flecainide
Flecainide helps normalize your heart rhythm if you have certain types of arrhythmias (abnormal heart rhythms). However it can cause dizziness and changes in vision.
What is Flecainide?
What is Flecainide used for?
Prevention of paroxysmal supraventricular tachycardias (PSVT)
Prevention of paroxysmal atrial fibrillation/flutter (PAF)
Prevention of ventricular arrhythmias
How Flecainide works
Flecainide is an antiarrhythmic. It works by blocking sodium channels, which play a major part in your heart's electrical activity. When your heart is firing too quickly in an abnormal rhythm (arrhythmia), flecainide slows down the electricity to help your rhythm return to normal.
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What are the side effects of Flecainide?
Common Side Effects
- Dizziness (19%)
- Changes in vision, such as blurriness or trouble focusing (16%)
- Shortness of breath (10%)
- Headache (10%)
- Nausea (9%)
- Tiredness (8%)
- Palpitations (feeling that your heart is racing) (6%)
- Chest pain (5%)
- Weakness or lack of energy (5%)
- Tremor (5%)
- Constipation (4%)
- Swelling due to fluid buildup (4%)
- Abdominal pain (3%)
Other Side Effects
- Vomiting, diarrhea, or poor appetite
- Rash
- Double vision
- Tingling or numbness
- Flushed skin
- Sweating
- Sleepiness
- Ringing in the ears
- Anxiety
- Insomnia (trouble sleeping)
- Depression
Serious Side Effects
- New or worsened irregular heart rhythm, which can be too fast or too slow. Common symptoms include sudden chest pain or discomfort, palpitations or irregular pulse, dizziness or weakness, or unexplained fainting.
- Worsened heart failure symptoms
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Difficult or labored breathing
dizziness, fainting, or lightheadedness
fast, irregular, pounding, or racing heartbeat or pulse
shortness of breath
tightness in the chest
Less common
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
fainting
feeling of warmth
increased sweating
partial or slight paralysis
redness of the face, neck, arms, and occasionally, upper chest
shakiness and unsteady walk
shakiness in the legs, arms, hands, or feet
swelling of the feet or lower legs
trembling or shaking of the hands or feet
unsteadiness, trembling, or other problems with muscle control or coordination
Rare
Arm, back, or jaw pain
black, tarry stools
bleeding gums
blood in the urine or stools
blurred vision
chest discomfort
chest tightness or heaviness
chills
confusion
convulsions
decrease in the frequency of urination
decrease in urine volume
difficulty in passing urine (dribbling)
difficulty with breathing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
general feeling of discomfort or illness
headache
increased volume of pale, dilute urine
nervousness
noisy breathing
painful or difficult urination
pinpoint red spots on the skin
pounding in the ears
sensation of pins and needles
slow or fast heartbeat
sores, ulcers, or white spots on the lips or in the mouth
stabbing pain
sweating
swollen glands
thickening of bronchial secretions
troubled breathing
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Blurred vision or seeing spots
Less common
Abdominal or stomach pain
acid or sour stomach
anxiety or mental depression
belching
continuing ringing or buzzing or other unexplained noise in the ears
feeling of constant movement of self or surroundings
general feeling of discomfort or illness
hearing loss
indigestion
lack or loss of strength
loss of appetite
sensation of spinning
sleepiness or unusual drowsiness
skin rash
stomach discomfort, upset, or pain
trouble with sleeping
unable to sleep
Rare
Bloated
change in color vision
change in taste
cracks in the skin
decreased awareness or responsiveness
decreased interest in sexual intercourse
difficulty seeing at night
difficulty with moving
excess air or gas in the stomach or intestines
eye pain or irritation
false or unusual sense of well-being
feeling of unreality
full feeling
hair loss or thinning of the hair
hives or welts
inability to have or keep an erection
increased sensitivity of the eyes to sunlight
itching skin
joint pain
lack of feeling or emotion
loss in sexual ability, desire, drive, or performance
loss of heat from the body
loss of memory
muscle aching or cramping
muscle pain or stiffness
passing gas
problems with memory
red, swollen skin
sense of detachment from self or body
severe sleepiness
swollen joints
swollen lips, mouth, or tongue
uncaring uncontrolled eye movements
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Flecainide
Pros
Works good to treat certain types of irregular heart rhythms that could be life-threatening
Is available as a cheaper generic formulation
Cons
Not a preferred medication if you have heart failure or have had a recent heart attack
Can cause dizziness or changes in vision
Dosing needs to be adjusted if you have kidney or liver problems
Pharmacist tips for Flecainide
You can take flecainide with or without food.
It will typically take up to 5 days for you to see the full effect after starting flecainide or after each dose change.
You might feel lightheaded or dizzy when first starting on flecainide. Stand or sit up slowly while taking this medication.
If you have heart failure, let your provider know if you notice any worsening of heart failure symptoms such as fluid buildup in your legs or more shortness of breath when lying down.
Flecainide can interact with other medications. To avoid dangerous drug interactions, make sure that your providers know exactly what medications you take at home.
Frequently asked questions about Flecainide
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What are the risks and warnings for Flecainide?
Flecainide can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Greater risk of death after recent heart attack
The Cardiac Arrhythmia Suppression Trial (CAST) was a medical study that showed that it might be harmful to take flecainide to prevent abnormal heart rhythms after a recent heart attack. If you have had a heart attack recently, depending on your symptoms and EKG results, your heart specialist will decide which medication is best for you.
