Flecainide is an antiarrhythmic agent prescribed for arrhythmia.

Generic Tambocor




Almus, Torrent Pharma, Actavis


100 mg




Historical Development of Flecainide

Flecainide was initially developed to create medications that could effectively manage arrhythmias. Its introduction brought forth a groundbreaking solution, leading to a notable shift in the field of cardiology and serving as a remarkable achievement in the realm of pharmaceuticals.

Classification and Role in Cardiac Arrhythmias

Flecainide falls under the category of Class IC drugs. These drugs impact the sodium channels in the heart muscle and have proven effective in managing irregular heart rhythms. The primary function of Flecainide is to prevent sodium entry into the cardiac cells, which helps stabilize their membranes.

Uses of Flecainide

Atrial Fibrillation and Atrial Flutter Management

Fibrillation and atrial flutter are two types of heart rhythm disorders that can be quite challenging for healthcare professionals. Flecainide, a medication known for its ability to treat arrhythmias, has several beneficial effects including restoring normal heart rhythm, decreasing the frequency and severity of episodes, and ultimately improving the overall quality of life for those affected by these conditions 12.

Here are some references that you can use for further reading:

1“Flecainide How and When: A Practical Guide in Supraventricular Arrhythmias” 2“Flecainide Considerations for Use - American College of Cardiology”

Ventricular Tachycardia Treatment

Ventricular tachycardia, a heart rhythm that starts in the lower chambers of the heart, requires immediate medical intervention. Although not typically used as a first choice treatment, Flecainide has proven effective in treating cases that do not respond to therapies.

Prevention of Paroxysmal Supraventricular Tachycardia

Paroxysmal supraventricular tachycardia (PSVT) is a condition characterized by intermittent rapid heart rates that originate above the heart's ventricles. Flecainide is known for its ability to prevent and reduce the frequency and severity of episodes of PSVT.

How Flecainide Works

Mechanism of Action: Sodium Channel Blockage

Flecainide works by slowing down the entry of sodium during the initial phase of the cardiac action potential. This helps to reduce the excitability and speed at which electrical signals are conducted in cells.

Effects on Cardiac Action Potentials

Flecainides impact goes beyond influencing cardiac action potentials. It actually prolongs the duration of the hearts activity, which in turn strengthens its ability to recover between beats. This complex process ultimately leads to a reduced risk of heart rhythms.

Duration of Action and Half-Life

Flecainide has a duration of action usually lasting, between 12 to 24 hours. Its pharmacokinetics show a half life of about 12 hours though this may vary depending on a persons metabolism and other medical conditions they may have.

Off-label Uses of Flecainide

Potential Uses in Non-cardiac Conditions

Although Flecainide is mostly praised for its effectiveness in treating heart-related issues, recent data suggests that it may also hold promise in addressing cardiac conditions. This includes neurological disorders that exhibit similarities in neuronal excitability to the cardiac environment 12.

Here are some references that you can use for further reading:

1“Isaacs Syndrome - Neurologic Disorders - MSD Manual Professional Edition” 2“Successful treatment of frequent premature ventricular contractions and non-sustained ventricular tachycardia with verapamil and flecainide in RYR1-related myopathy: a case report | European Heart Journal - Case Reports | Oxford Academic”

Research and Studies Supporting Off-label Applications

Scientists have been curious about the uses of Flecainide outside of its approved applications, in cardiology. Initial studies although in early stages show promising results and suggest that Flecainide could have various uses beyond the field of cardiology.

Dosage and Administration

Standard Dosing Recommendations

The usual starting dose for adults is 50mg taken every 12 hours. The dosage can be adjusted based on how it works and how well the patient tolerates it. However it's important to customize the treatment plan, for each patient taking into account their clinical condition.

Adjustments for Renal or Liver Impairment

For people with impaired kidney or liver function it is important to make adjustments to the dosage. Due, to the complexities of how the body processes and eliminates drugs these patients should be closely monitored to prevent the build up of medication and potential harm.

Instructions for Missed Doses and Discontinuation

If you happen to miss a dose it is recommended that you take it soon as you remember unless it is close to the time, for your next scheduled dose. It is not recommended to stop taking the medication without medical advice as this could lead to rebound arrhythmias and worsening of symptoms.


Active Ingredient Profile

Flecainide acetate is the component that gives the drug its well known antiarrhythmic properties.

Inactive Ingredients and Their Roles

Besides its component Flecainide contains various additional substances. Although these ingredients do not have any effects they play important roles in improving the drugs stability how well it is absorbed by the body and its taste.

Common Side Effects

Gastrointestinal Disturbances

Common gastrointestinal disturbances often include the following symptoms; 1. Feeling nauseous or experiencing queasiness. 2. Discomfort in the region. 3. Difficulties, with bowel movements, commonly known as constipation.

Neurological Symptoms: Dizziness and Headaches

Patients frequently mention experiencing bouts of dizziness or slight headaches, which are believed to be caused by the effects of Flecainide, on the central nervous system.

Visual Disturbances

Sometimes people may occasionally have blurry vision or perceive things differently which might require a reassessment of whether the medication is suitable.

