Drug interactions
Flecainide + Ibutilide
Severity: Major
Flecainide and Ibutilide: 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
Ibutilide markedly prolongs repolarization and can cause torsades de pointes. Flecainide adds conduction slowing and proarrhythmic effects, increasing the risk of life-threatening arrhythmia.
What this interaction means in plain words
Flecainide and Ibutilide 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.
Flecainide belongs to Cardiovascular; Ibutilide belongs to Cardiovascular.
Why it happens
Additive effects on cardiac repolarization and conduction (potassium channel blockade plus sodium channel blockade).
What to do
Avoid the combination outside a closely supervised setting. If used for cardioversion, give ibutilide with continuous ECG monitoring and have defibrillation available.
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 Ibutilide
- Amiodarone + Ibutilide Contraindicated
- Amisulpride + Ibutilide Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Clarithromycin + Ibutilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Dolasetron + Ibutilide Contraindicated
Frequently asked questions
Can I take Flecainide with Ibutilide?
MediHelp rates the interaction as major. Flecainide and Ibutilide 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. Ibutilide markedly prolongs repolarization and can cause torsades de pointes. Flecainide adds conduction slowing and proarrhythmic effects, increasing the risk of life-threatening arrhythmia.
How serious is the interaction between Flecainide and Ibutilide?
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 outside a closely supervised setting. If used for cardioversion, give ibutilide with continuous ECG monitoring and have defibrillation available.
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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