Side Effects of flecainide: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Flecainide is a drug used to treat cardiac arrhythmias. Many studies have shown the effectiveness of flecainide, but some side effects have also been reported. 3 showed that the higher the blood concentration of flecainide, the higher the risk of cardiovascular side effects. 19 also reported that patients with kidney disease are more likely to have higher blood concentrations of flecainide, which can lead to serious side effects such as mental disorders. 18 reported that flecainide can cause peripheral neuropathy.

Reasons for Side Effects

Flecainide inhibits sodium channels in the cell membranes of the heart, which suppresses electrical activity in the heart. However, this sodium channel blocking action can affect other tissues besides the heart. Therefore, flecainide can cause side effects in other systems such as the nervous system and digestive system, in addition to cardiovascular side effects.

Common Side Effects

Cardiovascular Side Effects

Since flecainide is used to suppress the electrical activity of the heart, it has a high risk of cardiovascular side effects. 3 showed that the higher the blood concentration of flecainide, the higher the risk of cardiovascular side effects. 11 reported a case where excessive intake of flecainide caused cardiac conduction abnormalities and seizures. These side effects are thought to occur when flecainide excessively inhibits sodium channels in the heart, disrupting electrical activity.

Nervous System Side Effects

Flecainide can also cause nervous system side effects. 19 reported a case where excessive intake of flecainide caused mental disorders. 18 reported that flecainide can cause peripheral neuropathy. These side effects are thought to occur when flecainide inhibits sodium channels in the nervous system.

Other Side Effects

Flecainide has also been reported to cause side effects in the digestive system and skin. 6 shows that flecainide can have a negative impact on the fetus when used during pregnancy. These side effects are thought to occur when flecainide inhibits sodium channels in other tissues.

Countermeasures for Side Effects

Countermeasures for Cardiovascular Side Effects

It is important to monitor blood concentration and adjust the dosage appropriately to reduce cardiovascular side effects caused by flecainide. 1 recommends monitoring blood concentration as blood concentration of flecainide is more likely to increase in patients with kidney disease and the risk of cardiovascular side effects is higher. If cardiovascular side effects occur, it is necessary to stop administration of flecainide or reduce the dosage.

Countermeasures for Nervous System Side Effects

It is important to monitor blood concentration and adjust the dosage appropriately to reduce nervous system side effects caused by flecainide. 19 recommends monitoring blood concentration as blood concentration of flecainide is more likely to increase in patients with kidney disease and the risk of serious side effects such as mental disorders is higher. If nervous system side effects occur, it is necessary to stop administration of flecainide or reduce the dosage.

Countermeasures for Other Side Effects

It is important to monitor blood concentration and adjust the dosage appropriately to reduce other side effects caused by flecainide. If side effects occur, it is necessary to stop administration of flecainide or reduce the dosage.

Comparison Between Studies

Commonalities Between Studies

These studies show that flecainide is an effective drug, but it also has a high risk of side effects. They also emphasize the importance of monitoring blood concentration and adjusting the dosage appropriately.

Differences Between Studies

These studies show that the type and severity of side effects of flecainide can vary depending on the patient. For example, 3 showed that the higher the blood concentration of flecainide, the higher the risk of cardiovascular side effects, but 19 reported that patients with kidney disease are more likely to have higher blood concentrations of flecainide, which can lead to serious side effects such as mental disorders. 18 reported that flecainide can cause peripheral neuropathy. These findings suggest that side effects of flecainide may vary depending on the individual’s constitution and medical condition.

Points to Note Regarding Real-Life Application

Flecainide is a drug used to treat cardiac arrhythmias, but it also has a high risk of side effects. Therefore, when taking flecainide, it is important to follow your doctor’s instructions and to avoid stopping or changing the dosage without consulting your doctor. It is also important to have regular checkups with your doctor and to monitor your blood concentration while taking flecainide.

Limitations of Current Research

Research on the side effects of flecainide is still not sufficient. In particular, there is not enough data on the long-term side effects of flecainide. Moreover, since side effects of flecainide can vary depending on the individual’s constitution and medical condition, these findings cannot be applied to all patients.

Future Research Directions

Further research on the side effects of flecainide is needed. In particular, more detailed research is needed on long-term side effects and differences in side effects due to the individual’s constitution and medical condition. It is also important to develop new methods to reduce side effects of flecainide and to develop new indicators for predicting the risk of side effects.

