Classifications: antiarrhythmic, class ic; Therapeutic: antiarrhythmic, class ic
Pregnancy Category: C
50 mg, 100 mg, 150 mg tablets
Local (membrane) anesthetic and antiarrhythmic with electrophysiologic properties similar to other class IC antiarrhythmic
drugs. Slows conduction velocity throughout myocardial conduction system, increases ventricular refractoriness.
Is an effective suppressant of PVCs and a variety of atrial and ventricular arrhythmias.
Life-threatening ventricular arrhythmias.
Atrial tachycardia and other arrhythmias unresponsive to standard agents (e.g., quinidine), Wolff-Parkinson-White syndrome,
and recurrent ventricular tachycardias.
Hypersensitivity to flecainide; preexisting second- or third-degree AV block, right bundle branch block when associated with
a left hemiblock unless a pacemaker is present; cardiogenic shock, significant hepatic impairment; CHF, acute MI; QT prolongation
syndromes; electrolyte imbalances; pregnancy (category C).
Atrial fibrillation; cardiac disease; elderly; sick sinus syndrome, renal impairment; children and infants.
Route & Dosage
|Life-Threatening Ventricular Arrhythmias
Adult: PO 100 mg q12h, may increase by 50 mg b.i.d. q4d (max: 400 mg/d)
Child: PO 13 mg/kg/d in 3 divided doses (max: 8 mg/kg/d)
- Do not increase dosage more frequently than every 4 d.
- Store in tightly covered, light-resistant containers at 15°30° C (59°86° F) unless otherwise
Adverse Effects (≥1%)CNS: Dizziness,
headache, light-headedness, unsteadiness, paresthesias, fatigue
. CV: Arrhythmias
, chest pain, worsening of CHF. Special Senses: Blurred vision, difficulty in focusing,
spots before eyes. GI: Nausea, constipation
, change in taste perception. Body as a Whole: Dyspnea
, fever, edema.
may increase flecainide levels; may increase digoxin
levels 1525%; beta blockers
may have additive negative inotropic effects.
Readily from GI tract. Peak:
23 h. Distribution:
Crosses placenta; distributed into breast milk. Metabolism:
In liver. Elimination:
Mainly in urine. Half-Life:
Assessment & Drug Effects
- Correct preexisting hypokalemia or hyperkalemia before treatment is initiated.
- Note: ECG monitoring, including Holter monitor for ambulating patients, is essential because of the possibility of drug-induced
- Determine pacing threshold for patients with pacemakers before initiation of therapy, after 1 wk of therapy, and at regular
- Monitor plasma level recommended, especially in patients with severe CHF or renal failure because drug elimination may be
delayed in these patients.
- Note: Effective trough plasma levels are between 0.71 mcg/mL. The probability of adverse reactions increases when trough levels
exceed 1 mcg/mL.
- Attempt dosage reduction with caution after arrhythmia is controlled.
Patient & Family Education
- Note: It is VERY important to take this drug at the prescribed times.
- Report visual disturbances to physician.