Flecainide
| Drug monograph · NCLEX study reference | |
| Trade names | Tambocor |
|---|---|
| Therapeutic class | Antiarrhythmic |
| Pharmacologic class | Class IC antiarrhythmic |
| Onset / peak / duration | Peak 1 to 6 hours; duration about 12 hours. |
| Half-life / level | Half-life 12 to 27 hours; no routine level. |
| Routes | PO (oral) |
| High-alert (ISMP) | No |
| Black box warning | Yes (see Safety) |
| Antidote / reversal | Supportive care. |
| Pregnancy / lactation | Use only if clearly needed. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Flecainide (brand name Tambocor) — Antiarrhythmic; Class IC antiarrhythmic.
Identification
- Therapeutic class: Antiarrhythmic.
- Pharmacologic class: Class IC antiarrhythmic.
Pharmacology
- Mechanism of action: Strongly blocks sodium channels, slowing cardiac conduction.
- Onset / peak / duration: Peak 1 to 6 hours; duration about 12 hours.
- Half-life / therapeutic level: Half-life 12 to 27 hours; no routine level.
Clinical use
- Indications: Paroxysmal atrial fibrillation and supraventricular tachycardia in patients without structural heart disease.
- Usual dose, route, frequency: 50 to 150 mg PO every 12 hours.
- Maximum dose / adjustments: Max about 400 mg/day; reduce in renal impairment.
Safety
- Contraindications: Structural or ischemic heart disease, second or third degree block, cardiogenic shock.
- Black box warning: Associated with increased mortality in patients with recent MI or structural heart disease (based on the CAST trial); limit to patients without structural heart disease.
- Interactions: Other antiarrhythmics, beta blockers, digoxin (raises level), CYP2D6 inhibitors.
- Pregnancy / lactation: Use only if clearly needed.
- High-alert: No.
Adverse effects
- Common side effects: Dizziness, visual disturbance, dyspnea, headache.
- Serious effects to report: New or worsening arrhythmia, heart failure symptoms.
- Antidote / reversal: Supportive care.
Nursing process
- Assessment before administration: ECG, structural heart disease screening, electrolytes, renal function.
- Interventions during therapy: Confirm absence of structural heart disease; monitor ECG.
- Monitor: ECG and QRS width, heart rhythm, renal function.
- Evaluation / expected outcome: Maintained normal rhythm.
Patient teaching
- Patient teaching: Keep follow-up ECGs; report palpitations.
- Notify provider if: Palpitations, fainting, shortness of breath.
- Administration tips: Consistent every-12-hour timing.