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Identification
NameFlecainide
Accession NumberDB01195  (APRD00129)
TypeSmall Molecule
GroupsApproved, Withdrawn
DescriptionA potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias. Paradoxically, however, in myocardial infarct patients with either symptomatic or asymptomatic arrhythmia, flecainide exacerbates the arrhythmia and is not recommended for use in these patients. [PubChem]
Structure
Thumb
Synonyms
(+-)-Flecainide
CCRIS 313
Flecaine
Flecainida
Flecainidum
N-(2-Piperidinylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide
External Identifiers Not Available
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Flecainidetablet50 mgoralAa Pharma Inc2006-05-08Not applicableCanada
Flecainidetablet100 mgoralAa Pharma Inc2006-05-08Not applicableCanada
Tambocortablet50 mgoralValeant Canada Lp Valeant Canada S.E.C.1988-12-31Not applicableCanada
Tambocortablet100 mgoralValeant Canada Lp Valeant Canada S.E.C.1966-12-31Not applicableCanada
Approved Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Flecainide Acetatetablet50 mg/1oralAv Pak2015-02-09Not applicableUs
Flecainide Acetatetablet50 mg/1oralRanbaxy Pharmaceuticals Inc.2004-02-28Not applicableUs
Flecainide Acetatetablet50 mg/1oralRoxane Laboratories, Inc.2003-01-14Not applicableUs
Flecainide Acetatetablet150 mg/1oralCitron Pharma LLC2015-07-08Not applicableUs
Flecainide Acetatetablet150 mg/1oralAurobindo Pharma Limited2015-07-08Not applicableUs
Flecainide Acetatetablet100 mg/1oralPhysicians Total Care, Inc.2005-09-02Not applicableUs
Flecainide Acetatetablet100 mg/1oralAmneal Pharmaceuticals of New York, LLC2009-12-01Not applicableUs
Flecainide Acetatetablet50 mg/1oralBarr Laboratories Inc.2002-11-18Not applicableUs
Flecainide Acetatetablet50 mg/1oralANI Pharmaceuticals, Inc.2015-12-28Not applicableUs
Flecainide Acetatetablet100 mg/1oralAv Pak2015-02-09Not applicableUs
Flecainide Acetatetablet100 mg/1oralRanbaxy Pharmaceuticals Inc.2004-02-28Not applicableUs
Flecainide Acetatetablet100 mg/1oralRoxane Laboratories, Inc.2003-01-14Not applicableUs
Flecainide Acetatetablet50 mg/1oralApotex Corp.2009-07-09Not applicableUs
Flecainide Acetatetablet100 mg/1oralAmerican Health Packaging2011-07-14Not applicableUs
Flecainide Acetatetablet150 mg/1oralPhysicians Total Care, Inc.2008-09-30Not applicableUs
Flecainide Acetatetablet150 mg/1oralAmneal Pharmaceuticals of New York, LLC2009-12-01Not applicableUs
Flecainide Acetatetablet100 mg/1oralBarr Laboratories Inc.2002-11-19Not applicableUs
Flecainide Acetatetablet100 mg/1oralANI Pharmaceuticals, Inc.2015-12-28Not applicableUs
Flecainide Acetatetablet150 mg/1oralAv Pak2015-02-09Not applicableUs
Flecainide Acetatetablet150 mg/1oralRanbaxy Pharmaceuticals Inc.2004-02-28Not applicableUs
Flecainide Acetatetablet150 mg/1oralRoxane Laboratories, Inc.2003-01-14Not applicableUs
Flecainide Acetatetablet100 mg/1oralApotex Corp.2009-07-09Not applicableUs
Flecainide Acetatetablet100 mg/1oralCarilion Materials Management2003-01-14Not applicableUs
Flecainide Acetatetablet50 mg/1oralCitron Pharma LLC2015-07-08Not applicableUs
Flecainide Acetatetablet50 mg/1oralAurobindo Pharma Limited2015-07-08Not applicableUs
Flecainide Acetatetablet150 mg/1oralANI Pharmaceuticals, Inc.2015-12-28Not applicableUs
Flecainide Acetatetablet150 mg/1oralBarr Laboratories Inc.2002-11-19Not applicableUs
Flecainide Acetatetablet50 mg/1oralPhysicians Total Care, Inc.2004-06-30Not applicableUs
Flecainide Acetatetablet50 mg/1oralAmneal Pharmaceuticals of New York, LLC2009-12-01Not applicableUs
Flecainide Acetatetablet100 mg/1oralKAISER FOUNDATION HOSPITALS2015-12-18Not applicableUs
Flecainide Acetatetablet150 mg/1oralApotex Corp.2009-07-09Not applicableUs
Flecainide Acetatetablet100 mg/1oralAvera Mc Kennan Hospital2015-03-01Not applicableUs
Flecainide Acetatetablet100 mg/1oralAurobindo Pharma Limited2015-07-08Not applicableUs
Flecainide Acetatetablet100 mg/1oralCitron Pharma LLC2015-07-08Not applicableUs
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
