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Flecainide

    Brands

    DEA Class; Rx

    Common Brand Names; Tambocor

    • Antidysrhythmics, Ic

    Oral Class IC antiarrhythmic; used to treat documented life-threatening ventricular arrhythmias; should be avoided in LVD or asymptomatic post-MI patients; also approved for prevention of PSVT; not considered first-line agent for suppression of ventricular arrhythmias due to risk of proarrhythmias (CAST trial).

    Indicated for the prevention of life-threatening ventricular arrhythmias, such as sustained ventricular tachycardia (i.e., ventricular tachycardia prophylaxis).

    For the conversion to† and/or prevention of paroxysmal atrial fibrillation and/or atrial flutter and paroxysmal supraventricular tachycardia (PSVT) prophylaxis in patients with AV reentry tachycardia and other supraventricular arrhythmias associated with disabling symptoms and without structural heart disease.

    Hypersensitivity

    2nd or 3rd degree AV block, right bundle branch block when associated with left hemiblock (bifascicular block), unless pacemaker is present to sustain cardiac rhythm; discontinue therapy immediately

    • Visual disturbances (5-16%)
    • Dizziness (10-19%)
    • Arrhythmias
    • Edema (1-4%)
    • Asthenia (2-5%)
    • Palpitations (2-7%)
    • Fatigue (3-8%)
    • Tremors (2-5%)
    • Constipation (1-4%)
    • Nausea (5-9%)
    • Chest pain (1-5%)
    • Dyspnea (5-10%)
    • Headache (5-10%)
    • Abdominal pain (1-3%)
    • Malaise (1-3%)
    • Fever (1-3%)
    • Tachycardia (1-3%)
    • Sinus pause/arrest (1-3%)
    • Vomiting (1-3%)
    • Diarrhea (1-3%)
    • Dyspepsia (1-3%)
    • Anorexia (1-3%)
    • Rash (1-3%)
    • Diplopia (1-3%)
    • Hypoesthesia (1-3%)
    • Paresthesia (1-3%)
    • Paresis (1-3%)
    • Ataxia (1-3%)
    • Flushing (1-3%)
    • Diaphoresis (1-3%)
    • Vertigo (1-3%)
    • Syncope (1-3%)
    • Somnolence (1-3%)
    • Tinnitus (1-3%)
    • Anxiety (1-3%)
    • Insomnia (1-3%)
    • Depression (1-3%)

    Atrial fibrillation, CHF, hypotension, HTN, post MI patients, geriatrics, proarrhythmia events, hepatic/renal impairment, sick sinus syndrome

    May slow cardiac conduction to produce dose-related increases in PR, QRS, and QT intervals; manage patient on lowest effective dose

    Discontinuation should be done in hospital

    Causes increased mortality in post-AMI period, also with chronic atrial fibrillation

    May affect endocardial pacemaker reversibly by increasing endocardial pacing thresholds or suppressing ventricular escape rhythms; do not administer to patients with existing poor thresholds or nonprogrammable pacemakers unless suitable pacing rescue is available

    Correct electrolyte imbalances, especially hypomagnesemia or hypokalemia before initiating therapy

    May cause visual disturbances

    Flecainide may depress LV function significantly with preexisting LV dysfunction

    Flecainide should be avoided in patients with HF or structural heart disease

    Pregnancy category: C

    Lactation: Enters breast milk

    Adults

    300 mg/day PO for paroxysmal supraventricular tachycardia (PSVT) prophylaxis, atrial fibrillation, or atrial flutter; 400 mg/day PO for ventricular tachycardia prophylaxis.

    Geriatric

    300 mg/day PO for paroxysmal supraventricular tachycardia (PSVT) prophylaxis, atrial fibrillation, or atrial flutter; 400 mg/day PO for ventricular tachycardia prophylaxis.

    Adolescents

    200 mg/m2/day PO or 8 mg/kg/day PO.

    Children

    200 mg/m2/day PO or 8 mg/kg/day PO.

    Infants

    200 mg/m2/day PO or 8 mg/kg/day PO.

    Neonates

    200 mg/m2/day PO or 8 mg/kg/day PO.

    Flecainide acetate

    tablet

    • 50mg
    • 100mg
    • 150mg