Drug interactions
Flecainide + Iloperidone
Severity: Major
Flecainide and Iloperidone: major interaction.
Last updated Sources: UK SmPC
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
Iloperidone prolongs the QT interval and may add to flecainide's proarrhythmic risk, potentially leading to torsades de pointes. Risk increases with bradycardia, electrolyte disturbance or heart disease.
What this interaction means in plain words
Flecainide and Iloperidone 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; Iloperidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation and proarrhythmic effects.
What to do
Avoid if possible, or monitor ECG and electrolytes closely. Consider an antipsychotic with less QT effect.
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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References
- Flecainide Acetate 100 mg tablets - SmPC sections 4.3/4.5 (class statement: Antipsychotics; "Antipsychotics: Clozapine, haloperidol and risperidone") — electronic medicines compendium (UK SmPC)
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 Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Flecainide with Iloperidone?
MediHelp rates the interaction as major. Flecainide and Iloperidone 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. Iloperidone prolongs the QT interval and may add to flecainide's proarrhythmic risk, potentially leading to torsades de pointes. Risk increases with bradycardia, electrolyte disturbance or heart disease.
How serious is the interaction between Flecainide and Iloperidone?
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 if possible, or monitor ECG and electrolytes closely. Consider an antipsychotic with less QT effect.
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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