Flecainide: MedlinePlus Drug Information (2023)

FAQs

What is the warning for flecainide? ›

Flecainide may cause some people to become dizzy, lightheaded, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert.

Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis). Flecainide may cause a condition that affects the heart rhythm (QT prolongation).

Flecainide is associated with some health risks, including possible: Allergic reaction. Heart attack in people who have already had a heart attack. New or worse arrhythmia.

Flecainide has an FDA Black Box Warning recommending restricting its use to life-threatening ventricular arrhythmias, as data show no surn=vival benefits without such arrhythmias. Proarrythmic effects may occur in atrial flutter or atrial fibrillation; the drug is not recommended for chronic atrial fibrillation.

Flecainide is not recommended if you have chronic atrial fibrillation. For people with abnormal heart rhythm: Flecainide may cause new or worsened abnormal heart rhythms. Depending on your condition, your doctor may first give you this medication in the hospital so that your heart rhythms can be closely monitored.

In comparison with propranolol, flecainide increased heart rate and QRS duration (p less than 0.01, p less than 0.001 respectively). It increased diastolic BP, PR interval, QS2-Index, PEP, and PEP/LVET ratio, and decreased LVET-Index (p less than 0.05).

The metabolism of Flecainide can be decreased when combined with Caffeine.

Similarly, the labeling for flecainide describes a high level of CNS adverse effects including dizziness (19-30%), visual disturbances (16%), fatigue (8%) and somnolence and insomnia at a frequency between 1% and 3%.

Adults—At first, 100 milligrams (mg) every 12 hours. Your doctor may increase your dose as needed. However, the dose is usually not more than 400 mg per day.

No information is available on the relationship of age to the effects of flecainide in elderly patients. However, elderly patients are more likely to have age-related kidney problems, which may require an adjustment in the dose for patients receiving flecainide.

What is the safest drug for AFIB? ›

Of all antiarrhythmic agents, dofetilide and amiodarone have been proven safe in patients with heart failure.

Flecainide has an average rating of 7.3 out of 10 from a total of 168 ratings on Drugs.com. 68% of reviewers reported a positive effect, while 20% reported a negative effect. Metoprolol has an average rating of 5.7 out of 10 from a total of 620 ratings on Drugs.com.

Flecainide was the most effective drug, with a primary response rate of 95% (see Figure 5).

A beta blocker, such as bisoprolol or atenolol, or a calcium channel blocker, such as verapamil or diltiazem, will be prescribed. The medicine you'll be offered will depend on what symptoms you're having and your general health. A medicine called digoxin may be offered if other drugs are not suitable.

Flecainide is also used to prevent life-threatening sustained ventricular tachycardia (sustained VT). Flecainide belongs to the group of medicines known as antiarrhythmics. It works directly on the heart tissue and will slow the nerve impulses in the heart. This helps keep the heart rhythm normal.

Flecainide is used to treat arrhythmias. An arrhythmia is an irregularity in your heartbeat, which causes your heart to skip a beat, beat unevenly or beat very fast or very slowly. Flecainide works by correcting irregular heartbeats to a normal rhythm and by slowing an overactive heart.

Flecainide is in a class of medications called antiarrhythmics. It works by slowing electrical signals in the heart to stabilize the heart rhythm.

Flecainide-induced arrhythmias include sinus bradycardia or arrest in 2%, bundle branch blocks in 1%, increased premature ventricular depolarizations in 1%, ventricular tachycardia or fibrillation in 0.5%, and sudden death in 0.2% of patients.

Abstract. Introduction: Flecainide is an anti-arrhythmic used in patients with symptomatic arrhythmias without structural heart anomalies. It is known to cause several non-cardiac adverse reactions, most commonly headaches, dizziness, fatigue and nausea.

Call your doctor at once if you have a serious side effect such as weak pulse, slow breathing, fast or uneven heartbeat, feeling like you might pass out, feeling short of breath, swelling, rapid weight gain, confusion, extreme thirst, increased urination, muscle weakness, or jaundice (yellowing of the skin or eyes).

Can flecainide damage kidneys? ›

Despite its growing use, the presenting signs and symptoms of flecainide toxicity are not familiar to most clinicians. In particular, our patient's particular presentation of acute kidney injury (AKI) resulting in flecainide accumulation is high risk for missed diagnosis in the emergency department.

No interactions were found between flecainide and Vitamin D3. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Conclusion: Flecainide-metoprolol combination therapy improves effectiveness of rhythm control in persistent symptomatic AF and increases tolerability, with a concomitant reduction of side effects and a better compliance.

Interactions between your drugs

No interactions were found between flecainide and Tylenol. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

The peak flecainide plasma concentration is generally reached within 2-3 hours. Flecainide does not undergo any significant first-pass metabolism. In vitro, flecainide is approximately 40%-50% bound to plasma proteins.

Results: 10.5% of the patients had blurred vision on lateral gaze lasting for a couple of seconds.

The single dose oral loading regimen of flecainide appears to be effective for cardioversion of recent-onset atrial fibrillation with a relatively rapid effect within 2-4 h, and is free of serious complications in patients without structural heart disease.

Milk (including breastmilk and infant formula) may reduce the amount of flecainide absorbed from the stomach. Flecainide doses should be given at least 30 minutes either side of milk or milk feeds.

metoprolol flecainide

Using metoprolol together with flecainide may have additive effects. Contact your doctor if you experience dizziness, slow or irregular heartbeats, fainting, or palpitations. You may need a dose adjustment or special tests to safely use both medications.

