[Be careful in using flecainide by hemodialyzed patients].
Cardiac arrhythmias are frequent by hemodialyzed patients and may lead to the prescription of antiarrhythmic drugs among which flecainide. However there is for this latter a wide interindividual variability in the dose-plasma concentration relationship because of a genetically controlled polymorphic metabolism. That explains why it is not possible to adjust dose only to renal clearance. It becomes even more difficult at hemodialysis stage, especially if hepatic insufficiency and/or certain medications join to it. So this antiarrhythmic drug has to be cautiously initiated and plasma concentrations have to be carefully monitored to avoid side effects, sometimes crippling as in our observation, sometimes as cardiac complications.
Montagnac
Richard
R
Service de Néphrologie-Hémodialyse, Centre Hospitalier de Troyes, 10003 Troyes cedex, France. richard.montagnac@ch-troyes.fr
Schoen
Eric
E
Aliouche
Camélia-Pop
CP
Schillinger
Francis
F
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000453:epidemiology*; D005424:Flecainide / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D006435:Renal Dialysis
D000889:Anti-Arrhythmia Agents; D005424:Flecainide