Flecainide is cleared via hepatic biotransformation and renal excretion. Infants < 1 year of age had a mean t½ of 11–12 hour; children aged 1 to 12 years had a t½ of 8 hours. Dosing schedules based on mg/m2 correlated better with plasma flecainide concentrations than did dosing based on mg/kg.[8, 9] Oral bioavailability in adults reported to be 78–100%.
References
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2. Ferlini M, Colli AM, Bonanomi C, Salvini L, Galli MA, Salice P, Ravaglia R, Centola M, Danzi GB. Flecainide as first-line treatment for supraventricular tachycardia in newborns. J Cardiovasc Med (Hagerstown). 2009;10:372-5.
3. Fish FA, Gillette PC, Benson DW, Jr. Proarrhythmia, cardiac arrest and death in young patients receiving encainide and flecainide. The Pediatric Electrophysiology Group. Journal of the American College of Cardiology. 1991;18:356-65.
4. Moffett BS, Valdes SO, Lupo PJ, delaUz C, Miyake C, Krenek M, Kim JJ. Flecainide use in children with cardiomyopathy or structural heart disease. Pediatr Cardiol. 2015;36:146-50.
5. 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;324:781-8.
6. Brugada J, Blom N, Sarquella-Brugada G, Blomstrom-Lundqvist C, Deanfield J, Janousek J, Abrams D, Bauersfeld U, Brugada R, Drago F, de Groot N, Happonen JM, Hebe J, Yen Ho S, Marijon E, Paul T, Pfammatter JP, Rosenthal E, European Heart Rhythm A, Association for European P, Congenital C. Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement. Europace. 2013;15:1337-82.
7. Moffett BS, Salvin JW, Kim JJ. Pediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care Antiarrhythmics. Pediatr Crit Care Med. 2016;17:S49-58.
8. Perry JC, McQuinn RL, Smith RT, Jr., Gothing C, Fredell P, Garson A, Jr. Flecainide acetate for resistant arrhythmias in the young: efficacy and pharmacokinetics. Journal of the American College of Cardiology. 1989;14:185-91; discussion 92-3.
9. Till JA, Shinebourne EA, Rowland E, Ward DE, Bhamra R, Haga P, Johnston A, Holt DW. Paediatric use of flecainide in supraventricular tachycardia: clinical efficacy and pharmacokinetics. Br Heart J. 1989;62:133-9.
10. Australian Medicines Handbook. Accessed online on 7 February 2017.
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