Drug reference
Supraventricular arrhythmias (initiated under direction of hospital consultant) ▶BY MOUTH ▶Adult: Initially 50 mg twice daily, increased if necessary up to 300 mg daily Ventricular arrhythmias (initiated under direction of hospital consultant) ▶BY MOUTH ▶Adult: Initially 100 mg twice daily for 3–5 days, maximum 400 mg daily reserved for rapid control or in heavily built patients; for maintenance, reduce to the lowest dose that controls the arrhythmia
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DUE TO INTERACTIONS ▶Manufacturer advises reduce dose by half with concurrent use of amiodarone.
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Abnormal left ventricular function. atrial conduction defects (unless pacing rescue available). bundle branch block (unless pacing rescue available). distal block (unless pacing rescue available). haemodynamically significant valvular heart disease. heart failure. history of myocardial infarction and either asymptomatic ventricular ectopics or asymptomatic non- sustained ventricular tachycardia. long-standing atrial fibrillation where conversion to sinus rhythm not attempted. second-degree or greater AV block (unless pacing rescue available). sinus node dysfunction (unless pacing rescue available)
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Atrial fibrillation following heart surgery. elderly (accumulation may occur). patients with pacemakers (especially those who may be pacemaker dependent because stimulation threshold may rise appreciably)
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→Appendix 1: antiarrhythmics
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▶Common or very common Arrhythmias. asthenia. dizziness . dyspnoea. fever. oedema. vision disorders ▶Uncommon Alopecia. appetite decreased. constipation. diarrhoea. flatulence. gastrointestinal discomfort. nausea . skin reactions. vomiting ▶Rare or very rare Anxiety. confusion. corneal deposits. depression. drowsiness. flushing. hallucination. headache. hepatic disorders. hyperhidrosis. inflammation . insomnia. memory loss. movement disorders. peripheral neuropathy. photosensitivity reaction. respiratory disorders. seizure. sensation abnormal. syncope. tinnitus . tremor. vertigo ▶Frequency not known Altered pacing threshold. atrioventricular block. cardiac arrest. chest pain. heart failure. hypotension. palpitations. QT interval prolongation
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Used in pregnancy to treat maternal and fetal arrhythmias in specialist centres; toxicity reported in animal studies; infant hyperbilirubinaemia also reported.
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Significant amount present in milk but not known to be harmful.
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Dose adjustments Avoid or reduce dose in severe impairment.
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Dose adjustments Reduce initial oral dose to max. 100 mg daily if eGFR less than 35 mL/minute/1.73 m2.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Tablet ▶Flecainide acetate (Non-proprietary) Flecainide acetate 50 mg Flecainide 50mg tablets | 60 tablet P £7.68 DT = £4.20 Flecainide acetate 100 mg Flecainide 100mg tablets | 60 tablet P £8.06 DT = £4.07 ▶Tambocor (Teva UK Ltd) Flecainide acetate 50 mg Tambocor 50mg tablets | 60 tablet P £11.57 DT = £4.20
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Initially 50 mg twice daily, increased if necessary
First-line fragment. Read the complete Indications and Dose section above.
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Initially 100 mg twice daily for 3–5 days,
First-line fragment. Read the complete Indications and Dose section above.
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