Flecainide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sheng Shi, M.D. [2]
For patient information about Flecainide, click here.
Synonyms / Brand Names: FLECAINIDE ACETATE®
Overview
Category
Antiarrhythmic agents;Piperidines;Benzamides;Phenol ethers;Organofluorides;Sodium channel blockers;Cardiovascular Drugs
FDA Package Insert
FLECAINIDE ACETATE tablet
Indications and Usage | Dosage and Administration | Dosage Forms and Strengths | Contraindications | Warnings and Precautions | Adverse Reactions | Drug Interactions | Use in Specific Populations | Overdosage | Description | Clinical Pharmacology | Nonclinical Toxicology | Clinical Studies | How Supplied/Storage and Handling | Patient Counseling Information | Labels and Packages
Mechanism of Action
Flecainide works by blocking the Nav1.5 sodium channel in the heart, causing prolongation of the cardiac action potential.[1] This thereby slows conduction of the electrical impulse within the heart. The greatest effect is on the His-Purkinje system and ventricular myocardium. The effect of flecainide on the ventricular myocardium causes decreased contractility of the muscle, which leads to a decrease in the ejection fraction.
The effect of flecainide on the sodium channels of the heart increases as the heart rate increases.[2] This is known as use-dependence. This means that flecainide is potentially more useful to break a tachyarrhythmia (because it has increased effect during the fast heart rate) than to prevent a bradyarrhythmia from occurring (because of its lowered effectiveness during slower heart rates).
Interaction with Alcohl
Concomitant overdose of other drugs and/or alcohol in many instances undoubtedly contributed to the fatal outcome.
References
- ↑ Ramos E, O'leary M (2004). "State-dependent trapping of flecainide in the cardiac sodium channel". J Physiol. 560 (Pt 1): 37–49. doi:10.1113/jphysiol.2004.065003. PMC 1665201. PMID 15272045.
- ↑ Wang Z, Fermini B, Nattel S (1993). "Mechanism of flecainide's rate-dependent actions on action potential duration in canine atrial tissue". J Pharmacol Exp Ther. 267 (2): 575–81. PMID 8246130.