Drug interactions
Amiodarone + Flecainide
Severity: Major
Amiodarone and Flecainide: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs slow cardiac conduction and amiodarone prolongs repolarization, raising the risk of proarrhythmia. Amiodarone also inhibits CYP2D6 and can increase flecainide concentrations substantially.
What this interaction means in plain words
Amiodarone and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Flecainide belongs to Cardiovascular.
Why it happens
Additive effects on conduction and QT plus amiodarone inhibition of CYP2D6-mediated flecainide metabolism.
What to do
If used together, reduce the flecainide dose (commonly by about half) and monitor ECG for QRS and QT prolongation and flecainide levels.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Flecainide?
MediHelp rates the interaction as major. Amiodarone and Flecainide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs slow cardiac conduction and amiodarone prolongs repolarization, raising the risk of proarrhythmia. Amiodarone also inhibits CYP2D6 and can increase flecainide concentrations substantially.
How serious is the interaction between Amiodarone and Flecainide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If used together, reduce the flecainide dose (commonly by about half) and monitor ECG for QRS and QT prolongation and flecainide levels.
What other medicines interact with Flecainide?
MediHelp also lists interactions of Flecainide with, for example, Nirmatrelvir, Nirmatrelvir / ritonavir, Pimozide. The full list is on the Flecainide page.
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