Ways a person can try to stop an A-fib episode on their own include taking slow, deep breaths, or coughing. The ideal way for a person to stop an A-fib episode is to see a doctor for evaluation and treatment of their symptoms, including treatment of any underlying disorders.

How long can an 80 year old live with AFib? ›

What's the Outlook for Older Adults With AFib? Men between the ages 55-74 with AFib have a 61.5% death rate within 10 years of diagnosis. This is compared to a 30% rate in men who don't have the condition. Women of the same age with AFib had a 10-year death rate of 57.6% versus 20.9% in women without AFib.

With the right treatment and regular management, most people with persistent atrial fibrillation can live active, healthy lives. The longer persistent Afib goes without treatment, however, the harder it is to manage. It may become permanent or lead to severe complications such as blood clots or stroke.

Its prevalence in the general population increases steadily with advancing age, from 0.12–0.16% in people younger than 49 years to 3.7–4.2% in those aged 60–70 years. Beyond the age of 80 years, prevalence can be as high as 10–17% (6).

WEDNESDAY, March 8, 2023 (HealthDay News) -- A quicker, safer option for treating an irregular heartbeat called atrial fibrillation might be just months away. Atrial fibrillation is currently treated with drugs or a procedure known as thermal ablation.

drinking excessive amounts of alcohol, particularly binge drinking. being overweight (read about how to lose weight) drinking lots of caffeine, such as tea, coffee or energy drinks. taking illegal drugs, particularly amphetamines or cocaine.

The most recent guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) recommend DOACs as the best blood thinners for AFib in most people.

If you are prescribed flecainide, you may also have to take a beta block or calcium channel blocker. This is to protect the lower chambers of the heart (ventricles) from contracting too quickly.

What is the “pill-in-the-pocket” approach? The “pill-in-the-pocket” approach is the administration of a prescribed class IC antiarrhythmic, either flecainide or propafenone, following recent onset of episodes of palpitations in patients with paroxysmal AF.

It has been shown recently that the beta-blocker metoprolol controlled release/extended release (CR/XL) is also effective in maintaining sinus rhythm after conversion of atrial fibrillation.

Background: Flecainide loses its efficacy to cardiovert when AF has been present for more than 24 hours. Most probably, the loss is caused by atrial electrical remodeling. Studies suggest electrical remodeling is completely reversible within 4 days after restoration of sinus rhythm (SR).

Why does flecainide cause atrial flutter? ›

Atrial proarrhythmia has been described as the development of a persistent atrial arrhythmia that is either new or was previously paroxysmal. Flecainide slows conduction through the atrial tissue more than it prolongs refractoriness, which enables organized AF activity and promotes atrial flutter.

While patients who have elevated stroke risks may be able to manage symptoms of AFib — such as a racing heartbeat — with other medications or medical procedures, they will still need to take blood thinners to protect against stroke.

Exercise regularly

Exercise can improve overall cardiovascular health and help restore the heart's natural rhythm. It can also help reduce stress and anxiety. Cardiovascular exercise helps strengthen the heart, which can prevent or reduce palpitations.

Cocaine, methamphetamine, opioids, and cannabis may independently increase risk of atrial fibrillation (AFib), based on data from almost 24 million people.

Is there an alternative to flecainide? There are many other antiarrhythmic medications that treat the same conditions as flecainide, such as propafenone, sotalol, or amiodarone.

Eight deaths were reported during a mean follow-up of 3.4 ± 2.4 years. Compared to the general population, the standardized mortality ratios were 1.57 (95% confidence interval (CI) 0.68–3.09) for all-cause mortality and 4.16 (95% CI 1.53–9.06) for death from cardiovascular disease.

The Adrenaline Challenge Test is safe, however as with any procedure, there is potential risk that may occur during or after procedure. It is common to experience a sensation of an increased heart rate, that your heart feels like it is beating harder and to feel sweaty during this procedure.

Flecainide has a narrow therapeutic index (0.2-1.0 mcg/mL), which increases the potential for toxicity. Some patients may even experience symptoms of toxicity at lower serum levels (as low as 0.7 mcg/mL or higher) [4].

The typical adult starting dose is 50 mg to 100 mg by mouth twice a day, and the maximum recommended daily dose is 300 mg to 400 mg per day depending on the reason for use.

Of all antiarrhythmic agents, dofetilide and amiodarone have been proven safe in patients with heart failure.

What is the best drug to stop atrial fibrillation episodes? ›

Beta blockers are usually the first line for treatment of AF regardless of it being for a rhythm or rate control strategy. We may also use them in combination with other anti-arrhythmic drugs such as: calcium channel blockers (diltiazem/verapamil) amiodarone.

Ranolazine as an Alternative Therapy to Flecainide for SCN5A V411M Long QT Syndrome Type 3 Patients.

Flecainide is a well-tolerated medication, even at 12 months, with very minor adverse effects.

Flecainide is more effective and safer than other AADs for the acute conversion of patients in AF.

Liver injury due to flecainide is rare and usually mild. Cases of prolonged jaundice, but no reports of acute liver failure, chronic hepatitis or vanishing bile duct syndrome attributed to flecainide, have been published.