Pharmacokinetics of flecainide in patients with mild and moderate renal failure compared with patients with normal renal function

Braun, J.; Kollert, J. R.; Becker, Joshua

doi:10.1007/bf00541300

Cited by 26 publications

(5 citation statements)

References 11 publications

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“…Flecainide is excreted mainly in the urine with about 40% as unchanged drug and the remainder as metabolites. Although the absorption and volume of distribution of flecainide are unaffected by renal failure [11, 12], the plasma elimination half-life is significantly prolonged in patients with mild to moderate renal impairment (10–30 h) compared with patients with normal renal function (6–15 h) [12, 13]. The half-life increases further in patients with stage 5 chronic kidney disease (up to 40 h).…”

Section: Discussionmentioning

confidence: 99%

Paranoid Psychosis and Myoclonus: Flecainide Toxicity in Renal Failure

Ting

Lee²,

MacLean³

et al. 2008

Cardiology

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Flecainide is a sodium channel blocker used mainly in the treatment of supraventricular arrhythmias. Central nervous system side effects such as dizziness, visual disturbances, headache and nausea are commonly associated with flecainide, but severe central nervous system toxicity is rare. We report the first case of flecainide toxicity in a patient with end-stage renal failure. Cessation of flecainide therapy resulted in a fall in serum flecainide levels, with associated resolution of adverse central nervous system effects. We also review the pharmacokinetics of flecainide in patients with chronic kidney disease.

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Section: Discussionmentioning

confidence: 99%

Paranoid Psychosis and Myoclonus: Flecainide Toxicity in Renal Failure

Ting

Lee²,

MacLean³

et al. 2008

Cardiology

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“…Braun et al 5 studied the pharmacokinetics of¯ecainide acetate in normal subjects and renal failure patients. Sixteen volunteers (eight subjects with 468 I. MAHMOOD normal renal function and eight subjects with impaired renal function) took part in this study, receiving 200 mg¯ecainide acetate tablets.…”

Section: Flecainide Acetatementioning

confidence: 99%

Prediction of Absolute Bioavailability for Drugs Using Oral and Renal Clearance Following a Single Oral Dose: A Critical View

Mahmood

1997

Biopharm. Drug Dispos.

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In order to determine the absolute bioavailability, both oral and intravenous administrations of a drug are often used. Recently a new method has been proposed to determine absolute bioavailability in the absence of intravenous dose. Following a single oral dose, this method requires oral and renal clearance data from normal subjects and renal failure patients. The bioavailability is calculated from a plot of oral against renal clearance following an oral dose, where the inverse of the slope is equal to absolute bioavailability. This study examines the prediction of absolute bioavailability from the proposed method for eight drugs which have a wide range of oral and renal clearance. From this study, it appears that the proposed method may not be reliable for the prediction of absolute bioavailability and further investigation is needed to test the validity of this method. © 1997 John Wiley & Sons, Ltd.

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“…Large individual variations in serum flecainide level have been reported (3, 9). Clearance for flecainide is altered by liver and renal dysfunction (10, 11), CHF (12), combination use of amiodarone (13) and CYP2D6 genotype status (14). In our patient, oral clearance of flecainide was low (0·14 L/h/kg) even though liver function was normal and the CYP2D6 genotype was of the wild type ( CYP2D6*1/*1 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of serum flecainide level on control of atrial fibrillation in a case treated with cardiac resynchronization therapy

Doki¹,

Homma²,

Kuga³

et al. 2007

J Clin Pharm Ther

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A 72-year-old male patient with dilated cardiomyopathy was treated with oral flecainide (100 mg/day) for persistent atrial fibrillation (AF) that could not be converted to sinus rhythm by electrical cardioversion. Initiation of flecainide treatment provided sinus rhythm without prolongation of QRS and QTc, bradycardia and first-degree atrioventricular block at a serum flecainide level of 438 ng/mL. Then, he received cardiac resynchronization therapy (CRT). Dose reduction to 50 mg/day because of stabilization of heart rate after CRT produced AF at a serum flecainide level of 270 ng/mL. Electrical cardioversion did not restore the AF to a sinus or pacing rhythm. Dose escalation of flecainide (to 100 mg/day) restored the pacing rhythm at a serum flecainide level of 401 ng/mL. This case suggests that in the Japanese population, serum flecainide level should be maintained at >300 ng/mL to control AF even after effective CRT.

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Pharmacokinetics of flecainide in patients with mild and moderate renal failure compared with patients with normal renal function

Cited by 26 publications

References 11 publications

Paranoid Psychosis and Myoclonus: Flecainide Toxicity in Renal Failure

Paranoid Psychosis and Myoclonus: Flecainide Toxicity in Renal Failure

Prediction of Absolute Bioavailability for Drugs Using Oral and Renal Clearance Following a Single Oral Dose: A Critical View

Impact of serum flecainide level on control of atrial fibrillation in a case treated with cardiac resynchronization therapy

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