AlmarytmNot Available
ApocardNot Available
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Flecainide acetate
Thumb
  • InChI Key: RKXNZRPQSOPPRN-UHFFFAOYNA-N
  • Monoisotopic Mass: 474.158941118
  • Average Mass: 474.3947
DBSALT000086
Categories
UNIIK94FTS1806
CAS number54143-55-4
WeightAverage: 414.3427
Monoisotopic: 414.137811746
Chemical FormulaC17H20F6N2O3
InChI KeyInChIKey=DJBNUMBKLMJRSA-UHFFFAOYSA-N
InChI
InChI=1S/C17H20F6N2O3/c18-16(19,20)9-27-12-4-5-14(28-10-17(21,22)23)13(7-12)15(26)25-8-11-3-1-2-6-24-11/h4-5,7,11,24H,1-3,6,8-10H2,(H,25,26)
IUPAC Name
N-(piperidin-2-ylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide
SMILES
FC(F)(F)COC1=CC(C(=O)NCC2CCCCN2)=C(OCC(F)(F)F)C=C1
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as salicylamides. These are carboxamide derivatives of salicylic acid. Salicylic acid is the ortho-hydroxylated derivative of benzoic acid.
KingdomOrganic compounds
Super ClassBenzenoids
ClassBenzene and substituted derivatives
Sub ClassBenzoic acids and derivatives
Direct ParentSalicylamides
Alternative Parents
Substituents
  • Salicylamide
  • Benzamide
  • Phenol ether
  • Benzoyl
  • Alkyl aryl ether
  • Piperidine
  • Secondary carboxylic acid amide
  • Carboxamide group
  • Azacycle
  • Organoheterocyclic compound
  • Secondary amine
  • Ether
  • Secondary aliphatic amine
  • Carboxylic acid derivative
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Organofluoride
  • Organohalogen compound
  • Carbonyl group
  • Amine
  • Alkyl halide
  • Alkyl fluoride
  • Aromatic heteromonocyclic compound
Molecular FrameworkAromatic heteromonocyclic compounds
External DescriptorsNot Available
Pharmacology
IndicationFlecainide is is a class Ic antiarrhythmic agent and as such, it is used for the prevention of paroxysmal supraventricular tachycardias (PSVT), including atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia and other supraventricular tachycardias of unspecified mechanism associated with disablin.
PharmacodynamicsFlecainide has local anesthetic activity and belongs to the membrane stabilizing (Class 1) group of antiarrhythmic agents; it has electrophysiologic effects characteristic of the IC class of antiarrhythmics.
Mechanism of actionFlecainide acts on sodium channels on the neuronal cell membrane, limiting the spread of seizure activity and reducing seizure propagation. The antiarrhythmic actions are mediated through effects on sodium channels in Purkinje fibers. Flecainide is a sodium channel blocker, binding to voltage gated sodium channels. It stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Ventricular excitability is depressed and the stimulation threshold of the ventricle is increased during diastole.
Related Articles
AbsorptionNearly complete following oral administration.
Volume of distributionNot Available
Protein binding40%
Metabolism

Hepatic. Flecainide does not undergo any consequential presystemic biotransformation. The two major urinary metabolites are meta-O-dealkylated flecainide (active, but about one-fifth as potent) and the meta-O-dealkylated lactam of flecainide (non-active metabolite).

SubstrateEnzymesProduct
Flecainide
Not Available
Meta-O-dealkylated flecainideDetails
Flecainide
Not Available
Meta-o-dealkylated lactamDetails
Route of eliminationIn healthy subjects, about 30% of a single oral dose (range, 10 to 50%) is excreted in urine as unchanged drug. Several minor metabolites (3% of the dose or less) are also found in urine; only 5% of an oral dose is excreted in feces. In patients, free (unconjugated) plasma levels of the two major metabolites are very low (less than 0.05 μg/mL).
Half life20 hours (range 12-27 hours)
ClearanceNot Available
ToxicityOral LD50 is 50-498 mg/kg in rat. Symptoms of overdose include nausea and vomiting, convulsions, hypotension, bradycardia, syncope, extreme widening of the QRS complex, widening of the QT interval, widening of the PR interval, ventricular tachycardia, AV nodal block, asystole, bundle branch block, cardiac failure, and cardiac arrest.
