Flecainide

Chemical

Amide local anaesthetic

Class IC antiarrhythmic

Use

Tx SVT – especially re-entry dysrhythmias (i.e. WPW) as obstructs conduction in accessory pathways

Presentation

50/100mg tablets

10mg/mL solution

Dose

PO: 100 – 200mg BD

Bolus: 2mg/kg

Infusion: 1.5mg/kg/hr

Route

PO/IV

MoA

Potent Na+ channel blocker with slow unblocking kinetics

  • ↓rate of depol Ph 4
  • Slows conduction esp. in His-Purkinje & accessory pathways
  • Marked suppression of ventricular ectopic foci
  • No effect on duration of AP

ECG: ↑PR, ↑QRS

PD

CVS: negative inotropy potential *↑pacing threshold → caution with PPM

CNS: visual disturbance

PK

A

Rapid & complete

90% OBA

D

35 – 60% PPB

VD 6 – 10L/kg

M

Liver metabolites → urine

E

t ½ B 20hrs

10% excreted unchanged

Adverse Effects

  • Reversible liver damage
  • Dizziness
  • Paraesthesia
  • Headache
  • Nausea

*** ↑incidence of sudden death if used to treat ventricular arrythmias after AMI