Generic Flecainide

Introduction

Flecainide is a Class IC anti‑arrhythmic medication used primarily to restore and maintain normal heart rhythm in adults living in the United Kingdom. The active compound is flecainide acetate, marketed globally under several brand names, the most widely recognised being Tambocor. It belongs to the general‑health medication group because its therapeutic effect modifies cardiac electrophysiology rather than addressing a specific disease organ system. In the UK, flecainide is prescribed for certain supraventricular and ventricular arrhythmias when other treatments are unsuitable or ineffective.

What is Flecainide?

Flecainide is the generic version of the original brand Tambocor, containing the same active compound flecainide. It is a synthetic sodium‑channel blocker developed in the early 198s by LEO Pharma and subsequently licensed worldwide. Our online pharmacy provides this generic alternative as a cost‑effective treatment option, delivering the same clinical benefits as the branded product while reducing patient expense.

How Flecainide Works

Flecainide exerts its anti‑arrhythmic effect by selectively and potently blocking the fast inward sodium channel (Nav1.5) during phase  of the cardiac action potential. This blockade reduces the rate of depolarisation, slowing impulse conduction through atrial, ventricular and His‑Purkinje tissue. The resulting prolongation of the refractory period suppresses premature ectopic beats and interrupts re‑entrant circuits that sustain tachyarrhythmias.

Oral flecainide is rapidly absorbed, reaching peak plasma concentrations within 1–3 hours. It has a bioavailability of about 90 % and is metabolised mainly by CYP2D6 to a minor inactive metabolite. The elimination half‑life in healthy adults ranges from 12 to 20 hours, allowing twice‑daily dosing for most indications. Renal excretion accounts for roughly one‑third of the cleared drug; dose adjustment is required in severe renal impairment.

Conditions Treated with Flecainide

• Paroxysmal Supraventricular Tachycardia (PSVT) – Flecainide terminates episodes of AV‑nodal re‑entrant tachycardia and atrial tachyarrhythmias when vagal maneuvers or adenosine fail.
• Atrial Fibrillation (AF) and Atrial Flutter – It can be used for “pill‑in‑the‑bag” of recent‑onset AF and for long‑term rhythm control in selected patients without structural heart disease.
• Ventricular Premature Beats and Non‑Sustained Ventricular Tachycardia – By stabilising ventricular conduction, flecainide reduces symptomatic ectopy in patients with otherwise normal ventricular function.

In the UK, atrial fibrillation affects an estimated 2 % of adults over 65, representing a major public‑health burden. Flecainide’s rapid onset and oral route make it a valuable option for rhythm‑control strategies, particularly in younger patients with preserved left‑ventricular function and no coronary artery disease.

Who is Flecainide For?

• Patients with documented supraventricular tachyarrhythmias who have contraindications to β‑blockers or calcium‑channel blockers, or who have not achieved adequate control with those agents.
• Individuals with paroxysmal atrial fibrillation without structural heart disease, congestive heart failure, or prior myocardial infarction, where a rhythm‑control approach is preferred.
• Young to middle‑aged adults (typically < 70 years) with normal left‑ventricular ejection fraction, as flecainide can exacerbate arrhythmias in the presence of scar tissue or ischaemia.
• Patients who require oral therapy because intravenous alternatives (e.g., procainamide) are unavailable in the community setting

Contra‑indications and cautions – Flecainide should be avoided in patients with coronary artery disease, previous myocardial infarction, heart failure with reduced ejection fraction, or significant ventricular hypertrophy. It is also contraindicated in severe renal or hepatic impairment without dose adjustment.

Risks, Side Effects, and Interactions

Common

• Dizziness or light‑headedness – often related to transient hypotension after the first dose.
• Visual disturbances (e.g., blurred vision, photopsia) – usually resolve with continued therapy.
• Mild gastrointestinal upset – nausea or dyspepsia that improves with food.

Rare

• Pro‑arrhythmic events – new‑onset atrial fibrillation, atrial flutter, or ventricular tachycardia, especially in patients with undiagnosed structural heart disease.
• Peripheral neuropathy – sensory changes reported in isolated case series.
• Hepatic enzyme elevation – mild transaminase rise in a minority of patients.

Serious

• Life‑threatening ventricular arrhythmias – rare but possible when flecainide is used inappropriately.
• Severe hypotension – may occur after rapid oral loading or intravenous administration.
• Allergic reactions – including Stevens‑Johnson syndrome or anaphylaxis, requiring immediate medical attention.

Clinically Relevant Drug–Drug Interactions

• CYP2D6 inhibitors (e.g., quinidine, paroxetine, fluoxetine) raise flecainide plasma levels, increasing the risk of toxicity.
• Concomitant β‑blockers or calcium‑channel blockers may potentiate bradycardia or AV‑block.
• Other anti‑arrhythmics (e.g., amiodarone, sotalol) can cause additive conduction slowing.
• Digoxin – combined use may enhance flecainide’s pro‑arrhythmic potential.