Affected organisms
  • Humans and other mammals
Pathways
PathwayCategorySMPDB ID
Flecainide Action PathwayDrug actionSMP00331
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9856
Blood Brain Barrier+0.8605
Caco-2 permeable+0.8867
P-glycoprotein substrateSubstrate0.7773
P-glycoprotein inhibitor IInhibitor0.5307
P-glycoprotein inhibitor IINon-inhibitor0.7716
Renal organic cation transporterNon-inhibitor0.6687
CYP450 2C9 substrateNon-substrate0.8921
CYP450 2D6 substrateSubstrate0.8918
CYP450 3A4 substrateNon-substrate0.5957
CYP450 1A2 substrateInhibitor0.9106
CYP450 2C9 inhibitorNon-inhibitor0.6853
CYP450 2D6 inhibitorNon-inhibitor0.6556
CYP450 2C19 inhibitorInhibitor0.5307
CYP450 3A4 inhibitorNon-inhibitor0.8309
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.5538
Ames testNon AMES toxic0.672
CarcinogenicityNon-carcinogens0.8821
BiodegradationNot ready biodegradable0.9968
Rat acute toxicity2.5680 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9409
hERG inhibition (predictor II)Inhibitor0.8474
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
Packagers
Dosage forms
FormRouteStrength
Tabletoral100 mg
Tabletoral50 mg
Tabletoral100 mg/1
Tabletoral150 mg/1
Tabletoral50 mg/1
Prices
Unit descriptionCostUnit
Tambocor 150 mg tablet5.75USD tablet
Tambocor 100 mg tablet4.27USD tablet
Flecainide acetate 150 mg tablet3.83USD tablet
Flecainide acetate 100 mg tablet2.95USD tablet
Tambocor 50 mg tablet2.72USD tablet
Flecainide acetate 50 mg tablet1.95USD tablet
Tambocor 100 mg Tablet1.19USD tablet
Apo-Flecainide 100 mg Tablet0.83USD tablet
Tambocor 50 mg Tablet0.6USD tablet
Apo-Flecainide 50 mg Tablet0.41USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
PatentsNot Available
Properties
StateSolid
Experimental Properties
PropertyValueSource
melting point228-229Bmitt, E.H. and Brown, W.R.; U.S. Patent 3,900,481; August 19,1975; assigned to Riker Laboratories, Inc.
water solubility48.4 mg/mL at 37 °C (acetate form)Not Available
logP3.78MANNHOLD,R ET AL. (1990)
pKa9.3Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.0324 mg/mLALOGPS
logP2.98ALOGPS
logP3.19ChemAxon
logS-4.1ALOGPS
pKa (Strongest Acidic)13.68ChemAxon
pKa (Strongest Basic)9.62ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count4ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area59.59 Å2ChemAxon
Rotatable Bond Count9ChemAxon
Refractivity88.4 m3·mol-1ChemAxon
Polarizability35.92 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
MSMass Spectrum (Electron Ionization)splash10-001i-9000000000-b732167df77d39193144View in MoNA
References
Synthesis Reference

Bmitt, E.H. and Brown, W.R.; U.S. Patent 3,900,481; August 19,1975; assigned to Riker Laboratories, Inc.

US3900481A
General References
  1. Gill JS, Mehta D, Ward DE, Camm AJ: Efficacy of flecainide, sotalol, and verapamil in the treatment of right ventricular tachycardia in patients without overt cardiac abnormality. Br Heart J. 1992 Oct;68(4):392-7. [PubMed:1449923 ]
  2. Sakurada H, Hiyoshi Y, Tejima T, Yanase O, Tokuyasu Y, Watanabe K, Motomiya T, Sugiura M, Hiraoka M: [Effects of oral flecainide treatment of refractory tachyarrhythmias]. Kokyu To Junkan. 1990 May;38(5):471-6. [PubMed:2115193 ]
  3. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, Arensberg D, Baker A, Friedman L, Greene HL, et al.: Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991 Mar 21;324(12):781-8. [PubMed:1900101 ]
  4. Greenberg HM, Dwyer EM Jr, Hochman JS, Steinberg JS, Echt DS, Peters RW: Interaction of ischaemia and encainide/flecainide treatment: a proposed mechanism for the increased mortality in CAST I. Br Heart J. 1995 Dec;74(6):631-5. [PubMed:8541168 ]
  5. Gasparini M, Priori SG, Mantica M, Napolitano C, Galimberti P, Ceriotti C, Simonini S: Flecainide test in Brugada syndrome: a reproducible but risky tool. Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 2):338-41. [PubMed:12687841 ]
External Links
ATC CodesC01BC04
AHFS Codes
  • 24:04.04.12
PDB EntriesNot Available
FDA labelNot Available
MSDSDownload (77.1 KB)
Interactions
Drug Interactions
Drug
AbirateroneThe metabolism of Flecainide can be decreased when combined with Abiraterone.
AcetazolamideThe serum concentration of Flecainide can be increased when it is combined with Acetazolamide.
AlfuzosinAlfuzosin may increase the QTc-prolonging activities of Flecainide.
