The following provides information on contraindications to the use of flecainide in general, pregnancy & amp; Breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).
When should Flecainid not be used?
The drug should not be used in case of hypersensitivity flecainide, blocking the conduction in the atrial (SA-blocking) and within the first three months after the occurrence of a heart attack (myocardial infarction) or impaired cardiac output (when the left ventricular ejection fraction lower than 35 percent is), except in patients with life-threatening ventricular arrhythmias.
In severe disturbance of cardiac output (heart failure NYHA III and IV respectively when the left ventricular ejection fraction lower than 35 percent) can only take place treatment of life-threatening ventricular arrhythmias with flecainide if additional use of substances that increase cardiac output, a Compensation (drug compensation) has been performed.
If the patient does not have a pacemaker, flecainide should not be prescribed for blockages in the conduction system of came from Mern (intraventricular conduction disorders), valvular heart disease (sick sinus syndrome) and limited functions of the heart chambers (bradycardia-tachycardia syndrome).
Similarly, the drug should not be prescribed for severe slowing of the heartbeat sequence (severe bradycardia), as well as pronounced heart failure (congestive heart failure), when triggered by the heart shock situations (cardiogenic shock) or a disorder of the electrolyte balance (for example, a potassium metabolism disorder).! !!!
A careful medical benefit-risk assessment in the application is required in patients with potassium deficiency or excess potassium in the blood, while taking dehydrating agents (diuretics), laxatives and glucocorticoids.
In patients with poorly controlled pacemakers, flecainide should only be taken under medical supervision. Treatment with flecainide should be started four to six weeks after pacemaker implantation. If the active substance is used beforehand, the treatment should be carried out during this period only under intensive medical conditions.
In patients with hepatic impairment or renal impairment (renal insufficiency with creatinine clearance below 50 milliliters per minute), the dosage should be adjusted by the physician.
Flecainide should not be combined with the equally antiarrhythmic active substance disopyramide.
Only after careful benefit-risk assessment of the active ingredient with concurrent use of other Class I antiarrhythmic agents, and blood-thinning drugs such as amiodarone or cimetidine may be given by the doctor.
What should you watch out for during pregnancy and lactation?
Flecainide must not be taken during pregnancy and during lactation.
What should be considered in children?
Children under the age of twelve are not allowed to receive flecainide.
Warnings and Precautions
- Regular medical check-ups of the heart activity (ECG) and blood levels are necessary for the treatment with the drug.
- Careful medical supervision is required when administering the drug to patients with liver disease or kidney disease.
- During treatment with the drug, the patient’s potassium balance must be monitored by a doctor.
- At the beginning of therapy and dose changes, the patient should be monitored in the hospital.
- Pacemaker patients should be given extra care by the doctor to treat the medication.
- The absorption of the drug into the body is hampered by food. It is therefore either fasted or one hour before a meal.
- The reactivity may be so impaired that the active participation in the road traffic and the use of machinery may be limited. This is especially true in conjunction with alcohol.
Sometimes medications release allergic reactions.
If you notice signs of allergic reaction, tell your doctor or pharmacist immediately.