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 CCPU (RCE, Biliary, DVT, E-FAST, AAA) Rob is an Emergency Medicine Advanced Trainee based in Melbourne, Australia. He has special interests in medical education, ECG interpretation, and the use of diagnostic and procedural ultrasound in the undifferentiated and unwell patient.

Follow him on twitter: @rob_buttner | ECG Library |

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