AmantadineAmantadine may increase the QTc-prolonging activities of Flecainide.
AmiodaroneFlecainide may increase the QTc-prolonging activities of Amiodarone.
AmiodaroneThe metabolism of Flecainide can be decreased when combined with Amiodarone.
AmitriptylineAmitriptyline may increase the QTc-prolonging activities of Flecainide.
AmoxapineAmoxapine may increase the QTc-prolonging activities of Flecainide.
AnagrelideFlecainide may increase the QTc-prolonging activities of Anagrelide.
ApomorphineApomorphine may increase the QTc-prolonging activities of Flecainide.
ArformoterolArformoterol may increase the QTc-prolonging activities of Flecainide.
AripiprazoleThe serum concentration of Aripiprazole can be increased when it is combined with Flecainide.
AripiprazoleAripiprazole may increase the QTc-prolonging activities of Flecainide.
Arsenic trioxideFlecainide may increase the QTc-prolonging activities of Arsenic trioxide.
ArtemetherFlecainide may increase the QTc-prolonging activities of Artemether.
ArtemetherThe metabolism of Flecainide can be decreased when combined with Artemether.
AsenapineFlecainide may increase the QTc-prolonging activities of Asenapine.
AtazanavirAtazanavir may increase the QTc-prolonging activities of Flecainide.
AtomoxetineAtomoxetine may increase the QTc-prolonging activities of Flecainide.
AzithromycinAzithromycin may increase the QTc-prolonging activities of Flecainide.
BedaquilineFlecainide may increase the QTc-prolonging activities of Bedaquiline.
BetaxololThe metabolism of Flecainide can be decreased when combined with Betaxolol.
BoceprevirThe serum concentration of Flecainide can be increased when it is combined with Boceprevir.
BortezomibBortezomib may increase the QTc-prolonging activities of Flecainide.
BrinzolamideThe serum concentration of Flecainide can be increased when it is combined with Brinzolamide.
BupropionThe metabolism of Flecainide can be decreased when combined with Bupropion.
BuserelinBuserelin may increase the QTc-prolonging activities of Flecainide.
CelecoxibThe metabolism of Flecainide can be decreased when combined with Celecoxib.
CeritinibFlecainide may increase the QTc-prolonging activities of Ceritinib.
ChloroquineFlecainide may increase the QTc-prolonging activities of Chloroquine.
ChloroquineThe metabolism of Flecainide can be decreased when combined with Chloroquine.
ChlorpromazineFlecainide may increase the QTc-prolonging activities of Chlorpromazine.
ChlorpromazineThe metabolism of Flecainide can be decreased when combined with Chlorpromazine.
CholecalciferolThe metabolism of Flecainide can be decreased when combined with Cholecalciferol.
CimetidineThe metabolism of Flecainide can be decreased when combined with Cimetidine.
CinacalcetThe metabolism of Flecainide can be decreased when combined with Cinacalcet.
CiprofloxacinCiprofloxacin may increase the QTc-prolonging activities of Flecainide.
CisaprideFlecainide may increase the QTc-prolonging activities of Cisapride.
CitalopramFlecainide may increase the QTc-prolonging activities of Citalopram.
CitalopramThe metabolism of Flecainide can be decreased when combined with Citalopram.
ClarithromycinFlecainide may increase the QTc-prolonging activities of Clarithromycin.
ClemastineThe metabolism of Flecainide can be decreased when combined with Clemastine.
ClobazamThe metabolism of Flecainide can be decreased when combined with Clobazam.
ClomipramineClomipramine may increase the QTc-prolonging activities of Flecainide.
ClotrimazoleThe metabolism of Flecainide can be decreased when combined with Clotrimazole.
ClozapineFlecainide may increase the QTc-prolonging activities of Clozapine.
ClozapineThe metabolism of Flecainide can be decreased when combined with Clozapine.
CobicistatThe serum concentration of Flecainide can be increased when it is combined with Cobicistat.
CocaineThe metabolism of Flecainide can be decreased when combined with Cocaine.
CrizotinibFlecainide may increase the QTc-prolonging activities of Crizotinib.
DabrafenibDabrafenib may increase the QTc-prolonging activities of Flecainide.
DarifenacinThe metabolism of Flecainide can be decreased when combined with Darifenacin.
DarunavirThe serum concentration of Flecainide can be increased when it is combined with Darunavir.
DasatinibDasatinib may increase the QTc-prolonging activities of Flecainide.
DegarelixDegarelix may increase the QTc-prolonging activities of Flecainide.
DelavirdineThe metabolism of Flecainide can be decreased when combined with Delavirdine.
DesfluraneDesflurane may increase the QTc-prolonging activities of Flecainide.
DesipramineDesipramine may increase the QTc-prolonging activities of Flecainide.
