• Heart Disease

Flecainide: Uses, Side Effects, and Precautions

Medically reviewed and edited by Heather Hanono, FNP

Treating and managing heart arrhythmias can often be challenging.

Not only is it difficult to know which treatment option will be most effective, but it’s also crucial to choose medication that doesn’t increase your risk of future health complications.

This is where drugs like flecainide have become popular as a primary treatment for various arrhythmias.

Flecainide is effective in managing these conditions while carrying a lower risk of severe side effects and long-term complications than other similar medications.

In this article, we’ll take a closer look at how flecainide works, the potential adverse reactions you can expect, and what to do to ensure you use this medication safely.

What is Flecainide and What Does it Treat?

Flecainide is a sodium-channel blocker that helps treat arrhythmic conditions that cause irregular heartbeats. It’s most commonly prescribed for individuals with chronic atrial fibrillation or atrial flutter.

This prescription drug works by blocking sodium channels in the heart muscle cells that cause the heart to beat too quickly or irregularly.

Over time, this slows down overactive electrical signals in the heart and allows flecainide to stabilize its rhythm. By helping the heart beat normally, flecainide can prevent life-threatening cardiac events.

How Should Flecainide Be Administered?

This drug is available in various forms, including tablets and extended-release capsules. It’s typically administered orally and should be taken with a glass of water.

When taking flecainide, do not chew, cut, or crush the tablets. They should be swallowed whole to retain the medication’s stability and efficacy and to ensure proper absorption.

Flecainide is typically taken with meals to reduce the risk of an upset stomach.

What is the recommended flecainide dosage?

The recommended dosage of flecainide may vary depending on the condition being treated, a person’s response to the drug, and any underlying medical issues.

Your doctor will determine the appropriate dose to help you treat your condition while minimizing the risk of adverse reactions.

Flecainide is usually administered with an initial dose of 50 to a maximum dose of 100 milligrams, taken every 12 hours. This dosage can be gradually increased based on how you respond to the drug.

Your doctor will adjust your dosage as required.

Does Flecainide Cause Any Side Effects?

Flecainide is known to cause a number of side effects ranging from mild to severe. The mild reactions are most common and may include:

• Headache

• Nausea

• Fatigue or weakness

• Dizziness

• Vision problems

• Breathing difficulties

Although these side effects are usually mild, they can still have a significant impact on your daily life.

It’s important to monitor any adverse reactions and to seek medical attention if they don’t go away after a few days.

In some cases, flecainide can also cause serious side effects that can be life-threatening if left untreated. These include:

• Fast, pounding, or irregular heartbeat

• Chest pain

• Sudden dizziness, like when you might pass out

• Fluttering in your chest

• Shortness of breath

• Slow heart rate

• Weak pulse

• Swollen limbs

• Rapid weight gain

• Jaundice (yellowing of the skin or eyes)

• Fever

• Flu-like symptoms

• Pale skin

• Unusual bruising or bleeding

• Signs of an allergic reaction (hives and swelling of the face, lips, tongue, and throat)

If you experience any severe side effects while using flecainide, seek emergency medical attention right away.

These reactions may indicate that your body isn’t responding well to flecainide, and your doctor may need to reevaluate your treatment regime.

Important Considerations and Precautions

Drug interactions

Flecainide has the potential to interact with several other drugs that can cause adverse reactions or reduce the efficacy of the medication. Notable interactions include:

• Other antiarrhythmic medications: Using flecainide with other antiarrhythmic medications puts you at an increased risk of developing adverse reactions and cardiac toxicity. Close monitoring and dose adjustments may be necessary when combining flecainide with other antiarrhythmic drugs.

• CYP2D6 inhibitors: Medications that inhibit the CYP2D6 enzyme — such as certain antidepressants and antipsychotics — may increase the concentration of flecainide in the body. This can worsen adverse effects and may make both drugs less effective.

• Cimetidine and ranitidine: These medications can slow the body’s natural waste removal process, potentially leading to a buildup of flecainide. This may increase your risk of developing potentially life-threatening side effects.

This is not an exhaustive list, and there are many other medications that flecainide can interact with.

If you are taking any other medications, remember to mention these to your doctor before you start using flecainide.

This helps your doctor to determine how the drugs will interact and to evaluate the potential risks involved with using these medications together.

People who should avoid flecainide

While flecainide is effective in managing cardiac arrhythmias, it’s not suitable for certain groups of people. These include:

• People with severe structural heart disease

• People with a known hypersensitivity to flecainide

• Individuals with preexisting heart blocks

• People with kidney or liver issues

• Individuals with pacemakers

• Pregnant or breastfeeding women

• Children younger than 18

If you fall into any of these groups, your doctor will not recommend this treatment for you.

