A packer is used for setting downhole in tubing subject to downhole flow at a high flow rate. The packer includes a setting element, a slip element, and a packing element. The setting element is disposed on the packer toward an uphole end and is activated hydraulically to move in a downhole direction toward a downhole end of the packer. The slip element is disposed toward the downhole end and is moveable outward toward the tubing in a first stage in response to the movement of the setting element. The packing element is disposed on the other elements and is at least partially carried by the setting element. The packing element is compressible outward toward the tubing in a second stage, after the first stage, in response to the movement of the setting element. Additionally, a choke ring or other element disposed on the packer at least downhole of the packing element can move outward toward the tubing in response to the setting movement to restrict the downhole flow in the annulus to a lower flow rate.