Plasma flecainide concentrations following acute myocardial infarction》.pdf

International Journal of Cardiology, 15 (1987) 341-346 341 Elsevier IJC 00541 Plasma flecainide concentrations following acute myocardial infarction M.L. Ong ‘, G. Jackson ‘, A. Johnston 2, R. Bhamra 3, D.W. Holt 3 ’ Cardiac Department, Lewisham Hospital, London, U.K.; ’ Department of Clinical Pharmucofogv. St Bartholomew’s Hospital, London, U.K., -’Poisons Unit, Gu.v’s Hospital, London. U.K. (Received 19 December 1986; accepted 12 January 1987) Ong ML, Jackson G, Johnston A, Bhamra R, Holt DW. Plasma flecainide con- centrations following acute myocardial infarction. Int J Cardiol 1987;15:341-346. Plasma flecainide concentrations were measured in 10 patients with acute myocar- dial infarction. Following an oral loading dose of 300 mg plasma concentrations were highly variable and unpredictable. Subsequently, doses of 150 mg twice daily pro- duced mean plasma flecainide concentrations consistently above 400 pg/l within 48 hours. Oral flecainide is, therefore, subject to the same problems of varying oral bioavailability as other antiarrhythmic drugs tested following acute myocardial infarc- tion and, initially, an intravenous regime remains preferable. Mild pulmonary oedema occurred in six patients and, although it responded to one dose of frusemide and did not recur, flecainide must be used with caution when