Generic Flecainide

Introduction

Flecainide is a class IC anti-arrhythmic medication used to control abnormal heart rhythms. It is supplied as a 100 mg oral tablet and belongs to the sodium-channel blocker group. The drug was originally developed by Warner-Lambert (now part of Pfizer) and is marketed under brand names such as Tambocor. Flecainide is indicated for certain supraventricular and ventricular arrhythmias; clinicians may also consider it for selected off-label applications when standard therapies are unsuitable.

What is Flecainide?

Flecainide is the generic version of well-known medications, containing the active compound flecainide. Our online pharmacy provides this generic alternative as a cost-effective treatment option. It is an oral tablet (100 mg) that belongs to the class IC anti-arrhythmic category, which primarily blocks fast inward sodium channels in cardiac tissue.

How Flecainide Works

Flecainide binds selectively to the open state of voltage-gated Na⁺ channels (Nav1.5) in myocardial cells. By reducing the rapid depolarizing sodium current (I_Na), it slows the upstroke of the cardiac action potential, thereby decreasing conduction velocity through the atria, ventricles, and His-Purkinje system. The resultant effect is a prolonged refractory period and suppression of premature electrical impulses that initiate tachyarrhythmias.

• Onset: Peak plasma concentrations occur 1-3 hours after oral ingestion.
• Duration: Therapeutic effects persist for 8-12 hours, supporting twice-daily dosing in most regimens.
• Clearance: Approximately 85 % is eliminated unchanged in the urine; the remainder is metabolised by CYP2D6. Renal or hepatic impairment may prolong the elimination half-life (≈12 hours in healthy adults).

Conditions Treated with Flecainide

• Paroxysmal Supraventricular Tachycardia (PSVT): Flecainide terminates episodes by interrupting re-entrant circuits in the atria or AV node.
• Atrial Fibrillation (AF) & Atrial Flutter (selected patients): When used in a “pill-in-the-pouch” strategy or as chronic therapy, flecainide maintains sinus rhythm by preventing premature atrial beats.
• Ventricular Premature Beats (PVCs) and Non-Sustained Ventricular Tachycardia (NSVT)-in patients with structurally normal hearts: Sodium-channel blockade stabilises ventricular excitability.

These indications are approved by major regulatory agencies (e.g., FDA, EMA) for patients without significant left-ventricular dysfunction or coronary artery disease, as flecainide can be pro-arrhythmic in compromised myocardium.

Off-Label and Investigational Uses of Flecainide

• Ablation-Adjunct Therapy: Small clinical series report that pre-procedural flecainide reduces the number of inducible atrial tachyarrhythmias during catheter ablation, potentially improving outcomes.
• Incessant Ventricular Tachycardia in Inherited Channelopathies (e.g., CPVT): Case reports suggest flecainide can suppress catecholamine-triggered ventricular beats by stabilising RyR2-mediated calcium release, though definitive trial data are lacking.
• Electrical Cardioversion Facilitation: A limited number of studies indicate that oral flecainide given before synchronized cardioversion increases conversion success for recent-onset AF.

These uses have not received formal regulatory approval. Patients should only consider off-label applications under the direct supervision of a qualified healthcare provider, after a thorough risk-benefit assessment.

Is Flecainide the Right Medication for You?

Flecainide is most appropriate for adults with:

• Documented paroxysmal supraventricular tachycardia, atrial fibrillation, or atrial flutter who have preserved left-ventricular function (ejection fraction ≥ 50 %).
• No history of myocardial infarction, uncontrolled coronary artery disease, or symptomatic heart failure (NYHA III-IV).
• No concurrent use of other class I or III anti-arrhythmics unless specifically instructed by a cardiologist.

Contraindications include:

• Structural heart disease (e.g., prior myocardial infarction, cardiomyopathy).
• Second- or third-degree atrioventricular block without a pacemaker.
• Severe hepatic or renal impairment (dose adjustment required).
• Known hypersensitivity to flecainide or any tablet excipients.

Patients with these conditions should discuss alternative therapies with their clinician.

Risks, Side Effects, and Interactions

Common

• Dizziness or light-headedness
• Visual disturbances (e.g., blurred vision, photopsia)
• Nausea, abdominal discomfort
• Mild fatigue

Rare

• Photosensitivity rash
• Elevated liver enzymes (transaminases)
• Taste alterations (dysgeusia)
• Peripheral edema

Serious

• Pro-arrhythmia: New or worsening ventricular tachyarrhythmias, especially in patients with underlying structural heart disease.
• Severe AV block requiring pacemaker implantation.
• Heart failure exacerbation due to negative inotropic effect.
• Hypotension or cardiogenic shock in overdose.

Drug-Drug Interactions

• Beta-blockers (e.g., metoprolol) - additive slowing of AV conduction; monitor ECG.
• Digoxin - increased risk of AV block; serum digoxin levels may rise.
• CYP2D6 inhibitors (e.g., fluoxetine, quinidine) - raise flecainide plasma concentrations; dose reduction often needed.
• Other anti-arrhythmics (e.g., amiodarone, sotalol) - heightened pro-arrhythmic potential; avoid unless under specialist supervision.

Drug-Food Interactions

• Grapefruit juice can inhibit CYP3A4 modestly, though flecainide is primarily metabolised by CYP2D6; limiting large amounts is prudent.

Patients should disclose all prescribed, over-the-counter, and herbal products before initiating therapy.

