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Related to Tambocor: flecainide, Concor

flecainide acetate

Apo-Flecainide (CA), Tambocor, Tambocor XL (UK)

Pharmacologic class: Cardiac benzamide local anesthetic

Therapeutic class: Antiarrhythmic (class IC)

Pregnancy risk category C


Inhibits fast sodium channels of myocardial cell membrane. Also slows conduction, shortens action potential, stops paroxysmal reentrant supraventricular tachycardia, and decreases conduction in accessory pathways in Wolff-Parkinson-White syndrome.


Tablets: 50 mg, 100 mg, 150 mg

Indications and dosages

Supraventricular tachyarrhythmias (including paroxysmal supraventricular tachycardia and paroxysmal atrial fibrillation or flutter)

Adults: Initially, 50 mg P.O. q 12 hours, increased by 50 mg b.i.d. q 4 days until desired response occurs or maximum daily dosage of 300 mg is reached

Sustained, life-threatening ventricular tachycardia

Adults: Initially, 100 mg P.O. q 12 hours, increased by 50 mg b.i.d. q 4 days until desired response occurs or maximum daily dosage of 400 mg is reached

Dosage adjustment

• Heart failure

• Renal impairment

Off-label uses

• Ventricular arrhythmias

• Wolff-Parkinson-White syndrome


• Hypersensitivity to drug

• Preexisting atrioventricular block or right bundle-branch block

• Recent MI

• Cardiogenic shock


Use cautiously in:

• heart failure, renal impairment

• patients taking concurrent amiodarone, beta-adrenergic blockers, disopyramide, or verapamil

• pregnant or breastfeeding patients

• children (safety not established).


• Initiate therapy only in hospital setting with trained personnel and continuous ECG monitoring.

• Before giving, correct hypokalemia or hyperkalemia.

• Be aware that dosage may be reduced once arrhythmias have been adequately controlled.

Adverse reactions

CNS: dizziness, anxiety, fatigue, headache, depression, malaise, tremor, weakness, hypoesthesia, paresthesia

CV: chest pain, palpitations, second- or third-degree heart block, heart failure, new or worsening arrhythmias

EENT: blurred vision, visual disturbances, corneal deposits

GI: nausea, vomiting, constipation, abdominal pain, dyspepsia, anorexia

Hepatic: hepatitis

Respiratory: dyspnea

Skin: rash, diaphoresis

Other: edema, fever


Drug-drug. Acidifying drugs: increased renal elimination, decreased efficacy of flecainide (with urine pH below 5)

Alkalizing drugs: increased flecainide blood level, possible toxicity

Amiodarone: doubling of flecainide blood level

Beta-adrenergic blockers: increased blood levels of both drugs

Beta-adrenergic blockers, disopyramide, verapamil: additive myocardial depressant effect

Digoxin: 15% to 25% increase in digoxin blood level

Other antiarrhythmics (including calcium channel blockers): increased risk of arrhythmias

Drug-diagnostic tests. Alkaline phosphatase: increased level (with prolonged therapy)

Drug-food. Foods that decrease urine pH below 5 (such as acidic juices): increased renal elimination and possibly decreased efficacy of drug

Foods that increase urine рH above 7 (as in strict vegetarian diets): increased drug blood level

Drug-behaviors. Smoking: increased plasma clearance and decreased efficacy of drug

Patient monitoring

Monitor ECG for worsening arrhythmias.

• Measure pacing threshold 1 week before therapy starts and again after 1 week of therapy.

• Monitor potassium and flecainide blood levels.

• Assess respiratory status regularly.

• Monitor hepatic function tests.

Patient teaching

Instruct patient to immediately report cardiac or respiratory symptoms, unusual tiredness, or yellowing of skin or eyes.

• Tell patient drug may cause numbness. Advise him to avoid injury to areas with sensory impairment.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, alertness, and vision.

• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking adequate fluids.

• Tell female patient to inform prescriber if she is pregnant or breastfeeding.

• Inform patient that he'll undergo regular blood testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


A trademark for the drug flecainide acetate.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


A brand name for FLECAINIDE ACETATE.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Tambocor suppresses tachyarrythmia by blocking cardiac sodium channels and slowing down cardiac conduction.
The book also charges that 3M, outside medical experts and some Food and Drug Administration (FDA) officials knew Tambocor could kill patients.
Furthermore, Tambocor is the only sodium channel blocking agent in Japan to be approved for the treatment of tachyarrythmia in pediatric patients.
Nonetheless, on October 31, 1985 - only three months later - FDA approved Tambocor for patients with less severe as well as life-threatening arrhythmias.(35) After approval, clinical trials sponsored by the National Heart, Lung, and Blood Institute revealed a two-and-a-half-fold increase in mortality among patients treated with Tambocor or Enkaid (encainide HCl) - another antiarrthythmic agent - compared to patients receiving a placebo.
The clinical usefulness of Tambocor in paediatric patients has been widely reported in medical literature.
Antiarrhythmic medications--such as amiodarone (Cordarone, Paceronc), dofetilide (Tikosyn), dronedarone (Multaq), flecainide (Tambocor), propafenone (Rythmol), and sotalol (Betapace)--can help you maintain normal heart (sinus) rhythm.
3M markets flecainide acetate tablets under the brand name Tambocor.
The drugs--including amiodarone (Cordarone, Pacerone), as well as sotalol (Betapace), dofetilide (Tikosyn), flecainide (Tambocor) and propafenone (Rythmol)--may then be used to maintain normal sinus rhythm.
Over the next few years the company expects to launch first-to-file generic versions of a number of market leaders, include Prilosec (omeprazole), Xalatan (latanprost), Tambocor (flecanide), Paxil (paroxetine hydrochloride) and Zyprexa (olanzapine).
Afterward, antiarrhythmics--such as amiodarone (Cordarone, Pacerone), sotalol (Betapace), dofetilide (Tikosyn), flecainide (Tambocor), propafenone (Rythmol) and, most recently, dronedarone (Multaq)--can help maintain normal sinus rhythm, but they have side effects ranging from fatigue and nausea to liver and thyroid disorders and dangerous ventricular arrhythmias.
Late last month it initiated a challenge of the raw material patents protecting 3M Pharmaceuticals' Tambocor tablets from generic competition.
Earlier this year Barr challenged the patent protecting the raw materials used in 3M Pharmaceuticals' heart drug Tambocor from generics competition; and it also challenged the patents protecting Ortho-McNeil Pharmaceutical Inc.'s Ortho Tri-Cyclen oral contraceptive.