Benefit of Monitoring the Level of Blood Flecainide Acetate in an Elderly Patient with Ventricular Premature Contractions

• Published in: Nihon Rōnen Igakkai zasshi Vol. 34; no. 1; pp. 54 - 59
• Main Authors: Kaku, Takashi, Chiba, Kazuo, Ueda, Keiji, Nagashima, Juni-ich
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 1997
• Subjects: Aged; Anti-Arrhythmia Agents - adverse effects; Anti-Arrhythmia Agents - blood; Drug Monitoring; Elderly; Electrocardiography; Female; Flecainide - adverse effects; Flecainide - blood; Flecainide acetate; Humans; Therapeutic drug monitoring; Ventricular Premature Complexes - chemically induced; Ventricular premature contractions
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.34.54

A 67-year-old woman without organic heart disease had symptomatic ventricular premature contractions. Because class Ia, Ib and IV antiarrhythmic drugs did not prevent the premature contractions, the patient was treated with flecainide acetate at a dose of 50mg t.i.d. Adverse reactions were noted. After measurement of the blood drug level, the dose was reduced to 50mg b.i.d. The adverse reactions disappeared, and the arrhythmia was controled. Flecainide acetate has a relatively long blood elimination half-life and a narrow safety margin. When some antiarrhythmic drugs are used in elderly patients, blood drug level monitoring is useful in preventing adverse reactions and in designing appropriate therapy.