Premium
Oral Flecainide Pharmacokinetics in Patients with Impaired Renal Function
Author(s) -
Forland Steven C.,
Burgess Ellen,
Blair Andrew D.,
Cutler Ralph E.,
Kvam Donald C.,
Weeks C. E.,
Fox J. M.,
Conard Gordon J.
Publication year - 1988
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1988.tb03142.x
Subject(s) - flecainide , pharmacokinetics , volume of distribution , medicine , renal function , hemodialysis , creatinine , oral administration , urine , urology , end stage renal disease , half life , pharmacology , atrial fibrillation
The pharmacokinetics of flecainide acetate were studied in 20 patients with varying degrees of renal impairment following a single oral dose. The patients were divided into two groups, on the basis of renal creatinine clearance (CL CR ), for statistical and kinetic analysis. Patients with a CL CR between 4 and 41 mL/min/m 2 were designated group 1 and those below 4 mL/min/m 2 or unmeasurable because of lack of urine output were designated group 2. In both groups peak plasma flecainide concentrations, time to peak concentrations, and apparent volume of distribution (V d ) were similar to those reported in healthy subjects with normal renal function. The mean flecainide plasma elimination half‐lives from both groups 1 and 2 were longer than those previously reported by several investigators in normal subjects. Nine patients in group 1 and seven patients in group 2 had half‐lives within the range reported in healthy subjects. Therefore, CL CR alone is not a good predictor of plasma elimination half‐life following a single oral dose of flecainide. Although renal clearance of flecainide is significantly reduced in end‐stage renal disease (ESRD), total plasma clearance of flecainide (CL flec ) was not reduced to the same degree, although there was a significant, modest correlation with CL CR . Less than 1% of the administered oral dose of flecainide was removed during hemodialysis. The relationship between dosage and plasma elimination half‐life in patients with ESRD needs further study to evaluate possible dose‐dependent kinetics.