Flecainide - Oral

Flecainide is used to prevent or control certain types of irregularity in your heartbeat, bringing it back to normal rhythm.

Take Flecainide exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

This medicine may need to be started in a hospital or under the close supervision of your doctor.

You may take this medicine with or without food. Try to take it at the same time each day.

Flecainide is available as a conventional tablet and controlled-release capsule.

If you are taking the controlled-release type of capsule (usually labelled as "CR"), swallow it whole. Do not open, chew, or crush the capsule.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type of your condition and your response to the medication.

Flecainide must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following heart conditions:

• heart block in the absence of an artificial pacemaker (device implanted in the chest that helps control your heartbeat)
• sinus node dysfunction (abnormal heart rhythms due to problems with your heart's natural pacemaker) in the absence of an artificial pacemaker
• cardiogenic shock (a serious sudden condition when the heart cannot supply enough oxygen-rich blood to the brain and vital organs of the body)
• heart failure (weakness and inability of the heart to pump blood)
• history of heart attack
• long-standing atrial fibrillation (abnormal heart rhythm causing the upper chambers of the heart to quiver)
• problem in the heart valves
• structural problems in the hearts

as Flecainide may not be suitable for you.

Inform your doctor if you have the following conditions:

• implanted permanent or temporary pacemaker
• suffered from cardiac arrhythmias (irregular or abnormal heartbeat) after heart surgery
• history of heart failure
• low potassium or magnesium levels in the blood
• kidney problems
• liver problems

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Flecainide to the elderly. Elderly people may be more sensitive to the side effects.

Do not switch between different brands unless advised by your doctor.

Some genetic traits can affect this medicine's level in the blood. Individuals who have reduced CYP2D6 activity, also known as poor metabolisers of CYP2D6 may experience enhanced effects from Flecainide. Although not routinely done, your doctor may advise you to take genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. level of Flecainide in the blood, ECG [test used to record the electrical activity of the heart]) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure and heart rate may rise or fall to unsafe levels without you noticing it. Monitor your blood pressure and heart rate regularly during treatment.

Flecainide may cause dizziness, lightheadedness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.

Other side effects include any of the following: headache, nausea, vomiting, upset stomach, weakness, and tiredness.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• chest pain, tightness or pressure, shortness of breath, swelling in the arms or legs, huge weight gain
• fast, slow or irregular heartbeat that is new or worse

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for irregular heartbeat e.g. amiodarone, quinidine
• medicines for high blood pressure e.g. verapamil, propranolol, sotalol
• medicines for HIV infection e.g. ritonavir, lopinavir, indinavir
• certain medicines to treat depression e.g. paroxetine, fluoxetine
• medicines for fits or seizures e.g. carbamazepine, phenytoin, phenobarbital
• medicines for constipation
• water pills or medicines for water retention
• cimetidine (medicine that reduces stomach acid production)
• corticosteroids (anti-inflammatory medicines)
• digoxin (medicine for heart failure)

This list does not include all medicines that may interact with Flecainide.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.