Flecainide
Class Ic
| IV Dose | No IV form |
| Oral dose | 50-200 mg/m2/day divided q 12 hours Maximum 400 mg/day. Or 6.7-9.5 mg/kg/d divided tid in Japanese study Acta Paediatr Jpn 1994 Feb;36(1):44-8 Improved efficacy with TID dosage in young children and patients with toxicity. Increase in 50 mg/m2 increments every 4 days Decrease by 50% when used with amiodarone. |
| Levels | Therapeutic effects at 0.200-1.000 ug/ml. Increased proarrhythmia and toxicity at > 1.0 ug/ml. |
| Kinetics | Elimination half-life 7-19 hours (mean 13). in adults, and 7-12 hours (mean 8.7) in children aged 1 month to 13 years. Reduced clearance in congestive heart failure. Peak levels at 2-3 hours after oral dose. |
| Cautions | Proarrhythmic effect worst in poor LV function. Significant negative inotropic effect. |
| Interactions | Amiodarone increases levels by 100%. Additive negative inotropic effect when used with propranolol, verapamil, or disopyramide. Increases digoxin levels 24% average. |
| Preparations | Tambocor scored tablets: 50, 100 mg. |
| FDA approval in children | no |