DiclofenamideThe serum concentration of Flecainide can be increased when it is combined with Diclofenamide.
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Flecainide.
DiphenhydramineDiphenhydramine may increase the QTc-prolonging activities of Flecainide.
DisopyramideFlecainide may increase the QTc-prolonging activities of Disopyramide.
DofetilideFlecainide may increase the QTc-prolonging activities of Dofetilide.
DolasetronDolasetron may increase the QTc-prolonging activities of Flecainide.
DomperidoneFlecainide may increase the QTc-prolonging activities of Domperidone.
DorzolamideThe serum concentration of Flecainide can be increased when it is combined with Dorzolamide.
DoxepinDoxepin may increase the QTc-prolonging activities of Flecainide.
DronedaroneFlecainide may increase the QTc-prolonging activities of Dronedarone.
DronedaroneThe metabolism of Flecainide can be decreased when combined with Dronedarone.
DroperidolDroperidol may increase the QTc-prolonging activities of Flecainide.
DuloxetineThe metabolism of Flecainide can be decreased when combined with Duloxetine.
EliglustatFlecainide may increase the QTc-prolonging activities of Eliglustat.
EliglustatThe metabolism of Flecainide can be decreased when combined with Eliglustat.
EribulinEribulin may increase the QTc-prolonging activities of Flecainide.
ErythromycinErythromycin may increase the QTc-prolonging activities of Flecainide.
EscitalopramFlecainide may increase the QTc-prolonging activities of Escitalopram.
EthoxzolamideThe serum concentration of Flecainide can be increased when it is combined with Ethoxzolamide.
EtravirineThe serum concentration of Flecainide can be decreased when it is combined with Etravirine.
EzogabineEzogabine may increase the QTc-prolonging activities of Flecainide.
FamotidineFamotidine may increase the QTc-prolonging activities of Flecainide.
FelbamateFelbamate may increase the QTc-prolonging activities of Flecainide.
FesoterodineThe serum concentration of the active metabolites of Fesoterodine can be increased when Fesoterodine is used in combination with Flecainide.
FingolimodFingolimod may increase the QTc-prolonging activities of Flecainide.
FluconazoleFluconazole may increase the QTc-prolonging activities of Flecainide.
FluoxetineFlecainide may increase the QTc-prolonging activities of Fluoxetine.
FluoxetineThe metabolism of Flecainide can be decreased when combined with Fluoxetine.
FlupentixolFlecainide may increase the QTc-prolonging activities of Flupentixol.
FluvoxamineThe metabolism of Flecainide can be decreased when combined with Fluvoxamine.
FormoterolFormoterol may increase the QTc-prolonging activities of Flecainide.
FosamprenavirThe serum concentration of Flecainide can be increased when it is combined with Fosamprenavir.
FoscarnetFoscarnet may increase the QTc-prolonging activities of Flecainide.
Gadobenic acidGadobenic acid may increase the QTc-prolonging activities of Flecainide.
GalantamineGalantamine may increase the QTc-prolonging activities of Flecainide.
GemifloxacinGemifloxacin may increase the QTc-prolonging activities of Flecainide.
GoserelinGoserelin may increase the QTc-prolonging activities of Flecainide.
GranisetronGranisetron may increase the QTc-prolonging activities of Flecainide.
HaloperidolFlecainide may increase the QTc-prolonging activities of Haloperidol.
HaloperidolThe metabolism of Flecainide can be decreased when combined with Haloperidol.
HistrelinHistrelin may increase the QTc-prolonging activities of Flecainide.
HydroxyzineHydroxyzine may increase the QTc-prolonging activities of Flecainide.
IbandronateIbandronate may increase the QTc-prolonging activities of Flecainide.
IbutilideFlecainide may increase the QTc-prolonging activities of Ibutilide.
IloperidoneFlecainide may increase the QTc-prolonging activities of Iloperidone.
ImipramineImipramine may increase the QTc-prolonging activities of Flecainide.
IndacaterolIndacaterol may increase the QTc-prolonging activities of Flecainide.
IndapamideIndapamide may increase the QTc-prolonging activities of Flecainide.
IndinavirThe metabolism of Flecainide can be decreased when combined with Indinavir.
IsofluraneIsoflurane may increase the QTc-prolonging activities of Flecainide.
IsoniazidThe metabolism of Flecainide can be decreased when combined with Isoniazid.
IsradipineIsradipine may increase the QTc-prolonging activities of Flecainide.
ItraconazoleItraconazole may increase the QTc-prolonging activities of Flecainide.
IvabradineIvabradine may increase the QTc-prolonging activities of Flecainide.
KetoconazoleKetoconazole may increase the QTc-prolonging activities of Flecainide.
Lactic AcidThe serum concentration of Flecainide can be increased when it is combined with Lactic Acid.