Proarrhythmic effects (new abnormal heart rhythms)
Risk factors: Chronic atrial fibrillation | Sustained ventricular arrhythmia
Antiarrhythmic medications like flecainide should always be used carefully because they can cause worse, life-threatening arrhythmias if used in the wrong scenario. If you have chronic atrial fibrillation, which is atrial fibrillation that is long-standing or doesn't go away on its own, you should avoid flecainide unless your heart specialist specifically recommends it. If you have a ventricular arrhythmia, your heart specialist will likely start you on flecainide in a hospital setting in order to monitor you more closely. Your provider will monitor your labs and EKG (test of your heart's electrical activity) on a regular basis to avoid serious problems. If you experience new arrhythmia symptoms like chest pain or discomfort, palpitations, dizziness, or unexplained fainting while taking flecainide, get medical help immediately.
Heart failure
Risk factors: Congestive heart failure (CHF) | Structural heart disease
People with heart failure should only take flecainide under the close supervision of a heart specialist because it can cause worsening symptoms of heart failure, such as buildup of fluid in the legs or lungs. When starting on flecainide, make sure that you continue to take all of your heart medications as prescribed. Your specialist may adjust your other doses depending on how flecainide affects your condition.
Delayed heart rhythm
Risk factors: Heart block | Sick sinus syndrome
In some rare cases, flecainide can slow down your heart too much and cause abnormally delayed heart rhythms. Your provider will monitor your labs and EKG (test of your heart's electrical activity) on a regular basis to make sure it doesn't become a serious problem. If you have a pacemaker, your provider will need to adjust your settings accordingly. If you notice a slow pulse, chest pain or discomfort, weakness, dizziness, or fainting while taking flecainide, get medical help right away.
Drug interactions
Flecainide can interact with many other medications, which can affect the blood levels of flecainide or other drugs such as digoxin. Taking flecainide with other medications can also cause worsening of symptoms of heart failure. To avoid dangerous drug interactions, make sure that your providers know exactly what medications you take.
Flecainide dosage forms
Typical dosing for Flecainide
The typical adult starting dose is 50 mg to 100 mg by mouth twice a day, and the maximum recommended daily dose is 300 mg to 400 mg per day depending on the reason for use.
Children have specialized dosing based on height and weight. Your child's heart specialist will decide the appropriate dose.
Interactions between Flecainide and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Cisapride
- Dronedarone
- Levomethadyl
- Mesoridazine
- Pimozide
- Piperaquine
- Ritonavir
- Saquinavir
- Sparfloxacin
- Terfenadine
- Thioridazine
- Tipranavir
- Vernakalant
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acecainide
- Ajmaline
- Alfuzosin
- Amiodarone
- Amisulpride
- Amitriptyline
- Amoxapine
- Anagrelide
- Apomorphine
- Aprindine
- Arbutamine
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Artemether
- Asenapine
- Astemizole
- Azimilide
- Azithromycin
- Bedaquiline
- Bendroflumethiazide
- Boceprevir
- Bretylium
- Buprenorphine
- Bupropion
- Buserelin
- Ceritinib
- Chloral Hydrate
- Chloroquine
- Chlorothiazide
- Chlorpromazine
- Chlorthalidone
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Cobicistat
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Darifenacin
- Dasabuvir
- Dasatinib
- Degarelix
- Delamanid
- Delavirdine
- Desipramine
- Deslorelin
- Deutetrabenazine
- Dibenzepin
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Droperidol
- Duloxetine
- Efavirenz
- Encorafenib
- Enflurane
- Entrectinib
- Erythromycin
- Escitalopram
- Etravirine
- Fingolimod
- Fluconazole
- Fluoxetine
- Formoterol
- Foscarnet
- Fostemsavir
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Halothane
- Histrelin
- Hydrochlorothiazide
- Hydroflumethiazide
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Inotuzumab Ozogamicin
- Isoflurane
- Isradipine
- Ivabradine
- Ivosidenib
- Ketoconazole
- Lacosamide
- Lapatinib
- Lefamulin
- Lenvatinib
- Levofloxacin
- Lidocaine
- Lidoflazine
- Lofexidine
- Lorcainide
- Lumefantrine
- Macimorelin
- Mefloquine
- Methadone
- Metolazone
- Metronidazole
- Mifepristone
- Mirtazapine
- Moxifloxacin
- Nafarelin
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Ombitasvir
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Ozanimod
- Paliperidone
- Panobinostat
- Paritaprevir
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2b
- Pentamidine
- Pimavanserin
- Pirmenol
- Pitolisant
- Polythiazide
- Ponesimod
- Posaconazole
- Prajmaline
- Prilocaine
- Probucol
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Ranolazine
- Ribociclib
- Risperidone
- Selpercatinib
- Sematilide
- Sertindole
- Sertraline
- Sevoflurane
- Simeprevir
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sorafenib
- Sotalol
- Spiramycin
- Sulfamethoxazole
- Sulpiride
- Sultopride
- Sunitinib
- Tacrolimus
- Tedisamil
- Telaprevir
- Telavancin
- Telithromycin
- Tetrabenazine
- Toremifene
- Trazodone
- Trichlormethiazide
- Triclabendazole
- Trifluoperazine
- Trimethoprim
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Vinflunine
- Voclosporin
- Voriconazole
- Zolmitriptan
- Zotepine
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Flecainide cost?
What are alternatives to Flecainide?
Prevention of paroxysmal supraventricular tachycardias (PSVT)
Prevention of paroxysmal atrial fibrillation/flutter (PAF)
Prevention of ventricular arrhythmias
High blood pressure
Chest pain (angina)
Lower the risk of hospitalization and death in heart failure
New chest pain
Long-term chest pain
Flecainide images
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