Use: Dosing, Missed Dose, Overdose

Standard adult dosing (tablet form, 100 mg):

• Paroxysmal SVT (acute): 200-300 mg single oral dose (under medical guidance).
• Chronic rhythm control (AF/atrial flutter): 100 mg twice daily; may be titrated up to 300 mg/day based on ECG response and tolerability.
• Ventricular ectopy in structurally normal hearts: 100 mg twice daily, with careful ECG monitoring.

Missed dose:

• If a dose is missed and the next scheduled dose is more than 6 hours away, take the missed tablet.
• If less than 6 hours remain until the next dose, skip the missed tablet and resume the regular schedule. Do not double-dose.

Overdose management:

• Symptoms may include severe dizziness, hypotension, arrhythmias, or seizures.
• Seek emergency medical care immediately.
• Activated charcoal may be considered if ingestion occurred within 1 hour.
• Intravenous sodium bicarbonate is the recommended antidote for pronounced QRS widening.
• Continuous cardiac monitoring and electrolyte correction are essential.

General precautions:

• Take tablets with a full glass of water; food does not markedly affect absorption, but consistent timing with regard to meals aids adherence.
• Avoid excessive alcohol, which can potentiate hypotension and arrhythmia risk.
• Do not operate heavy machinery or drive until you know how flecainide affects you, especially during the first few days of therapy.

FAQ

• Can Flecainide be taken with a low-sodium diet? Flecainide’s efficacy is not dependent on dietary sodium. A low-sodium diet does not interfere with drug absorption or action.

• Is it safe to travel internationally while on Flecainide? Yes, provided you carry the medication in its original labeled container, have a copy of the prescription (or a clinician’s note), and keep it in your carry-on luggage to avoid temperature extremes.

• Will Flecainide show up on a standard drug test? Routine employment drug screens do not test for anti-arrhythmic agents. Flecainide is not a controlled substance and is unlikely to be detected unless a specific assay is ordered.

• What should I do if I experience visual flashes while on Flecainide? Visual disturbances can be a side effect. Inform your healthcare provider promptly; they may adjust the dose or switch medications if the symptom persists.

• Are there any differences between the 100 mg tablet and higher-strength tablets? The 100 mg tablet contains the same active ingredient as larger strengths; the only difference is the amount of active compound per pill. Dosing is adjusted by tablet count, allowing flexible titration.

• How long does it take for Flecainide to reach steady-state levels? Steady state is typically achieved after 3-5 half-lives, roughly 36-60 hours of consistent twice-daily dosing.

• Can Flecainide be used in patients with mild renal impairment? Mild renal dysfunction (eGFR ≥ 60 mL/min) generally requires no dose change. More severe impairment may necessitate dosage reduction and closer monitoring.

• Is there any risk of dependence or tolerance with Flecainide? Flecainide does not produce dependence or tolerance. However, abrupt discontinuation can precipitate arrhythmia recurrence; tapering is recommended under medical advice.

• What excipients are present in the 100 mg tablet? Common inactive ingredients include lactose monohydrate, maize starch, and magnesium stearate. Patients with lactose intolerance or specific allergies should verify with the pharmacy.

• Does Flecainide interact with hormonal contraceptives? No clinically significant interaction has been reported between flecainide and combined oral contraceptives.

Glossary

Class IC anti-arrhythmic

A subgroup of anti-arrhythmic drugs that strongly block fast sodium channels, markedly slowing cardiac conduction.

Pro-arrhythmia

The paradoxical induction or worsening of abnormal heart rhythms caused by a medication intended to treat arrhythmias.

Pill-in-the-pouch

A self-administration strategy where a single dose of an anti-arrhythmic (often flecainide) is taken at the onset of an atrial fibrillation episode to restore sinus rhythm.

CYP2D6

An enzyme in the liver that metabolises many drugs, including flecainide; genetic variability can affect drug levels.

Buying Flecainide from Our Online Pharmacy

Flecainide can be purchased conveniently from our online pharmacy. We source the medication from licensed, audited suppliers, ensuring that each tablet meets stringent quality standards.

• Cost-effectiveness: Prices are set close to manufacturer cost, providing a significant savings compared with many retail pharmacies.
• Verified quality: All batches undergo independent testing for potency, purity, and stability before shipment.
• Discreet delivery: Orders are packaged in neutral, unmarked envelopes and dispatched via secure courier services (express delivery in 7 days or regular airmail in approximately 3 weeks).
• Global access: As a pharmacy-broker service, we collaborate with overseas licensed pharmacies, enabling patients in regions with limited local availability to obtain the medication legally and safely.
• Privacy protection: Personal information is handled under strict confidentiality protocols, and no identifying details appear on the packaging.

Our service is designed to help patients who face barriers such as high local prices, restricted insurance coverage, or shortages in their country. By choosing our online pharmacy, you gain a reliable, affordable, and private pathway to the generic flecainide you need.

Disclaimer

The information presented about Flecainide is intended for general educational purposes and does not substitute professional medical advice. Treatment decisions, including any off-label use, must be made under the supervision of a qualified healthcare provider. Readers are assumed to be responsible adults capable of making informed health choices. Our online pharmacy offers access to Flecainide for individuals who may encounter limited availability through conventional pharmacies or insurance formularies, or who seek cost-effective generic options. Always consult a qualified clinician before initiating, modifying, or discontinuing any medication.