CHF and arrhythmias:
Indications for: Flecainide Acetate
Documented, life-threatening ventricular arrhythmias. Paroxysmal supraventricular tachycardias (PSVT), paroxysmal atrial fibrillation/flutter (PAF) in patients without structural heart disease.
Sustained ventricular tachycardia: Initiate in hospital; initially 100mg every 12 hrs; may increase by 50mg twice daily at 4 day intervals; max 400mg/day. PSVT or PAF: 50mg every 12 hrs; may increase by 50mg twice daily at 4 day intervals; max 300mg daily. CrCl ≤35mL/min per 1.73m2: Initially 100mg once daily or 50mg every 12hrs.
<18yrs: not established.
Flecainide Acetate Contraindications:
2nd- or 3rd-degree AV block or right bundle branch block associated with left hemiblock, unless paced. Cardiogenic shock. Recent MI.
Study findings showed an excessive mortality or nonfatal cardiac arrest rate with flecainide in patients with asymptomatic non-life-threatening ventricular arrhythmias who had an MI >6 days but <2 years previously. Ventricular pro-arrhythmic effects in patients with atrial fibrillation/flutter.
Flecainide Acetate Warnings/Precautions:
Verify benefits outweigh risks; see full labeling. Increased risk of pro-arrhythmic effects. Chronic atrial fibrillation: not recommended. History of CHF or myocardial dysfunction. Sick sinus syndrome. Pacemaker patients. Correct potassium imbalances before use. Severe renal or hepatic impairment, concomitant amiodarone or reduced myocardial function: monitor plasma level. Discontinue if heart block occurs unless paced. Discontinue if liver dysfunction, blood dyscrasias occur. Pregnancy (Cat.C). Nursing mothers: not recommended.
Flecainide Acetate Classification:
Class IC antiarrhythmic.
Flecainide Acetate Interactions:
Increased digoxin toxicity. May potentiate negative inotropic effects of β-blockers. Potentiated by cimetidine. Antagonized by phenytoin, phenobarbital, carbamazepine. Avoid disopyramide, verapamil, nifedipine, diltiazem, other negative inotropics. ½ dose when given with amiodarone.
Dizziness, visual disturbances, dyspnea, headache, fatigue, palpitations, chest pain, asthenia, tremor, edema, GI upset, new or exacerbated arrhythmias, heart failure, cardiac arrest, conduction defects.
Formerly known under the brand name Tambocor.
Generic Drug Availability: