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3 Interactions found for:

flecainide
Interactions Summary
  • 1 Major
  • 1 Moderate
  • 1 Minor
  • flecainide

Drug Interactions

A total of 370 medications are known to interact with flecainide. Add another medication to view potential interactions with this medication.

Drug and Food Interactions

Moderate
Flecainide + Food

The following applies to the ingredients: Flecainide

Professional Content

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.

References

  1. "Product Information. Cytisine (cytisinicline)." Consilient Health Ltd (2024):
  2. jeong sh, Newcombe D, sheridan j, Tingle M "Pharmacokinetics of cytisine, an a4 b2 nicotinic receptor partial agonist, in healthy smokers following a single dose." Drug Test Anal 7 (2015): 475-82
  3. Vaughan DP, Beckett AH, Robbie DS "The influence of smoking on the intersubject variation in pentazocine elimination." Br J Clin Pharmacol 3 (1976): 279-83
  4. Zevin S, Benowitz NL "Drug interactions with tobacco smoking: an update" Clin Pharmacokinet 36 (1999): 425-38

Drug and Pregnancy Interactions

The following applies to the ingredients: Flecainide

Professional Content

Flecainide has been assigned to pregnancy category C by the FDA. Animal studies have revealed teratogenicity and embryotoxicity in rabbits that were given doses 30 to 35 mg/kg/day. No data from controlled studies in human pregnancy are available. Flecainide should only be given during pregnancy when there are no alternatives and benefit outweighs risk.

A series of 14 women who were given flecainide 300 to 400 mg per day to treat fetal supraventricular tachycardias complicated by fetal hydrops and ascites has been reported. The drug was given at a mean gestational age of 31 weeks, and was continued for up to five days. The mean umbilical cord to maternal plasma ratio was 0.80, with fetal concentrations ranging from 400 to 800 mcg per liter. One intrauterine death was observed three days after flecainide was begun, that may have been due to a proarrhythmic effect of flecainide. A second infant died later of sudden infant death syndrome. No adverse effects or problems were noted in the remaining 12 infants.

There have been several cases in which flecainide was used safely during human pregnancy. This drug has been used safely and successfully to treat refractory (to digoxin) fetal tachycardia. Average umbilical cord blood to maternal serum flecainide concentration ratios ranging from 0.63 to 0.97 have been reported. However, at least one case of neonatal cardiotoxicity related to maternal use of flecainide for fetal supraventricular tachycardia has been reported.

References

  1. Wagner X, Jouglard J, Moulin M, Miller AM, Petitjean J, Pisapia A "Coadministration of flecainide acetate and sotalol during pregnancy: lack of teratogenic effects, passage across the placenta, and excretion in human breast milk." Am Heart J 119 (1990): 700-2
  2. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals PROD (2001):
  3. Wren C, Hunter S "Maternal administration of flecainide to terminate and suppress fetal tachycardia." Br Med J 296 (1988): 249
  4. Macphail S, Walkinshaw S "Fetal supraventricular tachycardia: detection by routin auscultation and successful in utero management: case report." Br J Obstet Gynaecol 95 (1988): 1073-6
  5. Kofinas AD, Simon NV, Sagel H, Lyttle E, Smith N, King K "Treatment of fetal supraventricular tachycaardia with flecainide acetate after digoxin failure." Am J Obstet Gynecol 165 (1991): 630-1
  6. Allan LD, Chita SK, Sharland GK, Maxwell D, Priestley K "Flecainide in the treatment of fetal tachycardias." Br Heart J 65 (1991): 46-8
  7. Bourget P, Pons JC, Delouis C, Fermont L, Frydman R "Flecainide distribution, transplacental passage, and accumulation in the amniotic fluid during the third trimester of pregnancy." Ann Pharmacother 28 (1994): 1031-4
  8. Connaughton M, Jenkins BS "Successful use of flecainide to treat new onset maternal ventricular tachycardia in pregnancy." Br Heart J 72 (1994): 297
  9. Page RL "Treatment of arrhythmias during pregnancy." Am Heart J 130 (1995): 871-6
  10. Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation." Baltimore, MD: Williams & Wilkins (1998):
  11. Hall CM, Ward Platt MP "Neonatal flecainide toxicity following supraventricular tachycardia treatment." Ann Pharmacother 37 (2003): 1343-4

Drug and Breastfeeding Interactions

The following applies to the ingredients: Flecainide

Professional Content

Flecainide is excreted into human milk. Adverse effects on the nursing infant are unlikely. Flecainide is considered compatible with breast-feeding by the American Academy of Pediatrics.

Flecainide concentration in human milk averages 2.5 times that found in maternal plasma. Some experts have calculated that, assuming an infant consumes 700 mL of milk every 24 hours and the maternal plasma concentration is 1 mcg/mL, a suckling infant would be exposed to about 3 mg of flecainide per day. The calculated resultant infant plasma flecainide level would be 62 ng per mL. This represents a negligible amount of drug to the nursing infant.

References

  1. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals PROD (2001):

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Professional Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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