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