LapatinibLapatinib may increase the QTc-prolonging activities of Flecainide.
LenvatinibFlecainide may increase the QTc-prolonging activities of Lenvatinib.
LeuprolideLeuprolide may increase the QTc-prolonging activities of Flecainide.
LevofloxacinLevofloxacin may increase the QTc-prolonging activities of Flecainide.
LithiumLithium may increase the QTc-prolonging activities of Flecainide.
LopinavirFlecainide may increase the QTc-prolonging activities of Lopinavir.
LopinavirThe metabolism of Flecainide can be decreased when combined with Lopinavir.
LorcaserinThe metabolism of Flecainide can be decreased when combined with Lorcaserin.
LumefantrineFlecainide may increase the QTc-prolonging activities of Lumefantrine.
LumefantrineThe metabolism of Flecainide can be decreased when combined with Lumefantrine.
MaprotilineMaprotiline may increase the QTc-prolonging activities of Flecainide.
MefloquineMefloquine may increase the QTc-prolonging activities of Flecainide.
MethadoneFlecainide may increase the QTc-prolonging activities of Methadone.
MethadoneThe metabolism of Flecainide can be decreased when combined with Methadone.
MethazolamideThe serum concentration of Flecainide can be increased when it is combined with Methazolamide.
MethotrimeprazineMethotrimeprazine may increase the QTc-prolonging activities of Flecainide.
MetoclopramideMetoclopramide may increase the QTc-prolonging activities of Flecainide.
MetoprololThe serum concentration of Metoprolol can be increased when it is combined with Flecainide.
MetoprololThe metabolism of Flecainide can be decreased when combined with Metoprolol.
MetronidazoleMetronidazole may increase the QTc-prolonging activities of Flecainide.
MifepristoneMifepristone may increase the QTc-prolonging activities of Flecainide.
MirabegronThe serum concentration of Flecainide can be increased when it is combined with Mirabegron.
MirtazapineMirtazapine may increase the QTc-prolonging activities of Flecainide.
MoexiprilMoexipril may increase the QTc-prolonging activities of Flecainide.
MoxifloxacinMoxifloxacin may increase the QTc-prolonging activities of Flecainide.
NelfinavirNelfinavir may increase the QTc-prolonging activities of Flecainide.
NevirapineThe metabolism of Flecainide can be decreased when combined with Nevirapine.
NicardipineNicardipine may increase the QTc-prolonging activities of Flecainide.
NilotinibFlecainide may increase the QTc-prolonging activities of Nilotinib.
NilotinibThe metabolism of Flecainide can be decreased when combined with Nilotinib.
NorfloxacinNorfloxacin may increase the QTc-prolonging activities of Flecainide.
NortriptylineNortriptyline may increase the QTc-prolonging activities of Flecainide.
OctreotideOctreotide may increase the QTc-prolonging activities of Flecainide.
OfloxacinOfloxacin may increase the QTc-prolonging activities of Flecainide.
OlanzapineOlanzapine may increase the QTc-prolonging activities of Flecainide.
OlodaterolOlodaterol may increase the QTc-prolonging activities of Flecainide.
OndansetronOndansetron may increase the QTc-prolonging activities of Flecainide.
OxytocinOxytocin may increase the QTc-prolonging activities of Flecainide.
PaliperidoneFlecainide may increase the QTc-prolonging activities of Paliperidone.
PanobinostatFlecainide may increase the QTc-prolonging activities of Panobinostat.
PanobinostatThe metabolism of Flecainide can be decreased when combined with Panobinostat.
ParoxetineParoxetine may increase the QTc-prolonging activities of Flecainide.
PasireotidePasireotide may increase the QTc-prolonging activities of Flecainide.
PazopanibFlecainide may increase the QTc-prolonging activities of Pazopanib.
Peginterferon alfa-2bThe serum concentration of Flecainide can be decreased when it is combined with Peginterferon alfa-2b.
PentamidinePentamidine may increase the QTc-prolonging activities of Flecainide.
PerflutrenPerflutren may increase the QTc-prolonging activities of Flecainide.
PimozideFlecainide may increase the QTc-prolonging activities of Pimozide.
PosaconazolePosaconazole may increase the QTc-prolonging activities of Flecainide.
PrimaquinePrimaquine may increase the QTc-prolonging activities of Flecainide.
ProcainamideFlecainide may increase the QTc-prolonging activities of Procainamide.
PromazineFlecainide may increase the QTc-prolonging activities of Promazine.
PromazineThe metabolism of Flecainide can be decreased when combined with Promazine.
PromethazinePromethazine may increase the QTc-prolonging activities of Flecainide.
PropafenonePropafenone may increase the QTc-prolonging activities of Flecainide.
PropofolPropofol may increase the QTc-prolonging activities of Flecainide.
ProtriptylineProtriptyline may increase the QTc-prolonging activities of Flecainide.