In many cases, using flecainide alongside these conditions can cause potentially fatal complications such as a heart attack or sudden cardiac death.

Discontinuing use

There are several reasons why you might have to consider stopping the use of flecainide to treat your condition. This may include:

• Developing severe adverse effects: If you experience intolerable side effects from taking flecainide, your doctor may consider discontinuing the medication. Common adverse effects include dizziness, visual disturbances, and gastrointestinal issues. Any signs of serious allergic reactions or significant changes in overall health will require immediate medical attention and may lead to the discontinuation of the drug.

• Worsening cardiac condition: In some cases, flecainide may not effectively control cardiac arrhythmias, and the condition may worsen. If your arrhythmia persists or worsens, your doctor will reevaluate your treatment plan and consider alternatives.

• Negative drug interactions: Flecainide can interact with various medications, potentially leading to adverse effects or reduced efficacy of either drug. If you are currently taking medications that have significant interactions with flecainide, your doctor may discontinue this medication.

• Developing severe contraindications: If you develop new medical conditions or experience changes in your health that contraindicate the use of flecainide, your doctor may stop prescribing the medication. Conditions such as severe heart failure, certain types of heart block, or specific structural abnormalities may require you to stop using Flecainide.

• Patient noncompliance: In cases where a patient is unable or unwilling to adhere to the prescribed treatment regimen, discontinuing flecainide may be necessary. Noncompliance can significantly impact the effectiveness of the medication and may compromise an individual’s overall health and well-being.

• Pregnancy or breastfeeding: Flecainide can negatively affect your pregnancy and may pass into breast milk, potentially harming the baby. In these cases, your doctor may decide to discontinue the medication and recommend safer treatment options.

If you do stop using flecainide, it’s important to avoid abrupt discontinuation without consulting your doctor first.

Immediately discontinuing flecainide may cause rebound arrhythmia, which can result in more severe health issues in the future.

Your doctor can help you avoid this by recommending a structured discontinuation plan.

Are There Any Alternatives for Flecainide?

Several alternatives to flecainide may also be suitable for treating and managing cardiac arrhythmias. These options include:

Beta blockers: Beta blockers are often used as an alternative or in combination with flecainide to manage certain types of arrhythmias. They work by blocking the effects of adrenaline on the heart, helping to restore a balanced rhythm to the muscle.

Calcium channel blockers: Certain calcium channel blockers — such as verapamil or diltiazem — may be used to manage various arrhythmias. They work by blocking calcium channels in the heart and blood vessels, which reduces the heart rate and improves its rhythm.

Amiodarone: Amiodarone is another antiarrhythmic medication that is often used as an alternative to flecainide, especially when other medications have not been effective. This drug can be used to manage various types of arrhythmias, but it is associated with severe potential side effects, so it’s only used as a last resort.

Sotalol: Sotalol is a nonselective beta-blocker with antiarrhythmic properties. It’s commonly used for atrial and ventricular arrhythmias and may be recommended as an alternative to flecainide.

Should You See a Doctor about Using Flecainide?

It’s essential to consult your health care provider if you are considering using flecainide as the drug is available only by prescription.

Your doctor will conduct a proper evaluation of your medical history and current arrhythmia diagnosis to determine if it’s the most appropriate treatment option for managing your condition.

It’s also recommended to make an appointment with your doctor about using flecainide if you:

• Experience symptoms of arrhythmia, including heart palpitations, rapid or irregular heartbeat, dizziness, lightheadedness, and fainting.

• Have any known cardiac conditions that you’re not currently receiving treatment for

• Have had prior allergic reactions to certain medications

• Are pregnant or breastfeeding

• Experience persistent or worsening side effects that don’t seem to improve over time

It also helps your doctor monitor any adverse reactions, allowing them to adjust your dosage or recommend alternatives to avoid long-term health complications.

Where Can You Learn More about Flecainide and Similar Drugs?

If you’re concerned about your heart condition or want to know more about medications like flecainide, LifeMD can help.

A team of doctors can provide you with information and guide you on how to keep your heart healthy and use flecainide safely — all from the comfort of your home.

Make an appointment today to learn more about how LifeMD can help you manage your heart condition.

Heather Hanono, FNP

Heather is a dedicated Advanced Practice Registered Nurse with experience in urgent care, primary care, emergency medicine, and men's health. A South Florida native, she is bilingual in English and Spanish. Heather completed her Master's in Family Nurse Practitioner at Nova Southeastern University. She is passionate about building trustful relationships with her patients while promoting health and wellness. In her free time, Heather enjoys spending time with her daughter and family, going on vacation, and shopping.

Talk To A Doctor

How does LifeMD work?

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

Connect with a doctor now!

Join Now

Text

Call