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
V_d 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

References

Katzung BG. Basic and Clinical Pharmacology. 14e. 2018: 242

Pharmacology 101

Top 200 drugs

…more drugs

Robert Buttner

MBBS (UWA) CCPU (RCE, Biliary, DVT, E-FAST, AAA) Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor-in-chief of the LITFL ECG Library. Twitter: @rob_buttner