Pharm 101: Flecainide


Class IC anti-arrhythmic

  • 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
  • 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
  • Hypotension
  • LV dysfunction
Further reading

Pharmacology 101

Top 200 drugs

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

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