Conclusion

Flecainide is an effective drug used to treat cardiac arrhythmias, but it also has a high risk of side effects. When taking flecainide, it is important to follow your doctor’s instructions and to avoid stopping or changing the dosage without consulting your doctor. It is also important to have regular checkups with your doctor and to monitor your blood concentration while taking flecainide. Further research on the side effects of flecainide is needed.

Literature analysis of 19 papers
Positive Content
11
Neutral Content
4
Negative Content
4
Article Type
1
0
0
2
18
2.

[Central nervous system side effects due to anti-arrhythmia therapy. Psychotic depression due to flecainide].

Author: DrerupU

Acoustic hallucinations
Delusions
Depressive psychosis

A 69-year-old man developed severe depressive psychosis after taking flecainide for atrial fibrillation and ventricular extrasystoles. The psychosis resolved after discontinuation of flecainide.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : German

3.

Pharmacodynamics and side effects of flecainide acetate.

Author: SalernoD M, GranrudG, SharkeyP, KrejciJ, LarsonT, ErlienD, BerryD, HodgesM

Cardiovascular side effects

Higher flecainide plasma levels were associated with cardiovascular side effects, while lower levels were associated with the absence of side effects. The risk of side effects increased at higher plasma levels and was linked to greater increases in the PR and QRS intervals from baseline.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Two cases of wide QRS complex tachycardia caused by anamorelin.

Author: OkidonoYutaro, OsadaJun, OtsuKazuya, KowaseShinya, AokiHajime, YumotoKazuhiko

Life-threatening adverse effects
Wide QRS complex tachycardia

This report describes two cases of wide QRS complex tachycardia caused by anamorelin, a drug prescribed for cancer cachexia treatment. Both patients had liver dysfunction. Anamorelin is mainly metabolized in the liver, and sodium channel blockade by anamorelin during liver dysfunction can cause serious side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

6.

Antiarrhythmic drugs-safety and efficacy during pregnancy.

Author: FischerAlicia Jeanette, DillerGerhard-Paul, UebingAnselm, NürnbergJan-Hendrik, HebeJoachim

Rhythm disorders treatment
Fetal development

This review discusses the challenges of antiarrhythmic drug (AAD) treatment during pregnancy, considering the physiological adaptations that occur, potential side effects, and fetal risks. AADs commonly used during pregnancy include adenosine, beta-blockers, sotalol, and flecainide.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

The Case of Flecainide Toxicity: What to Look for and How to Treat.

Author: NewsonJoshua M, SantosCynthia D, WaltersBradford L, ToddBrett R

Prevent and treat tachycardias
AKI
Cardiac arrest
Dysrhythmias
Heart failure

Flecainide is a drug used to treat heart rhythm problems. This case report highlights a patient who developed acute kidney injury (AKI) as a result of flecainide toxicity. This presentation of flecainide toxicity is uncommon, and it is important for clinicians to be aware of this potential side effect.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Flecainide: Electrophysiological properties, clinical indications, and practical aspects.

Author: PaoliniEnrico, StronatiGiulia, GuerraFederico, CapucciAlessandro

Treat arrhythmias
Side effects

Flecainide, a commonly used antiarrhythmic drug, has proven to be effective in managing atrial fibrillation in patients without structural heart disease. This review provides a comprehensive overview of its electrophysiological properties, clinical use, side effects, and contraindications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Pharmacogenetics of myotonic hNav1.4 sodium channel variants situated near the fast inactivation gate.

Author: FarinatoAlessandro, AltamuraConcetta, ImbriciPaola, MaggiLorenzo, BernasconiPia, MantegazzaRenato, PasqualiLivia, SicilianoGabriele, Lo MonacoMauro, VialChristophe, SternbergDamien, CarratùMaria Rosaria, ConteDiana, DesaphyJean-François

Myotonia treatment
Side effects

This study investigated the pharmacological characteristics of myotonic Nav1.4 mutations clustered near the fast inactivation gate of the sodium channel. While mexiletine is the first-line treatment, some mutations reduce its effectiveness. The study found that class Ic antiarrhythmics, such as flecainide and propafenone, may offer a valuable alternative for patients with these specific mutations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies.

