Flecainide pharmacokinetics after multiple dosing in patients with impaired renal function

Area of Science:

• Pharmacology
• Nephrology
• Clinical Pharmacy

Background:

• Flecainide acetate is an antiarrhythmic drug.
• Renal impairment can affect drug pharmacokinetics.
• Understanding flecainide acetate behavior in renal disease is crucial for safe dosing.

Purpose of the Study:

• To evaluate the pharmacokinetics of oral flecainide acetate.
• To assess flecainide acetate pharmacokinetics after single and multiple doses.
• To determine flecainide acetate pharmacokinetics in patients with impaired renal function.

Main Methods:

• Paired study design with single and multiple oral doses of flecainide acetate.
• Twenty-one patients with impaired renal function, including ten on hemodialysis.
• Venous blood sampling for pharmacokinetic parameter determination.

Main Results:

• Peak flecainide acetate concentrations increased with multiple dosing.
• Plasma elimination half-life was significantly longer after multiple doses (37.8 hours) compared to single doses (20.4 hours).
• Total body clearance decreased with multiple dosing; no significant differences between hemodialysis and non-dialysis patients.

Conclusions:

• Flecainide acetate exhibits altered pharmacokinetics with multiple dosing in renal impairment.
• Dosing adjustments may be necessary in patients with impaired renal function.
• Flecainide acetate pharmacokinetics were comparable between hemodialysis and non-dialysis patients.