Flecainide
Supraventricular Tachycardia, Ventricular Tachycardia ... show more
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
Possible
Pharmaceutical Class
Antiarrhythmic
Controlled Drug Substance
NO
Flecainide
Summary
Flecainide is used to prevent certain types of life-threatening irregular heartbeats, including paroxysmal supraventricular tachycardias and paroxysmal atrial fibrillation/flutter. It is typically prescribed for serious arrhythmias where the benefits outweigh the risks.
Flecainide works by slowing down electrical signals in the heart, which helps stabilize the heart rhythm. This action helps prevent and control life-threatening irregular heartbeats.
For adults, the usual starting dose is 50 mg every 12 hours, which can be increased to a maximum of 300 mg per day. It is taken orally, usually once every 12 hours, with or without food.
Common side effects of Flecainide include dizziness, visual disturbances, headache, and nausea. Serious adverse effects can include new or worsened arrhythmias, heart failure, and conduction block.
Flecainide is contraindicated in patients with certain heart conditions, recent heart attack, or known hypersensitivity to the drug. It can cause new or worsened arrhythmias and should be used cautiously in patients with heart failure.
Indications and Purpose
How does Flecainide work?
Flecainide is a Class IC antiarrhythmic agent that works by slowing electrical signals in the heart, which helps stabilize the heart rhythm. It decreases intracardiac conduction in all parts of the heart, with the greatest effect on the His-Purkinje system. This action helps prevent and control life-threatening irregular heartbeats.
How does one know if Flecainide is working?
The benefit of Flecainide is evaluated through regular monitoring by a healthcare provider. This includes checking the patient's heart rhythm, conducting lab tests to monitor plasma levels, and assessing the patient's response to the medication. Regular follow-up appointments are important to ensure the medication is effectively managing the condition without causing adverse effects.
Is Flecainide effective?
Flecainide has been shown to be effective in preventing paroxysmal supraventricular tachycardias (PSVT) and paroxysmal atrial fibrillation/flutter (PAF) in clinical trials. In studies, a significant percentage of patients remained attack-free while on Flecainide compared to those on placebo. It is also effective in suppressing ventricular arrhythmias, such as sustained ventricular tachycardia, in patients with life-threatening conditions.
What is Flecainide?
Flecainide is an antiarrhythmic medication used to prevent certain types of life-threatening irregular heartbeats, such as paroxysmal supraventricular tachycardias and paroxysmal atrial fibrillation/flutter. It works by slowing electrical signals in the heart to stabilize the heart rhythm. Flecainide is typically prescribed for patients with serious arrhythmias where the benefits outweigh the risks.
What is Flecainide used for?
Flecainide is indicated for the prevention of paroxysmal supraventricular tachycardias (PSVT), paroxysmal atrial fibrillation/flutter (PAF), and documented ventricular arrhythmias such as sustained ventricular tachycardia. It is used in patients without structural heart disease and should be reserved for those with life-threatening arrhythmias where the benefits outweigh the risks.
Directions for Use
For how long do I take Flecainide?
Flecainide is typically used for long-term management of certain types of life-threatening irregular heartbeats. It is important to continue taking it even if you feel well, as it controls the condition but does not cure it. The duration of use should be determined by a healthcare provider based on individual needs and response to treatment.
How do I take Flecainide?
Flecainide should be taken exactly as prescribed by your doctor, usually once every 12 hours. It can be taken with or without food, and there are no specific food restrictions unless advised by your doctor. It is important to take Flecainide at the same times every day to maintain consistent blood levels.
How long does it take for Flecainide to start working?
Flecainide is absorbed nearly completely after oral administration, with peak plasma levels typically reached within 1 to 6 hours. However, it may take 3 to 5 days to reach steady-state levels in the body. The time it takes to notice an improvement in symptoms can vary, and it is important to follow your doctor's instructions and attend regular follow-up appointments.
How should I store Flecainide?
Flecainide should be stored in its original container, tightly closed, and kept out of reach of children. It should be stored at room temperature, away from excess heat and moisture, and not in the bathroom. Unneeded medications should be disposed of through a medicine take-back program to ensure safety.
What is the usual dose of Flecainide?
For adults, the usual starting dose for paroxysmal supraventricular tachycardias (PSVT) and paroxysmal atrial fibrillation/flutter (PAF) is 50 mg every 12 hours, which can be increased to a maximum of 300 mg per day. For sustained ventricular tachycardia (VT), the starting dose is 100 mg every 12 hours, with a maximum of 400 mg per day. For children under six months, the initial dose is approximately 50 mg/m² per day, divided into two or three doses. For children over six months, the dose can be increased to 100 mg/m² per day, with a maximum of 200 mg/m² per day. Always follow a doctor's guidance for dosing.
Warnings and Precautions
Can Flecainide be taken safely while breastfeeding?
Flecainide is excreted in human breast milk in concentrations higher than plasma levels. Although the risk to a nursing infant is considered small, Flecainide should only be used during breastfeeding if the potential benefits outweigh the risks. Consult a healthcare provider for personalized advice.
Can Flecainide be taken safely while pregnant?
Flecainide is categorized as Pregnancy Category C, indicating that there is no adequate and well-controlled studies in pregnant women. Animal studies have shown some teratogenic effects, but the relevance to humans is unclear. Flecainide should only be used during pregnancy if the potential benefits justify the potential risks to the fetus. Consult a healthcare provider for personalized advice.
Can I take Flecainide with other prescription drugs?
Flecainide can interact with several medications, including digoxin, propranolol, and amiodarone. It may increase plasma levels of digoxin and propranolol, and when used with amiodarone, Flecainide levels may increase significantly. Cimetidine can also increase Flecainide levels. Patients should inform their doctor of all medications they are taking to avoid potential interactions.
Is Flecainide safe for the elderly?
In elderly patients, the elimination of Flecainide from the body may be slower, which should be considered when adjusting doses. It is important to monitor plasma levels and adjust the dosage carefully to avoid potential side effects. Elderly patients should be closely monitored for any adverse effects, and the lowest effective dose should be used to minimize risks.
Is it safe to exercise while taking Flecainide?
Flecainide may cause dizziness, fatigue, and other side effects that could potentially limit your ability to exercise. If you experience any symptoms that affect your ability to exercise, it is important to discuss them with your doctor. They may adjust your dosage or provide guidance on how to safely engage in physical activity while taking this medication.
Who should avoid taking Flecainide?
Flecainide is contraindicated in patients with pre-existing second- or third-degree AV block, right bundle branch block with left hemiblock, cardiogenic shock, or known hypersensitivity to the drug. It should not be used in patients with recent myocardial infarction or chronic atrial fibrillation. Flecainide can cause new or worsened arrhythmias and should be used cautiously in patients with heart failure or myocardial dysfunction. It is important to follow the recommended dosage schedule and monitor for adverse effects.
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