Flecainide administration in children: dosage, drug levels, and clinical effect

Thomas, Shôn A. L., Ferguson, Richard and Wilson, Dirk G. 2023. Flecainide administration in children: dosage, drug levels, and clinical effect. Cardiology in the Young 33 (10) , pp. 2072-2077. 10.1017/S1047951122003729

Preview

PDF - Published Version Available under License Creative Commons Attribution. Download (390kB) | Preview

Abstract

Therapeutic drug monitoring of flecainide in children using plasma concentration measurements is undertaken by some clinicians. There is very little published evidence surrounding factors which influence plasma flecainide concentration, particularly in paediatric populations. We undertook a retrospective study of 45 children receiving flecainide to identify factors that influence its plasma concentration. Patients receiving a dose of 6 mg/kg/day had a higher mean plasma flecainide concentration than those receiving lower doses. Younger age and lighter weight were also associated with higher plasma flecainide concentrations. Children aged younger than 1 year receiving flecainide three times a day had a higher mean plasma flecainide concentration than older children who received flecainide twice a day. All supratherapeutic levels occurred in children aged less than 1 year who were receiving flecainide three times a day. Supratherapeutic levels were more common in those receiving 6 mg/kg/day while subtherapeutic levels were more common in those receiving 2 mg/kg/day. A supratherapeutic level did not correlate with adverse effects or clinical toxicity. Our results would suggest the need for a change of practice from prescribing flecainide at a frequency of three times a day in children aged younger than 1 year to twice a day in line with other ages.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Cambridge University Press
ISSN:	1047-9511
Date of First Compliant Deposit:	22 December 2022
Date of Acceptance:	12 November 2022
Last Modified:	17 Apr 2024 01:05
URI:	https://orca.cardiff.ac.uk/id/eprint/155231

Actions (repository staff only)

Edit Item