Pharm 101: Flecainide

Class

Class IC anti-arrhythmic


Pharmacodynamics
  • Potent blocker of Na and K channels with slow unblocking kinetics
  • Does not prolong APD, or QT interval
  • No antimuscarinic effects
  • Very effective in suppressing PVCs

Pharmacokinetics
  • Well absorbed orally
  • Peak plasma levels at 3 hours
  • Half-life 20 hours
  • Vd 8L/kg
  • Hepatic metabolism
  • 30% of single oral dose is excreted unchanged in urine

Clinical uses
  • Supraventricular arrhythmias in patients with no cardiac disease
  • Usual dose 100-200 mg BD

Adverse effects
  • May cause severe exacerbation of arrhythmia when administered to patients with:
    • Preexisting ventricular tachyarrhythmias
    • Previous MI and ventricular ectopy

Precautions/contraindications
  • Hypotension
  • LV dysfunction

Further reading

References

Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU Emergency Medicine Trainee with interests in medical education, ECG interpretation, and the use of point-of-care ultrasound in the undifferentiated patient. Co-author of the LITFL ECG Library | Twitter

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