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Oral flecainide pharmacokinetics in patients with impaired renal function
S C Forland1, E Burgess, A D Blair
1Department of Medicine, Loma Linda University, California 92357.
Journal of Clinical Pharmacology
|March 1, 1988
Summary
Flecainide acetate pharmacokinetics in renal impairment show longer elimination half-lives. Creatinine clearance alone does not predict flecainide half-life in these patients.
Area of Science:
- Pharmacology
- Nephrology
- Clinical Pharmacy
Background:
- Flecainide acetate is an antiarrhythmic drug.
- Renal impairment can affect drug pharmacokinetics.
- Understanding flecainide behavior in renal disease is crucial for patient management.
Purpose of the Study:
- To investigate the pharmacokinetics of flecainide acetate in patients with varying degrees of renal impairment.
- To assess the relationship between renal creatinine clearance (CLCR) and flecainide elimination half-life.
- To determine the impact of end-stage renal disease (ESRD) on flecainide clearance.
Main Methods:
- A single oral dose pharmacokinetic study was conducted in 20 patients with renal impairment.
- Patients were divided into two groups based on CLCR.
- Plasma flecainide concentrations were measured over time to determine pharmacokinetic parameters.
Main Results:
- Peak plasma concentrations and volume of distribution were similar to healthy subjects.
- Mean flecainide elimination half-lives were longer in patients with renal impairment.
- CLCR was not a reliable predictor of flecainide half-life; renal clearance was reduced in ESRD but total plasma clearance less so.
- Hemodialysis removed less than 1% of the administered dose.
Conclusions:
- Flecainide acetate elimination half-life is prolonged in patients with renal impairment.
- Creatinine clearance is not a sole determinant of flecainide half-life in renal impairment.
- Further studies are needed to explore potential dose-dependent kinetics in ESRD patients.