FLECAINIDE ACETATE

Description

Flecainide acetate (54143-56-5) is an open Na+?channel blocker that inhibits fast Na+?current in cardiac muscle in a use- and concentration-dependent manner.1?Orally-active class Ic antiarrhythmic agent2,3. Inhibits hERG potassium channels at clinically relevant concentrations.4

Chemical properties

White or almost white, very hygroscopic, crystalline powder.

The Uses of FLECAINIDE ACETATE

Flecainide acetate is used as a sodium channel blocker and as an anti-arrhythmic. In general, it is used to regulate heartbeats of the upper heart and lower heart chambers. It can also be used to slow down an overactive heart. It is also useful in the treatment of ventricular tachycardias and ventricular arrhythmias.

The Uses of FLECAINIDE ACETATE

Class I antiarrhythmic.

What are the applications of Application

Flecainide acetate is a cadiac Na+ channel blocker

Definition

ChEBI: An acetate salt obtained by combining flecainide with one molar equivalent of acetic acid. An antiarrhythmic agent used to prevent and treat tachyarrhythmia (abnormal fast rhythm of the heart).

brand name

Tambocor (3M Pharmaceuticals).

General Description

Flecainide acetate, N-(2-piperidinylmethyl)-2,5-bis (2,2,2-trifluoroethoxy)benzamide monoacetate(Tambocor), is a class IC antiarrhythmic drug withlocal anesthetic activity; it is a chemical derivative of benzamide.The drug undergoes biotransformation, forming ameta-O-dealkylated compound, whose antiarrhythmic propertiesare half as potent as those of the parent drug, and ameta-O-dealkylated lactam of flecainide with little pharmacologicalactivity. Flecainide acetate is given orally to suppresschronic ventricular ectopy and ventricular tachycardia.It has some limitations because of CNS side effects.

Biological Activity

Open Na + channel blocker that inhibits fast Na + current in cardiac muscle in a use- and concentration-dependent manner. Orally-active class Ic antiarrhythmic agent.

Biochem/physiol Actions

Class IC antiarrhythmic agent; sodium channel blocker

Drug interactions

Potentially hazardous interactions with other drugs
Anti-arrhythmics: concentration increased by amiodarone - halve dose of flecainide; increased myocardial depression with other anti-arrhythmics.
Antidepressants: concentration increased by fluoxetine; increased risk of ventricular arrhythmias with tricyclics.
Antihistamines: increased risk of ventricular arrhythmias with mizolastine - avoid.
Antihypertensives: increased myocardial depression and bradycardia with beta-blockers; increased myocardial depression and asystole with verapamil.
Antimalarials: concentration increased by quinine; avoid with artemether/lumefantrine.
Antimuscarinics: increased risk of ventricular arrhythmias with tolterodine.
Antipsychotics: increased risk of ventricular arrhythmias with antipsychotics that prolong the QT interval and phenothiazines; increased risk of arrhythmias with clozapine.
Antivirals: concentration possibly increased by fosamprenavir, indinavir, lopinavir, ritonavir and saquinavir, increased risk of ventricular arrhythmias - avoid; use telaprevir with caution.
Diuretics: increased cardiac toxicity if hypokalaemia occurs.

Metabolism

Flecainide is extensively metabolised (subject to genetic polymorphism), the 2 major metabolites being m-Odealkylated flecainide and m-O-dealkylated lactam of flecainide, both of which may have some activity. Its metabolism appears to involve the cytochrome P450 isoenzyme CYP2D6, which shows genetic polymorphism.
Flecainide is excreted mainly in the urine, approximately 30% as unchanged drug and the remainder as metabolites. About 5% is excreted in the faeces. Haemodialysis removes only about 1% of unchanged flecainide.

storage

Desiccate at +4°C

References

1) Rouet and Ducouret (1994), Use- and concentration-dependent effects of flecainide in guinea pig right ventricular muscle; J. Cardiovasc. Pharmacol.,?24?177 2) Singh?et al. (1984),?The electrophysiology and pharmacology of verapamil, flecainide, and amiodarone: correlations with clinical effects and antiarrhythmic actions; Ann. N.Y. Acad. Sci.,?432?210 3) Banitt?et al.?(1977),?Anti-arrhythmics. 2. Synthesis and antiarrhythmic activity of N-(piperidylalkyl)trifluoroethoxybenzamides; J. Med. Chem.,?20?821 4) Melgari?et al.?(2015),?Molecular basis of hERG potassium channel blockade by the class Ic antiarrhythmic flecainide; J. Mol. Cell. Cardiol.,?86?42