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Pharmacodynamics and side effects of flecainide acetate
Author(s) -
Salerno David M,
Granrud Gregory,
Sharkey Patricia,
Krejci Jeananne,
Larson Teresa,
Erlien Darryl,
Berry Donald,
Hodges Morrison
Publication year - 1986
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1986.145
Subject(s) - flecainide , qt interval , pharmacodynamics , qrs complex , medicine , dosing , side effect (computer science) , pr interval , anesthesia , pharmacokinetics , cardiology , pharmacology , heart rate , atrial fibrillation , blood pressure , computer science , programming language
We compared side effects with flecainide trough levels and ECG intervals among 43 patients who received flecainide for up to 34 months. Flecainide plasma levels were higher when associated with cardiovascular side effects (mean 1063 ng/ml; range 296 to 2050 ng/ml) than when no side effects occurred (mean 609 ng/ml; range 89 to 1508 ng/ml; P < 0.001). The PR interval (P < 0.001), QRS interval (P < 0.001), and the rate‐corrected QT interval (P < 0.001) were greater at the time of cardiovascular side effects, but the rate‐corrected JT interval was not. The therapeutic‐toxic window for flecainide plasma level was 381 ng/ml (at least 50% probability of efficacy) to 710 ng/ml (<10% probability of cardiovascular side effects). The risk of cardiovascular side effects increases at higher plasma levels of flecainide and is associated with greater increases in the PR and QRS intervals from baseline than are routinely observed during flecainide dosing. Clinical Pharmacology and Therapeutics (1986) 40, 101–107; doi: 10.1038/clpt.1986.145