Flecainide with Aprindine Interaction Details
Brand Names Associated with Flecainide
- Flecainide
- Tambocor®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Interaction Summary
Coadministration of drugs that potentially prolong the QTc interval, such as Class I antiarrhythmics, should be approached with caution.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
The concurrent administration of two drugs that prolong the QT interval, such as Class I antiarrhythmic agents, is not recommended.
Mechanism Of Interaction
Additive effects on QT prolongation
Literature Reports
A) Torsade de pointes (variant of ventricular tachycardia) in a 59-year-old male following mexiletine 100 mg orally every 6 hours has been reported . The ventricular tachycardia did not recur upon discontinuation of the drug.
B) Flecainide slows cardiac conduction in most patients to produce dose-related increases in PR, QRS, and QT intervals .
C) Lorcainide has been reported to cause widening of the QRS complex and QT intervals and rarely can cause a negative inotropic effect (less than 1%). As with all antiarrhythmic agents, lorcainide can trigger rhythm disturbances .
D) Aprindine-induced polymorphous ventricular tachycardia (PVT; torsades de pointes) has been reported, in both sustained and nonsustained forms, following oral and intravenous administration (125 to 600 mg/day). PVT manifested as QT prolongation and recurrent syncope. PVT occurred within 10 days after initiation of aprindine therapy and resolved within 2 to 48 hours after discontinuation of aprindine. The QT interval regressed to predrug values after discontinuation of aprindine. In some cases PVT terminated spontaneously and in other cases electrical cardioversion was necessary. In one case, hypokalemia may have contributed to the proarrhythmic effect. Patients with an antiarrhythmic drug-induced acquired QT syndrome may be predisposed to aprindine-induced PVT .
Flecainide Overview
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Flecainide is used to prevent certain types of life-threatening irregular heartbeats. Flecainide is in a class of medications called antiarrhythmics. It works by slowing electrical signals in the heart to stabilize the heart rhythm.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.