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 FAQs A-Fib Drug Therapy: Pill in Pocket

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

2. “Is the “Pill-In-The-Pocket” treatment a cure for A-Fib? When should it be used?”

The “Pill-In-The-Pocket” treatment refers to taking an antiarrhythmic med at the time of an A-Fib attack.

One approach is to take 100 mg of flecainide up to three times at 20 minute intervals to stop or shorten an A-Fib episode.

Another approach is to take Rythmol 300 mg and Inderal 20 mg, wait three hours, then take Inderal 20 mg, wait three hours, then take Rythmol 300 mg and Inderal 20 mg again. (Other meds and dosages are used depending on the needs of the patient).

Another variation of the “Pill-In-The-Pocket” treatment is to take an antiarrhythmic med on a regular basis, then take a higher dose at the time of an A-Fib attack. A-Fib patient, Reg, writes he takes 300 mg of flecainide, and 2 hours later goes back into SR. He normally is on a loading dose of flecainide 100 mg in the morning and 50 mg in the afternoon.

However, not everyone can tolerate antiarrhythmic meds on a regular basis. The “Pill-In-The-Pocket” treatment is an excellent, welcome option for A-Fib patients who feel bad when taking antiarrhythmic meds every day.

(When the author had A-Fib, he never tried the “Pill-In-The-Pocket” treatment. He welcomes comments and corrections to this opinion.)

The “Pill-In-The-Pocket” treatment should probably not be considered a “cure” for A-Fib, but more of a help to get one out of or shorten an A-Fib attack. For more, go to our Treatments page and look for Pill-in-the-Pocket”. Read about two different approaches in Marilyn Shook’s personal experience story: “Pill-In-The-Pocket” Approaches—Both Turn To Catheter Ablation For A Cure.

Editor’s comments:
In my opinion, the ideal use of an antiarrhythmic med is to take it on a regular basis to keep one from having an A-Fib attack. Taking an antiarrhythmic med only when one has an A-Fib attack is like trying to put out a fire after it has started. From a patient’s perspective, it’s better to keep A-Fib from starting in the first place—to be proactive rather than reactive.

Return to FAQ Drug Therapies
Last updated: Monday, May 8, 2017

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