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What is this medication?

Antiarrhythmic Agent, Class Ic

Flecainide is indicated for the treatment of Paroxysmal Atrial Fibrillation/Flutter and Paroxysmal Supraventricular Tachycardia, Ventricular Arrhythmias.

An excessive mortality or nonfatal cardiac arrest rate was seen in patients treated with flecainide compared with that seen in patients assigned to a carefully matched placebo-treated group. It is prudent to consider the risks of Class ΙC agents (including flecainide), coupled with the lack of any evidence of improved survival, generally unacceptable in patients without life-threatening ventricular arrhythmias, even if the patients are experiencing unpleasant, but not life-threatening, symptoms or signs.

Ventricular Proarrhythmic Effects in Patients with Atrial Fibrillation/Flutter
A review of the world literature revealed reports of 568 patients treated with oral flecainide for paroxysmal atrial fibrillation/flutter (PAF). Ventricular tachycardia was experienced in 0.4% of these patients. Of 19 patients in the literature with chronic atrial fibrillation (CAF), 10.5% experienced ventricular tachycardia (VT) or ventricular fibrillation (VF). Flecainide is not recommended for use in patients with CAF. Case reports of ventricular proarrhythmic effects in patients treated with flecainide for atrial fibrillation/flutter have included increased premature ventricular contractions (PVCs), VT, VF, and death.  As with other Class Ι agents, patients treated with flecainide for atrial flutter have been reported with 1:1 atrioventricular conduction due to slowing the atrial rate. A paradoxical increase in the ventricular rate also may occur in patients with atrial fibrillation who receive flecainide.

How does this medication work? 

Flecainide is a Class Ic antiarrhythmic which slows down conduction in cardiac tissue by altering transport of ions across cell membranes; causing slight prolongation of refractory periods; decrease in the rate of rise of the action potential without affecting its duration; increase in electrical stimulation threshold of ventricle while have a moderately negative inotropic effect.

How should I take this medication? 

Oral: Take 50mg to 200mg twice daily.

How to Take: When used for the management of fetal tachycardia, oral doses of Flecainide should be given to the fetus can receive through the maternal/transplacental route.

What should I watch for while using this medication? 

Before starting Flecainide make sure your physician is aware of any allergies or medications you currently take.  The proarrhythmic effects of Flecainide include an increase in premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, and death in patients with atrial fibrillation.  Flecainide is not recommended for patients with chronic atrial fibrillation. Flecainide can cause electrolyte disturbances (i.e. hypokalemia, hypomagnesemia), hepatic and renal impairment.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Dizziness, visual disturbances, dyspnea, palpitations, chest pain, edema, tachycardia, proarrhythmic, sinus node dysfunction, syncope, headache, fatigue, nervousness, fever, hypoesthesia, paresis, ataxia, vertigo, tinnitus, anxiety, insomnia, depression, rash, nausea, constipation, abdominal pain, anorexia, diarrhea, tremor, weakness, paresthesia, blurred vision, diplopia. 

Note this is not a complete list of side effects for Flecainide, only common ones.