Drug interactions
Eliglustat + Flecainide
Severity: Major
Eliglustat 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
Eliglustat can prolong PR, QRS and QT intervals at higher exposures, and flecainide slows conduction. Eliglustat is also a CYP2D6 substrate and inhibitor, so flecainide exposure may rise and compound the arrhythmia risk.
What this interaction means in plain words
Eliglustat 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.
Eliglustat belongs to Miscellaneous; Flecainide belongs to Cardiovascular.
Why it happens
Additive conduction and QT effects, together with CYP2D6 inhibition by eliglustat that reduces flecainide clearance.
What to do
Avoid the combination where possible, since eliglustat labeling advises against it with class I antiarrhythmics. If it cannot be avoided, monitor the ECG and flecainide levels closely.
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 Eliglustat
- Amiodarone + Eliglustat Contraindicated
- Clarithromycin + Eliglustat Contraindicated
- Dronedarone + Eliglustat Contraindicated
- Eliglustat + Itraconazole Contraindicated
- Eliglustat + Ketoconazole Contraindicated
- Eliglustat + Pimozide Contraindicated
Frequently asked questions
Can I take Eliglustat with Flecainide?
MediHelp rates the interaction as major. Eliglustat 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. Eliglustat can prolong PR, QRS and QT intervals at higher exposures, and flecainide slows conduction. Eliglustat is also a CYP2D6 substrate and inhibitor, so flecainide exposure may rise and compound the arrhythmia risk.
How serious is the interaction between Eliglustat 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: Avoid the combination where possible, since eliglustat labeling advises against it with class I antiarrhythmics. If it cannot be avoided, monitor the ECG and flecainide levels closely.
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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