Flecainide / FlexMed – Flecainide acetate 10 mg/ml
Flecainide / FlexMed is an intravenous Class Ic antiarrhythmic agent designed for rapid and effective rhythm restoration and rate control in selected patients with recent atrial fibrillation and re‑entry tachyarrhythmias. It works by blocking sodium channels, slowing conduction, and interrupting re‑entry circuits, but requires close ECG monitoring during administration.
Advantages
- Useful for pharmacological cardioversion of recent atrial fibrillation.
- Reported high success rate of rhythm restoration within a few hours in appropriate patients.
- Helpful in AVRT and atrial tachycardia.
- Suitable only for patients without severe structural heart disease or coronary artery disease.
- Practical packaging for hospital use.
Use
Flecainide / FlexMed is used for:
Atrial fibrillation with recent onset, when pharmacological cardioversion is intended.
Atrioventricular re‑entry tachycardia (AVRT) when vagal maneuvers or adenosine fail.
Atrial tachycardia (AT) as a second‑line therapy.
The initial adult dose in patients with normal renal function is 2 mg/kg IV over 10–30 minutes, with a maximum of 150 mg, and may be repeated depending on response. In renal impairment (CrCl ≤35 mL/min), a lower dose of 1–1.5 mg/kg with a maximum of 100 mg is recommended.
Safety notes
Flecainide is contraindicated in severe structural heart disease, heart failure, coronary artery disease, Brugada syndrome, and significant renal dysfunction.
QRS monitoring is required; treatment should be stopped if QRS widening exceeds 25% or a bundle‑branch block appears.
