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Flecainide and Pacerone

Determining the interaction of Flecainide and Pacerone and the possibility of their joint administration.

Check result:

Flecainide <> Pacerone

Relevance: 25.06.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using amiodarone together with flecainide can increase the blood levels of flecainide. This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may need a dose adjustment and more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience tiredness, dizziness, fainting, confusion, tremor, difficulty breathing, and an irregular heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Amiodarone may markedly increase serum flecainide concentrations. The proposed mechanism is amiodarone inhibition of CYP450 2D6, the isoenzyme responsible for the metabolism of flecainide. This combination may lead to an increase in the QT-prolonging potential of flecainide; one case of torsades de pointes has been reported. This interaction has a rapid onset but may take several weeks to maximally develop.

MANAGEMENT: A 30% to 50% reduction in flecainide dosage is recommended for patients receiving amiodarone. Flecainide plasma levels should be monitored and patients should be closely observed for clinical response and signs of flecainide toxicity (nausea, vomiting, new or worsened arrhythmias) for several weeks.

References

"Product Information. Amiodarone Hydrochloride (amiodarone)." Bedford Laboratories, Bedford, OH.
Shea P, Lal R, Kim SS, Schechtman K, Ruffy R "Flecainide and amiodarone interaction." J Am Coll Cardiol 7 (1986): 1127-30
Shea P, Lal R, Kim SS, et al "Flecainide and amiodarone interaction." J Am Coll Cardiol 7 (1986): 1127-30
"Product Information. Pacerone (amiodarone)." Upsher-Smith Laboratories LLC, Maple Grove, MN.
Cerner Multum, Inc. "Australian Product Information." O 0
Leclercq JF, Denjoy I, Mentre F, Coumel P "Flecainide acetate dose-concentration relationship in cardiac arrhythmias: influence of heart failure and amiodarone." Cardiovasc Drugs Ther 4 (1990): 1161-5
Gill J, Heel RC, Fitton A "Amiodarone: an overview of its pharmacological properties, and review of its therapeutic use in cardiac arrhythmias." Drugs 43 (1992): 69-110
Kerin NZ, Aragon E, Faitel K, Frumin H, Rubenfire M "Long-term efficacy and toxicity of high- and low-dose amiodarone regimens." J Clin Pharmacol 29 (1989): 418-23
Agencia Española de Medicamentos y Productos Sanitarios Healthcare "Centro de información online de medicamentos de la AEMPS - CIMA. Available from: URL: https://cima.aemps.es/cima/publico/home.html." ([2018]):
Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
Cerner Multum, Inc. "Canadian Product Information." O 0 (2015):
"Product Information. Flecainide Acetate (flecainide)." West-Ward Pharmaceuticals Corporation (previously Roxane Laboratories Inc), Columbus, OH.
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Flecainide

Generic Name: flecainide

Brand name: Tambocor

Synonyms: n.a.

What is Flecainide?

Pacerone

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: n.a.

What is Pacerone?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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