Author: ErgulYakup, OzturkErkut, OzgurSenem, OzyurtAbdullah, CilsalErman, GuzeltasAlper

Congenital JET treatment
Cardiac side effects

Junctional ectopic tachycardia (JET) is a rare arrhythmia commonly seen in infancy. This article presents three cases of infantile congenital JET treated with ivabradine, a new-generation antiarrhythmic, which rapidly converted the tachycardia into sinus rhythm without any significant side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

When potion becomes poison! A case report of flecainide toxicity.

Author: BajajS, TulluM S, KhanZah, AgrawalM

Cardiac conduction abnormalities
Seizures

This study reports a 48-day-old female infant who developed cardiac conduction abnormalities and seizures secondary to supratherapeutic doses of oral flecainide. Flecainide was started in this infant for treatment of supraventricular tachycardia. The drug was withdrawn with successful normalization of the QRS complex and no further recurrence of seizures.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Flecainide as first-line treatment for fetal supraventricular tachycardia.

Author: EkizAli, KayaBasak, BornaunHelen, AcarDeniz Kanber, AvciMuhittin Eftal, BestelAysegul, YildirimGokhan

Fetal SVT treatment

Flecainide, an anti-arrhythmic medication, demonstrated high efficacy (88.2%) in treating fetal supraventricular tachycardia (SVT) with a low side effect profile and easy utilization. This suggests flecainide as the drug of first choice for treating fetal SVT cases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Flecainide-metoprolol combination reduces atrial fibrillation clinical recurrences and improves tolerability at 1-year follow-up in persistent symptomatic atrial fibrillation.

Author: CapucciAlessandro, PiangerelliLuca, RicciottiJenny, GabrielliDomenico, GuerraFederico

Preventing AF recurrences
Serious side effects

This study investigates the efficacy and safety of a combination of flecainide and metoprolol for preventing atrial fibrillation (AF) recurrences.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

In silico prediction of drug therapy in catecholaminergic polymorphic ventricular tachycardia.

Author: YangPei-Chi, MorenoJonathan D, MiyakeChristina Y, Vaughn-BehrensSteven B, JengMao-Tsuen, GrandiEleonora, WehrensXander H T, NoskovSergei Y, ClancyColleen E

CPVT treatment
Proarrhythmia
Side effects

This study investigated the mechanism of therapeutic efficacy of flecainide for catecholaminergic polymorphic ventricular tachycardia (CPVT). Model predictions suggest that Na(+) channel effects are insufficient to explain flecainide's efficacy. The study highlights the need for further research to identify the underlying mechanisms and explore alternative polytherapeutic approaches for more effective CPVT management.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Effects of flecainide on left ventricular pressure gradient and symptoms in obstructive hypertrophic cardiomyopathy: a comparison of flecainide and disopyramide.

Author: HarukiShintaro, MinamiYuichiro, SuzukiAtsushi, HagiwaraNobuhisa

HCM treatment
Side effects

Flecainide, a Class I antiarrhythmic drug, is a potentially useful alternative for symptomatic obstructive HCM patients, showing similar efficacy to disopyramide but with fewer side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

Antiarrhythmic drug therapy for maintaining sinus rhythm early after pulmonary vein ablation in patients with symptomatic atrial fibrillation.

Author: SohnsChristian, von GrubenValerie, SossallaSamuel, BergauLeonard, SeegersJoachim, LüthjeLars, VollmannDirk, ZabelMarkus

Following pulmonary vein ablation (PVA), antiarrhythmic drug (AAD) therapy is not superior to beta-blocker (BB) treatment for the prevention of early atrial arrhythmias. No drug was superior to another regarding the maintenance of sinus rhythm.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Skin biopsy-proven flecainide-induced neuropathy.

Author: BurakgaziAhmet Z, PolydefkisMichael, HökeAhmet

Cardiac arrhythmia treatment
Peripheral neuropathy

This case report describes a patient with flecainide-induced sensory neuropathy that was confirmed with skin biopsy. Subsequent improvement of neuropathy was documented with assessment of intraepidermal nerve fiber density in a repeat nerve biopsy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

Paranoid psychosis and myoclonus: flecainide toxicity in renal failure.

Author: TingStephen M S, LeeDouglas, MacleanDouglas, SheerinNeil S

Flecainide cessation effective
CNS toxicity
Renal failure

This study reported a case of flecainide toxicity in a patient with end-stage renal failure. Flecainide toxicity resolved after stopping treatment, highlighting the importance of monitoring flecainide levels in patients with renal impairment.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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