QuetiapineFlecainide may increase the QTc-prolonging activities of Quetiapine.
QuinidineFlecainide may increase the QTc-prolonging activities of Quinidine.
QuinidineThe metabolism of Flecainide can be decreased when combined with Quinidine.
QuinineFlecainide may increase the QTc-prolonging activities of Quinine.
QuinineThe metabolism of Flecainide can be decreased when combined with Quinine.
RanolazineRanolazine may increase the QTc-prolonging activities of Flecainide.
RilpivirineRilpivirine may increase the QTc-prolonging activities of Flecainide.
RisperidoneRisperidone may increase the QTc-prolonging activities of Flecainide.
RitonavirThe serum concentration of Flecainide can be increased when it is combined with Ritonavir.
RolapitantThe metabolism of Flecainide can be decreased when combined with Rolapitant.
RopiniroleThe metabolism of Flecainide can be decreased when combined with Ropinirole.
SalbutamolSalbutamol may increase the QTc-prolonging activities of Flecainide.
SalmeterolSalmeterol may increase the QTc-prolonging activities of Flecainide.
SaquinavirSaquinavir may increase the arrhythmogenic activities of Flecainide.
SaquinavirFlecainide may increase the QTc-prolonging activities of Saquinavir.
SertralineSertraline may increase the QTc-prolonging activities of Flecainide.
SevofluraneSevoflurane may increase the QTc-prolonging activities of Flecainide.
Sodium bicarbonateSodium bicarbonate may decrease the arrhythmogenic activities of Flecainide.
SolifenacinSolifenacin may increase the QTc-prolonging activities of Flecainide.
SorafenibSorafenib may increase the QTc-prolonging activities of Flecainide.
SotalolFlecainide may increase the QTc-prolonging activities of Sotalol.
StiripentolThe metabolism of Flecainide can be decreased when combined with Stiripentol.
SulfamethoxazoleSulfamethoxazole may increase the QTc-prolonging activities of Flecainide.
SulfisoxazoleSulfisoxazole may increase the QTc-prolonging activities of Flecainide.
SunitinibSunitinib may increase the QTc-prolonging activities of Flecainide.
TamoxifenTamoxifen may increase the QTc-prolonging activities of Flecainide.
TelaprevirThe risk or severity of adverse effects can be increased when Telaprevir is combined with Flecainide.
TelavancinFlecainide may increase the QTc-prolonging activities of Telavancin.
TelithromycinTelithromycin may increase the QTc-prolonging activities of Flecainide.
TerbinafineThe metabolism of Flecainide can be decreased when combined with Terbinafine.
TerbutalineTerbutaline may increase the QTc-prolonging activities of Flecainide.
TetrabenazineFlecainide may increase the QTc-prolonging activities of Tetrabenazine.
ThioridazineThe serum concentration of Thioridazine can be increased when it is combined with Flecainide.
ThioridazineThe metabolism of Flecainide can be decreased when combined with Thioridazine.
ThiothixeneThiothixene may increase the QTc-prolonging activities of Flecainide.
TiclopidineThe metabolism of Flecainide can be decreased when combined with Ticlopidine.
TipranavirThe serum concentration of Flecainide can be increased when it is combined with Tipranavir.
TizanidineTizanidine may increase the QTc-prolonging activities of Flecainide.
TolterodineTolterodine may increase the QTc-prolonging activities of Flecainide.
ToremifeneFlecainide may increase the QTc-prolonging activities of Toremifene.
TranylcypromineThe metabolism of Flecainide can be decreased when combined with Tranylcypromine.
TrazodoneTrazodone may increase the QTc-prolonging activities of Flecainide.
TreprostinilTreprostinil may increase the QTc-prolonging activities of Flecainide.
TrimethoprimTrimethoprim may increase the QTc-prolonging activities of Flecainide.
TrimipramineTrimipramine may increase the QTc-prolonging activities of Flecainide.
TriptorelinTriptorelin may increase the QTc-prolonging activities of Flecainide.
TrisThe serum concentration of Flecainide can be increased when it is combined with Tris.
VandetanibFlecainide may increase the QTc-prolonging activities of Vandetanib.
VardenafilVardenafil may increase the QTc-prolonging activities of Flecainide.
VemurafenibFlecainide may increase the QTc-prolonging activities of Vemurafenib.
VenlafaxineVenlafaxine may increase the QTc-prolonging activities of Flecainide.
VerapamilThe risk or severity of adverse effects can be increased when Verapamil is combined with Flecainide.
VilanterolVilanterol may increase the QTc-prolonging activities of Flecainide.
VoriconazoleVoriconazole may increase the QTc-prolonging activities of Flecainide.
VorinostatVorinostat may increase the QTc-prolonging activities of Flecainide.
