Flecainide Brand Name– Tambocor
What is Flecainide
Flecainide is an oral, local anesthetic-type antiarrhythmic.
It is classified as category IC, similar to encainide, propafenone, and moricizine, and is used to treat documented life-threatening ventricular arrhythmias. Flecainide is also indicated for conversion to and/or maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation and/or atrial flutter associated with disabling symptoms and without structural heart disease.
It is approved for the prevention of various forms of paroxysmal supraventricular tachycardia (PSVT) caused by both reentrant and non-reentrant mechanisms.
As a result of the Cardiac Arrhythmia Suppression Trial (CAST), flecainide is not considered a first-line agent to suppress ventricular arrhythmias because of its propensity for fatal proarrhythmic effects.
Class IC agents as a whole markedly depress cardiac conduction, which might explain their proarrhythmic effects.
Flecainide should not be used in patients with left ventricular dysfunction or recent acute myocardial infarction.
Flecainide was approved by the FDA in October 1985.
Generic flecainide tablets were approved in July 2002.
Indications
- atrial fibrillation
- atrial flutter
- paroxysmal supraventricular tachycardia (PSVT) prophylaxis
- supraventricular arrhythmias
- ventricular tachycardia prophylaxis
For the prevention of life-threatening ventricular arrhythmias, such as sustained ventricular tachycardia (i.e., ventricular tachycardia prophylaxis)
NOTE: Although flecainide has been shown to be highly effective in suppressing chronic stable ventricular arrhythmias in many patients, there is no documented beneficial effect on mortality. There is, however, evidence of an increased risk of death and non-fatal cardiac arrest with the use of flecainide after myocardial infarction in patients with asymptomatic PVCs or non-sustained ventricular tachycardia (CAST).
Therefore, its use is no longer recommended in patients without documented life-threatening ventricular arrhythmias.
Side Effects
- abdominal pain
- alopecia
- amnesia
- angina
- anorexia
- anxiety
- arrhythmia exacerbation
- arthralgia
- asthenia
- ataxia
- AV block
- bradycardia
- bronchospasm
- chest pain (unspecified)
- cholestasis
- confusion
- constipation
- depression
- diaphoresis
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- dyspnea
- edema
- elevated hepatic enzymes
- euphoria
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- flushing
- headache
- heart failure
- hepatic failure
- hypertension
- hypoesthesia
- hypotension
- impotence (erectile dysfunction)
- insomnia
- jaundice
- leukopenia
- libido decrease
- malaise
- myalgia
- nausea
- nightmares
- nystagmus
- ocular irritation
- ocular pain
- palpitations
- paresis
- paresthesias
- photophobia
- pneumonitis
- polyuria
- pruritus
- QT prolongation
- rash
- sinus tachycardia
- syncope
- thrombocytopenia
- tinnitus
- torsade de pointes
- tremor
- urinary retention
- urticaria
- ventricular fibrillation
- ventricular tachycardia
- vertigo
- visual impairment
- vomiting
- weakness
- xerostomia
Monitoring Parameters
- ECG
- serum creatinine/BUN
Contraindications
- apheresis
- atrial fibrillation
- AV block
- bradycardia
- breast-feeding
- bundle-branch block
- cardiac arrhythmias
- cardiac disease
- cardiogenic shock
- cardiomyopathy
- celiac disease
- electrolyte imbalance
- females
- fever
- geriatric
- heart failure
- hepatic disease
- human immunodeficiency virus (HIV) infection
- hyperparathyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- long QT syndrome
- mortality
- myocardial infarction
- pheochromocytoma
- pregnancy
- QT prolongation
- renal disease
- renal failure
- renal impairment
- rheumatoid arthritis
- sick sinus syndrome
- sickle cell disease
- sleep deprivation
- stroke
- systemic lupus erythematosus (SLE)
- ventricular arrhythmias
- ventricular dysfunction
Interactions
- Abarelix
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