Flecainide Acetate
Cardiac Therapy · Anti-arrhythmic
Indications
Tab: AV nodal reciprocating tachycardia. Wolff-Parkinson-White syndrome. Paroxysmal atrial fibrillation in patients with disabling symptoms. Symptomatic sustained ventricular tachycardia. Premature ventricular contractions and/or non-sustained ventricular tachycardia not responding to other therapy. Inj: Rapid control of resistant ventricular tachyarrhythmias, AV nodal reciprocating tachycardia, Wolff-Parkinson-White syndrome, paroxysmal atrial fibrillation in patients with disabling symptoms.
Dosage
Adults: ORAL: Supraventricular arrhythmias: Initially 50 mg twice daily; max 300 mg daily. Ventricular arrhythmias: Initially 100 mg twice daily; max 400 mg daily. Reduce after 3-5 days to lowest dose required to maintain control. Adults: INJECTION: Ventricular tachyarrhythmias resistant to other treatments: Slow IV injection: 2 mg/kg over 10-30 min, max 150 mg; followed by IV infusion at a rate 1.5 mg/kg/hr for 1 hr, subsequently reduced to 100-250 mcg/kg/hr up to 24 hr, max total dose in first 24 hr, 600 mg, transfer to oral treatment as mentioned above. Children: Under 12 yr, not recommended. Resistant re-entry supraventricular tachycardia, ventricular ectopic beats or ventricular tachycardia, arrhythmias associated with accessory conduction pathways (e.g. Wolff-Parkinson-White syndrome), paroxysmal atrial fibrillation: ORAL: 12-18 yr, initially 50-100 mg twice daily; max 300 mg…
Administration
Administration should be done under the supervision of expert medical practitioners only. Stability: Store at controlled room temperature 15°C-30°C (59°F-86°F) in a tight, light-resistant container.
Adverse Effects
Photosensitivity, nausea, vomiting, dizziness, visual disturbances, elevated liver enzymes, jaundice. Allergic skin reactions, increased antinuclear antibodies. Decreased blood counts. Peripheral neuropathy paraesthesia, ataxia. Rarely corneal deposits, pneumonitis, urticaria, hallucinations, depression, confusion, amnesia, dyskinesia, convulsions.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Cardiac failure, history of MI with asymptomatic ventricular arrhythmias, long standing atrial fibrillation where no attempt to convert sinus rhythm, haemodynamically significant valvular heart disease, 2nd or 3rd degree AV block, sinus node disease in absence of pacemaker, structural organic heart disease, abnormal left ventricular function. Precautions: Therapy should be initiated under hospital supervision. Correct electrolytes before admin. Pacemakers or temporary pacing electrodes. Renal or hepatic insufficiency; monitor plasma levels. Cardiac disease. Acute onset of atrial fibrillation following cardiac surgery. Elderly.
Interactions
Other antiarrhythmics, amiodarone, digoxin, cardiac depressants, liver enzyme inducers, fluoxetine, TCADs, reboxetine, dolasetron, phenytoin, phenobarbital, carbamazepine, clozapine, mizolastine, terfenadine, quinine, protease inhibitors, diuretics, cimetidine, bupropion.
Advice to Patient
Take oral forms with or without meals. Take a missed dose as soon as you remember if it is within 6 hours of the scheduled time. Contact prescriber if there is palpitations, chest pain, acute nervousness, fatigue, headache, excessively slow or rapid heartbeat, unusual cough, unusual weight gain, swelling of hands or ankles, respiratory difficulty, muscle tremor, weakness or numbness. Do not stop taking medication suddenly, taper dosage gradually according to prescriber’s instructions. Learn how to take pulse and record it daily alongwith weight.
Pharmacokinetics
Absorption: Almost completely absorbed. Decreased absorption with milk. Bioavailability: Approx. 90%. Metabolism: Hepatic. Half-life elimination: Approx. 20 hrs. Time to peak, plasma: Approx. 3 hrs. Excretion: Urine (>30%). Faeces (5%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.