Flecainide is used in the treatment of ventricular or life- threatening supraventricular arrhythmias.
It is administered as a bolus intravenously in a dose of 2 mg per kg over 10 to 30 minutes, up to a maximum of 150 mg.
Infusion may follow the bolus, and is 150 mg in 100 mls 5% dextrose, 1ml per hour, followed by 100 to 250 micrograms per kg per hour for up to 24 hours.
Cautions include hepatic and renal failure, cardiac failure due to negative inotropism, pacing due to increased endocardial pacing threshold, or amiodarone - in which case flecainide doses should be reduced by 50%
Contraindications include severe cardiac impairment and recent myocardial infarction.
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