Flecainide
- Atc Codes:C01BC04
- CAS Codes:54143-56-5#54143-55-4
- PHARMGKB ID:54143-56-5#54143-55-4
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Aristocor; Belgium: Apocard, Docflecai, Flecainide, Tambocor; Czech Republic: Tambocor; Denmark: Flecainid, Tambocor; Estonia: Tambocor; Finland: Tambocor; France: Flecaine, Flecainide; Germany: Flecadura, Flecagamma, Flecainid, Tambocor; Greece: Tambocor; Ireland: Flecainide, Tambocor; Italy: Almarytm, Flecainide; Luxembourg: Tambocor; Malta: Tambocor; Netherlands: Flecainide, Tambocor; Portugal: Apocard; Romania: Tambocor; Slovakia: Flekainid; Spain: Apocard; Sweden: Flekainid, Tambocor; UK: Flecainide, Tambocor.
North America
Canada: Flecainide, Tambocor; USA: Flecainide, Tambocor.
Latin America
Argentina: Diondel; Mexico: Tambocor.
Asia
Japan: Tambocor.
Drug combinations
Chemistry
Flecainide Acetate: C~17~H~20~F~6~N~2~O~3~ C~2~H~4~O~2~. Mw: 474.39. Benzamide, N-(2-piperidinylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)-, monoacetate. CAS-54143-56-5; CAS-54143-55-4 (flecainide)(1977).
Pharmacologic Category
Class Ic Antiarrhythmics. (ATC-Code: C01BC04).
Mechanism of action
Flecainide is a local anesthetic-type class Ic antiarrhythmic agent. Slows conduction in cardiac tissue by altering transport of ions across cell membranes. Causes slight prolongation of refractory periods. Decreases rate of rise of action potential without affecting duration. Increases electrical stimulation threshold of ventricle, His-Purkinje system. Possesses local anesthetic and moderate negative inotropic effects.
Therapeutic use
Prevention and suppression of documented life-threatening ventricular arrhythmias (e.g. sustained ventricular tachycardia). Control of symptomatic, disabling supraventricular tachycardias in patients without structural heart disease where other agents fail.
Pregnancy and lactiation implications
There are no adequate, controlled studies to date using oral flecainide in pregnant women, and the drug should be used during pregnancy only when potential benefits justify possible risks to the fetus.
Unlabeled use
Contraindications
Hypersensitivity to flecainide or any component of the formulation. Pre-existing second- or third-degree AV block or with right bundle branch block when associated with a left hemiblock (bifascicular block)(except in patients with a functioning artificial pacemaker). Cardiogenic shock. Coronary artery disease. Concurrent use of ritonavir or amprenavir.
Warnings and precautions
Proarrhythmic effects might occur (not recommended for chronic atrial fibrillation). When treating atrial flutter, 1:1 atrioventricular conduction may occur. Dose-related increases in PR and QRS intervals occur (use with caution in sick sinus syndrome). Electrolyte imbalances should be corrected. Use with caution in heart failure (may precipitate or exacerbate condition). Use with caution in significant hepatic impairment. Use with caution in patients with permanent pacemakers or temporary pacing wires (can increase endocardial pacing thresholds).