Patients should provide a full medication list to their prescriber before initiating flecainide.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dosing for PSVT or AF conversion – 200 mg oral loading dose, followed by 50–100 mg twice daily, adjusted to plasma concentration and clinical response.
• Maintenance dosing – most adult regimens fall between 50 mg twice daily and 200 mg twice daily, depending on arrhythmia type, renal function, and tolerability.
• Renal impairment – reduce dose by 25‑50 % when creatinine clearance is < 30 mL/min.
• Missed dose – take the missed tablet as soon as remembered unless it is within 6 hours of the next scheduled dose; do not double‑dose.
• Overdose – symptoms may include severe hypotension, ventricular arrhythmias, and conduction block. Immediate emergency care is required. Activated charcoal can be considered if ingestion is recent; sodium bicarbonate infusion may mitigate sodium‑channel blockade under specialist supervision.

Practical precautions – flecainide should be taken with food to minimise gastrointestinal irritation. Alcohol may potentiate hypotensive effects and should be limited. Patients with a history of syncope or dizziness should avoid driving or operating heavy machinery until they are certain of tolerability.

Buying Flecainide from Our Online Pharmacy

Flecainide can be purchased securely from our online pharmacy in the UK. We specialise in providing affordable, high‑quality generic medications that meet stringent European Medicines Agency (EMA) standards.

• Cost‑effective pricing – our supplies are sourced near manufacturer cost, delivering significant savings compared with branded equivalents.
• Verified quality – all batches are obtained from licensed overseas suppliers who hold GMP certification; each shipment undergoes independent laboratory testing.
• Discreet, reliable delivery – options include express shipping (approximately 7 days) and regular airmail (about 3 weeks). Packages are unmarked and arrive in secure, tamper‑evident envelopes.
• Pharmacy‑broker model – we act as a broker, coordinating with overseas licensed pharmacies to bring otherwise inaccessible medicines to UK patients. This structure enables a privacy‑first service that respects patient confidentiality while complying with UK import regulations for personal use.

For patients who encounter limited stock or high costs in traditional pharmacies, our service offers a safe alternative to maintain uninterrupted therapy.

FAQ

• How should Flecainide be stored at home?
  Flecainide tablets should be kept at room temperature (15‑25 °C), protected from direct sunlight, moisture and heat. Do not store them in bathrooms or near kitchen stoves.

• Can Flecainide be taken while traveling abroad?
  Yes, but carry the medication in its original labelled container, bring a copy of the prescription (or a doctor’s letter) and be aware of the destination country’s import limits for personal use.

• What does the Flecainide tablet look like?
  Generic tablets are typically white, round, and engraved with “F” or “200 mg” depending on strength. Brand formulations such as Tambocor are orange‑coloured, oval tablets.

• Are there differences between UK and EU Flecainide formulations?
  The active ingredient and dosage strength are identical across regions; however, inactive excipients (e.g., lactose, magnesium stearate) may vary slightly. Patients with excipient allergies should check the specific product’s ingredient list.

• Is Flecainide detectable in standard drug‑screening tests?
  Flecainide does not appear on routine occupational or forensic drug panels because it is not a substance of abuse. Specialized toxicology assays can detect it if specifically requested.

• What are the specific warnings for Asian populations?
  Limited data suggest a higher prevalence of CYP2D6 polymorphisms that reduce metabolism, potentially increasing plasma levels. Clinicians may consider a lower starting dose and close monitoring in these patients.

• Can Flecainide be used in combination with anticoagulant therapy?
  While flecainide does not directly interact with anticoagulants, patients with atrial fibrillation often require stroke‑prevention medication. The combination is permissible but warrants regular monitoring of cardiac rhythm and bleeding risk.

• What is the historical significance of Flecainide’s development?
  Introduced in the early 198s, flecainide represented the first highly selective sodium‑channel blocker with rapid oral absorption. Its efficacy in terminating supraventricular tachycardias reshaped rhythm‑control strategies before the widespread use of newer agents.

• How does Flecainide compare with older Class IC drugs like propafenone?
  Both share sodium‑channel blocking properties, but flecainide has a longer half‑life and a more pronounced effect on conduction velocity, making it more suitable for certain ventricular arrhythmias. Propafenone also possesses mild β‑blocking activity, which may be advantageous in patients with concomitant hypertension.

• Is there a generic version of Flecainide available in the United States?
  Yes, the United States market also offers generic flecainide tablets that contain the same active compound as the UK product, though regulatory approvals and packaging differ between jurisdictions.

• What should I do if I notice a change in my pulse after starting Flecainide?
  Record the pulse rate and rhythm, and contact a healthcare professional promptly. A sudden slowdown or irregularity may indicate over‑conduction block or pro‑arrhythmic activity requiring dose adjustment or cessation.

Glossary

Sodium‑channel blocker

A class of drugs that inhibit the flow of sodium ions through cardiac cell membranes, slowing electrical conduction and stabilising heart rhythm.

Pro‑arrhythmic

The paradoxical potential of some anti‑arrhythmic agents to induce new or worsening arrhythmias, especially in patients with underlying heart disease.

CYP2D6

An enzyme in the liver that metabolises many medications, including flecainide; genetic variations can affect drug levels.

Therapeutic window

The plasma concentration range in which a medication is effective without causing unacceptable side effects.

⚠️ Disclaimer

The information provided about Flecainide is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Flecainide for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.