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Flecainide Acetate
Flecainide Acetate is an antiarrhythmic medication used to treat certain types of serious irregular heartbeats (arrhythmias), such as paroxysmal supraventricular tachycardia (PSVT), paroxysmal atrial fibrillation/flutter, and ventricular arrhythmias. It works by stabilizing the electrical activity in the heart, helping to maintain a normal heart rhythm. Flecainide is typically prescribed when other treatments have not been effective.
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Frequently Asked Questions
How long does it take for Flecainide to start working?
Flecainide can start controlling arrhythmias within a few hours of taking the first dose. However, it may take a few days for full therapeutic effects.
Can I stop taking Flecainide if I feel better?
No, you should not stop taking Flecainide without consulting your healthcare provider, as stopping the medication suddenly may worsen your heart rhythm.
What should I do if I miss a dose of Flecainide?
If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not double the dose to make up for a missed one.
Can Flecainide cause vision problems?
Yes, Flecainide can cause blurred vision or seeing spots, which are common side effects. If you experience severe or persistent visual disturbances, contact your healthcare provider.
Is Flecainide safe for long-term use?
Yes, Flecainide can be used long-term to manage arrhythmias, but regular monitoring, including ECG checks, is necessary to ensure the medication remains effective and safe.
Comprehensive Drug Guide
How Does Flecainide Acetate Work?
Flecainide works by blocking sodium channels in the heart cells, which slows down the electrical impulses that can cause an irregular heartbeat. By stabilizing the heart's electrical system, it helps restore and maintain a normal rhythm. Flecainide affects both atria and ventricles, making it effective in treating various types of arrhythmias.
Common Dosages
The typical dosage of Flecainide Acetate depends on the condition being treated:
- For supraventricular arrhythmias: The usual starting dose is 50 mg to 100 mg twice daily.
- For ventricular arrhythmias: The typical starting dose is 100 mg twice daily, with adjustments based on the patient's response and tolerability.
Typical Dosing
- For paroxysmal atrial fibrillation/flutter: Start with 50 mg to 100 mg twice daily. The dose may be increased up to 150 mg twice daily if needed, depending on the patient's response and tolerability.
- For life-threatening ventricular arrhythmias: The dose is typically 100 mg twice daily, with the option to adjust based on therapeutic response. The maximum recommended dose is 400 mg per day.
Typical Dosing
FDA Approved Indications
- Paroxysmal atrial fibrillation and atrial flutter in patients without structural heart disease.
- Ventricular tachycardia (a potentially life-threatening irregular heartbeat) in patients with life-threatening ventricular arrhythmias.
- Paroxysmal supraventricular tachycardia (PSVT), including Wolff-Parkinson-White syndrome.
Who Shouldn't Take Flecainide Acetate?
- Known hypersensitivity to flecainide or any components of the formulation.
- Structural heart disease, such as a history of heart attack, heart failure, or significant left ventricular dysfunction, due to an increased risk of pro-arrhythmia (worsening arrhythmias).
- AV block without a pacemaker, unless the patient has a functioning pacemaker.
- Cardiogenic shock or recent myocardial infarction.
Advice From The Pharmacist
- Take Flecainide exactly as prescribed, typically twice a day, with or without food. It’s important to take it at the same times every day.
- Do not stop taking Flecainide suddenly without consulting your doctor, as this can lead to a worsening of your arrhythmia.
- Regular monitoring is required while on Flecainide, including ECG checks to ensure the medication is working effectively and not causing harmful side effects like new arrhythmias.
- Avoid using other medications that can affect heart rhythm, including some over-the-counter cold and cough medications, without discussing with your healthcare provider.
Side Effects of Flecainide Acetate
Common Side Effects
- Dizziness
- Visual disturbances (blurred vision, seeing spots)
- Nausea
- Fatigue
- Headache
Uncommon/Severe Side Effects
- New or worsened arrhythmias (pro-arrhythmic effects), which can be life-threatening.
- Shortness of breath, swelling in the ankles or feet, or weight gain (signs of heart failure).
- Chest pain, severe dizziness, or fainting.
- Liver problems (yellowing of the skin or eyes, dark urine).
Risks and Warnings of Flecainide Acetate
- Pro-arrhythmic Effects: Flecainide can cause new or worsened arrhythmias, especially in patients with structural heart disease. It should be used cautiously and only in patients without significant structural heart issues.
- Heart Failure: Flecainide can cause worsening of heart failure symptoms, including shortness of breath, edema, and weight gain. Patients with a history of heart failure or left ventricular dysfunction should be closely monitored.
- Use in Elderly Patients: Older adults may be more susceptible to side effects, especially pro-arrhythmic effects and dizziness.
Interactions with Flecainide Acetate
Common Drug Interactions
- Beta-blockers: May enhance the effect of Flecainide on slowing heart rate, increasing the risk of bradycardia (slow heart rate).
- Calcium channel blockers: When combined with Flecainide, they can increase the risk of arrhythmias.
- CYP2D6 inhibitors (e.g., amiodarone, fluoxetine): These can increase flecainide levels in the blood, raising the risk of toxicity and side effects.
- Digoxin: Flecainide can increase blood levels of digoxin, potentially leading to digoxin toxicity.
Alternatives to Flecainide Acetate
- Amiodarone: A commonly used antiarrhythmic for managing atrial and ventricular arrhythmias, particularly in patients with structural heart disease.
- Sotalol: Another antiarrhythmic used for treating atrial fibrillation and ventricular arrhythmias.
- Dofetilide: Used to treat atrial fibrillation and flutter.
- Propafenone: A Class Ic antiarrhythmic similar to Flecainide, used for atrial and ventricular arrhythmias.
