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Pharmacokinetics of flecainide acetate in patients with severe renal impairment
Author(s) -
Williams A J,
McQuinn R L,
Walls J
Publication year - 1988
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.1988.57
Subject(s) - pharmacokinetics , volume of distribution , flecainide , medicine , creatinine , oral administration , plasma levels , renal function , plasma concentration , urology , pharmacology , atrial fibrillation
We studied the effect of renal disease on the pharmacokinetics of flecainide after single intravenous, single oral, and multiple oral doses to patients with severe renal disease (creatinine clearances <12 ml/min/m 2 ). The absorption and volume of distribution of flecainide were not altered by renal impairment. The average plasma half‐life was prolonged by about twofold that of healthy subjects but most patients were within the range of values for healthy subjects. Total body clearance was reduced. With multiple oral doses of 50 mg b.i.d. or 50 mg daily, steady‐state plasma levels were reached by 6 days and no further accumulation in plasma was observed. In patients with severe renal disease, therapy with flecainide should be initiated at 100 mg daily (or 50 mg b.i.d.). If necessary, dosage increases should be made cautiously at intervals of more than 4 days when plasma levels have plateaued as demonstrated by plasma level monitoring. Clinical Pharmacology and Therapeutics (1988) 43, 449–455; doi: 10.1038/clpt.1988.57