Less Common and Serious Side Effects

Potential Cardiovascular Risks: Worsening Arrhythmias

Interestingly even though the main intention of Flecainide is to treat arrhythmias it can sometimes inadvertently. Worsen certain types of abnormal heart rhythms. Therefore it is crucial to monitor patients taking this medication.

Effects on Blood Count: Neutropenia and Thrombocytopenia

Although it doesn't happen often Flecainide can potentially affect the function of the bone marrow causing a decrease, in neutrophils or platelets. This would require monitoring of blood counts.

Liver Function Alterations

Some patients may show changes in liver enzymes, which could indicate that their liver is, under stress. It is important to evaluate their liver function.

Interactions with Other Medications

Risk with Beta-blockers and Other Antiarrhythmics

Taking Flecainide together with beta blockers or other antiarrhythmics may increase the chances of cardiac events. This combined effect can enhance heart rhythms or lead to problems, with blood circulation.

Potential Changes in Blood Levels with Certain Antifungals

Some antifungal medications when taken together with Flecainide can affect the levels of Flecainide, in the bloodstream. This interaction can. Enhance its desired therapeutic effects or worsen its side effects.

Adjustments Needed with Anticoagulants

Flecainide can potentially affect the way anticoagulants are metabolized which may require adjustments in their dosage. It is important to monitor blood clotting, in these situations to prevent the occurrence of blood clots or excessive bleeding.

Warnings and Important Precautions

Pre-existing Heart Conditions: Risks and Recommendations

Patients who have standing heart conditions may have a higher susceptibility to Flecainide. It is crucial to conduct an examination of their cardiac health and carefully weigh the potential benefits, against the risks before initiating any treatment.

Monitoring Needs: Electrocardiogram and Blood Tests

Regular monitoring is crucial. By using surveillance we can detect any abnormal heart rhythms or changes in the QT interval. Blood tests help us assess the impact of Flecainide on aspects such, as blood count, kidney function and liver health allowing for a comprehensive evaluation.

Situations Requiring Immediate Medical Attention

Situations such as a decrease in heart rate sudden fainting spells or the occurrence of chest discomfort, after starting Flecainide should be promptly addressed by medical professionals. These events highlight the importance of addressing any issues related to the medication.


Patients with Specific Cardiac Conditions

Flecainide should not be used by people who have heart conditions such, as structural heart diseases, a previous heart attack or severe and unresponsive heart failure because it increases the chances of experiencing dangerous irregular heart rhythms.

Known Allergies to Flecainide or Constituents

Patients who have a known sensitivity, to Flecainide or any of its ingredients should avoid using it to prevent the occurrence of allergic reactions.

Careful Administration and Special Considerations

Flecainide and Chronic Kidney Disease

Patients who have insufficiencies may experience difficulties, in excreting Flecainide, which could require adjusting the dosage and closely monitoring to prevent potential toxicity.

Management in Patients with Liver Dysfunction

Due to the fact that the liver's primarily responsible for metabolizing Flecainide any issues with liver function can have an impact on how this medication is processed and how it affects the body. Therefore personalized treatment approaches may be necessary to account for variations, in pharmacokinetics and pharmacodynamics.

Administration to Specific Populations

Elderly Patients

Dosage Adjustments and Monitoring Requirements; When it comes to the population lower dosages may be necessary due to the natural decline in organ functions. Increased monitoring is important to ensure that the medication is effective while minimizing any adverse effects. Possibly Heightened Sensitivity; Older individuals may experience a heightened sensitivity to Flecainide both in terms of its benefits and any potential side effects. This emphasizes the need, for adjustment of the dosage.

Pregnant Women and Nursing Mothers

There is not information available regarding the safety of Flecainide during pregnancy. While animal studies have not definitively shown any effects on fetal development it is advised to use this medication only if absolutely necessary. As for breastfeeding Flecainide does pass into breast milk. In very small quantities. It is crucial to consider the benefits to the mother and any potential risks, to the infant before making a decision.


Pediatric Dosage and Safety; Children have a response, to medications compared to adults. Although Flecainide has been used in patients it is crucial to carefully determine the dosage based on their weight and closely monitor their progress. When dealing with adolescents who are transitioning from pediatric to adult physiology it may be necessary to adjust the dosage and keep a watch to ensure that the treatment remains effective.


Symptoms of Flecainide Overdose

Taking an amount of Flecainide can result in feelings of lightheadedness problems with vision, instability in the cardiovascular system and even seizures. If any of these symptoms occur suddenly it is important to seek medical attention, for evaluation.

Immediate Management and Interventions

In case of an overdose it is essential to take actions such, as performing gastric lavage administering activated charcoal and providing symptomatic treatment in a hospital setting.

Long-term Monitoring and Prognosis

After the treatment patients may need ongoing cardiac monitoring, with particular attention, to their heart rhythm and rate in order to prevent any potential long term effects of the overdose.

Storage Guidelines

Store flecainide, at room temperature making sure to protect it from moisture and light to maintain its pharmacological effectiveness.

Shelf Life and Stability Considerations

It's really important to follow the expiration date indicated on the medicines label. Once it has expired the medication may lose its effectiveness or worse could potentially become harmful.

Handling Precautions to Ensure Potency

To minimize handling it is advisable to utilize the original container and ensure that it is securely closed after use. This practice can effectively reduce the risk of contamination or loss of potency.

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