Flecainide Uses

Flecainide is used to prevent certain types of life-threatening irregular heartbeats, including paroxysmal supraventricular tachycardia (PSVT), paroxysmal atrial fibrillation / atrial flutter (PAF), and sustained ventricular tachycardia. 

This medication is considered for use in patients who don’t have coronary artery disease or left ventricular dysfunction. Flecainide is not used for arrhythmia management in people who have had a recent myocardial infarction (heart attack). This medication is also not recommended for people with chronic atrial fibrillation as it can increase the risk of certain types of irregular heart rhythms in such individuals. In addition, flecainide is contraindicated in people with left ventricular hypertrophy, ischemic heart disease, sick sinus syndrome, and high-degree (second- or third-degree) AV block or bifascicular block (right bundle branch block with left hemiblock) unless a pacemaker is in place. It is also contraindicated in individuals who are in cardiogenic shock.

There may be other uses for flecainide—your doctor or health system pharmacists can give you further drug information.

Flecainide Mechanism of Action

Flecainide works by decreasing abnormal electrical signals in the heart and stabilizing irregular heart rhythms.

Flecainide Doses

Flecainide acetate tablet is available in strengths of 50 mg, 100 mg, and 150 mg.

The recommended dosage of flecainide in adults is as follows:

For paroxysmal supraventricular tachycardia and paroxysmal atrial fibrillation: The total daily dose ranges between 50 and 300 mg per day. This is taken in divided doses at 8- to 12-hour intervals. The usual initial dose is 50 mg by mouth every 12 hours. This can be increased by 100 mg per day every 4 days. The maximum dose is 300 mg daily. 

For the prevention of ventricular arrhythmias: The total dose ranges between 100 and 400 mg daily. It is taken in divided doses at 8- or 12-hour intervals. The usual starting dose is 100 mg by mouth every 12 hours. It can be increased by 100 mg per day every 4 days. The maximum dose is 400 mg daily. 

Note: Your doctor will measure the blood levels of the drug to make dose adjustments.

Note: Intravenous flecainide may be used in the emergency department for cardioversion (to return the heartbeat to a normal rhythm).