ZiprasidoneFlecainide may increase the QTc-prolonging activities of Ziprasidone.
ZiprasidoneThe metabolism of Flecainide can be decreased when combined with Ziprasidone.
ZuclopenthixolFlecainide may increase the QTc-prolonging activities of Zuclopenthixol.
Food Interactions
  • Take without regard to meals.

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Voltage-gated sodium channel activity involved in sa node cell action potential
Specific Function:
This protein mediates the voltage-dependent sodium ion permeability of excitable membranes. Assuming opened or closed conformations in response to the voltage difference across the membrane, the protein forms a sodium-selective channel through which Na(+) ions may pass in accordance with their electrochemical gradient. It is a tetrodotoxin-resistant Na(+) channel isoform. This channel is respon...
Gene Name:
SCN5A
Uniprot ID:
Q14524
Molecular Weight:
226937.475 Da
References
  1. Nagatomo T, January CT, Makielski JC: Preferential block of late sodium current in the LQT3 DeltaKPQ mutant by the class I(C) antiarrhythmic flecainide. Mol Pharmacol. 2000 Jan;57(1):101-7. [PubMed:10617684 ]
  2. Benhorin J, Taub R, Goldmit M, Kerem B, Kass RS, Windman I, Medina A: Effects of flecainide in patients with new SCN5A mutation: mutation-specific therapy for long-QT syndrome? Circulation. 2000 Apr 11;101(14):1698-706. [PubMed:10758053 ]
  3. Priori SG, Napolitano C, Schwartz PJ, Bloise R, Crotti L, Ronchetti E: The elusive link between LQT3 and Brugada syndrome: the role of flecainide challenge. Circulation. 2000 Aug 29;102(9):945-7. [PubMed:10961955 ]
  4. Cerrone M, Crotti L, Faggiano G, De Michelis V, Napolitano C, Schwartz PJ, Priori SG: [Long QT syndrome and Brugada syndrome: 2 aspects of the same disease?]. Ital Heart J Suppl. 2001 Mar;2(3):253-7. [PubMed:11307783 ]
  5. Viswanathan PC, Bezzina CR, George AL Jr, Roden DM, Wilde AA, Balser JR: Gating-dependent mechanisms for flecainide action in SCN5A-linked arrhythmia syndromes. Circulation. 2001 Sep 4;104(10):1200-5. [PubMed:11535580 ]
  6. Ramos E, O'leary ME: State-dependent trapping of flecainide in the cardiac sodium channel. J Physiol. 2004 Oct 1;560(Pt 1):37-49. Epub 2004 Jul 22. [PubMed:15272045 ]
  7. Shimizu W, Antzelevitch C, Suyama K, Kurita T, Taguchi A, Aihara N, Takaki H, Sunagawa K, Kamakura S: Effect of sodium channel blockers on ST segment, QRS duration, and corrected QT interval in patients with Brugada syndrome. J Cardiovasc Electrophysiol. 2000 Dec;11(12):1320-9. [PubMed:11196553 ]
  8. Liu H, Atkins J, Kass RS: Common molecular determinants of flecainide and lidocaine block of heart Na+ channels: evidence from experiments with neutral and quaternary flecainide analogues. J Gen Physiol. 2003 Mar;121(3):199-214. [PubMed:12601084 ]
  9. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
inhibitor
General Function:
Voltage-gated sodium channel activity
Specific Function:
This protein mediates the voltage-dependent sodium ion permeability of excitable membranes. Assuming opened or closed conformations in response to the voltage difference across the membrane, the protein forms a sodium-selective channel through which Na(+) ions may pass in accordance with their electrochemical gradient. This sodium channel may be present in both denervated and innervated skeleta...
Gene Name:
SCN4A
Uniprot ID:
P35499
Molecular Weight:
208059.175 Da
References
  1. Desaphy JF, De Luca A, Didonna MP, George AL Jr, Camerino Conte D: Different flecainide sensitivity of hNav1.4 channels and myotonic mutants explained by state-dependent block. J Physiol. 2004 Jan 15;554(Pt 2):321-34. Epub 2003 Nov 7. [PubMed:14608015 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrateinhibitor
General Function:
Steroid hydroxylase activity
Specific Function:
Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants.
Gene Name:
CYP2D6
Uniprot ID:
P10635
Molecular Weight:
55768.94 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
  2. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inhibitor
General Function:
Steroid hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. This enzyme contributes to the wide pharmacokinetics variability of the metabolism of drugs such as S-warfarin, diclofenac, phenyto...
Gene Name:
CYP2C9
Uniprot ID:
P11712
Molecular Weight:
55627.365 Da
References
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. doi: 10.1093/nar/gkp970. Epub 2009 Nov 24. [PubMed:19934256 ]
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Drug created on June 13, 2005 07:24 / Updated on August 17, 2016 12:23