples to the MHRA. I suspect that the control of any medical condition, that tends to be volatile, will by nature be variable. However, as I have experienced a significant difference in side effects from different brands, I will continue chip away at the issue.

      I do have a packet of "Spanish Flecainide" in reserve, as an earlier experience in Portugal, proved to me that UK medication is weaker mg for mg than the continental stuff. On that occasion it was Bisoprolol.

      I trust your BP remains under good control.

      Best wishes

    • derek76
      derek76 malex57

      Posted

      You will need to contact MHRA before sending your meds. If you Google them you will find who to contact.

      I have another 'Battle' going on at the moment.

      I went back into AFIB in December (don't laugh) after a colonoscopy when the probe stimulated my vagus nerve. I was put on Warfarin while waiting for cardioversion and later Amiodarone. Within a week my INR went from 2.1 to 3.9. The practice nurse was puzzled and slightly reduced my warfarin without much benefit.

      I did some research and found that when Amiodarone is prescribed warfarin dosage should be reduced by 33-50% until INR settles. American packet insert warn of this but not the British version.

      Obviously the cardiologist who prescribed it was unaware or negligent. I showed the evidence to my GP who was not aware that the dosage should be reduced. He passed my research onto the nurses. I contacted the two companies whose Amiodarone I had taken. They tried to tell me that the effect is well known but is only vaguely worded even in the BNF.

      They are quizzing me on other drugs I am taking in the hope of wriggling out. The patient is the last line of defence on dangerous drugs. The packet insert does say inform your doctor if you are taking warfarin! Well they prescribed it so are well aware. Amiodarone also says only prescribe for life threatening arrhythmias and not for people with a slow heart rate and care to be taken in prescribing it for over 65's. Basically they should have ruled me out.  

    • malex57
      malex57 derek76

      Posted

      Hi Derek, thanks for the mail. I have sussed out how to approach MHRA, but will wait until I have re-tested "suspect" brand/batch. I have ascertained that Brand A have discontiued production of Flecainide, i.e. the band that worked for me.

      I was on Amiodorone for a few years. It was effective, but it eventually sent my Thyroid overactive, resulting in a very high pulse rate. Thyroid recovery time is several months and again drug side-effects are not good. Do request regular blood test for Thyroid activity and keep out of the Sun, or use factor 50 or greater Sun protection.

      Best wishes.

    • derek76
      derek76 malex57

      Posted

      At first my GP suggested reducing the Amiodarone to 100mg a day but  the equilibrium problems continued so I stopped it completely. I gradually returned to normal, When I went for an ECG I was still in sinus rhythm. I told the different cardiologist of the problem and he agree that it affects quite a lot of peope that way.

      When on it previously my thyroid readings were borderline. I had some blood tests the other day and will see what has hapenned. I have already said no to taking statins again and to metformin as my blood glucose levels were high. I first heard of amiodarone about ixteen years ago when a friend was prescribed it. I saw him coming towards me one day and it looked like a big blue birthmark going down his face into his neck an after effect of the sun

      Have you Googled the 'history of amiodarone'? Quite frightening and I like the conclusion that if Satan had invented it he would have considered it to be quite good for a first attempt.

    • malex57
      malex57 derek76

      Posted

      Yes Derek, not the best of prescriptions. As I said earlier, an previous GP called them  "dirty drugs." I have since been offered it again and refused.

      Best wishes

  • john84040
    john84040 malex57

    Posted

    Hi, im male 51 and have had random episodes of AF for at least 15 years, each episode not normally lasting more than 24 hours. When i was first diagnosed with AF i was advised to cut out the usuals, caffine, alchohol , keep hydrated etc..i did all this but episodes still randomley occured . i was put on sotalol at first and that didnt work , i,m was then put on flecinide and my symptoms have improved but they gradually got worse again . i was then added soloprolol, this made a big difference. but i started to notice over a few years that my symptons would get worse soon after intoducing new brands. i mentioned this to my GP and he quickly dismissed my observations . Luckily my pharmist was more understanding. i have now worked out which brand works best .I also have the same problem with both my medications , bisoprolol and flecinide. At the moment everything is good, but last week my pharmacy informed me the brand of bisoprolol that works fine is no longer available. i know from past expeiriences that when i change over the brand to a different then the episodes of AF will return. At the moment i have 28 days supply of the good one and i know what is coming.

    i  would also like to add my expeirence with  AF that may help someone. Even though on meds i was still having random episodes of AF. I traced my diet back after each episode and i realised my symptoms would start to happen if i wasn,t hydrated. I also started to notice that wheat was also major trigger and so was cheese. Since going on a gluten free diet i have never felt so good and symptons vastley improved. I,m fully aware without medication  i would certainly go into AF but since i have cut out wheat i feel signifIcantly alot better. i used to drink beer but had to stop but now since realising wheat was a culprtit i now drink cider in moderation and with no AF symptoms. i also mentioned this to my GP and he quickly dissed my wheat observation as he said hed never hered of the connection before. . When i look  back to my teens i had episodes of a fast heart rate and it was then diagnosed as panick attacks.Looking back im now convinced it was the wheat intolerence that triggerd the fast heart rate because im not an anxious person. The upshot is i,m now on flecinide and bisoprolol,. i keep myself hydrated, i have no caffine not even de-caff , no cheese, im on a gluten free diet and i have to say it took me years of AF episodes to get to this stage and i only now have the odd episode ,i do get episodes but they  mainly happen after i have let my my guard down against the triggers mentioed.

      Getting back to the main point i can back up that in my case certain brands of meds do not work for me , i also hope my obsevations that i have had over the years with living with random AF willalso  help someone with the same condition

    john.. good luck.

     

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