Drug interactions
Flecainide + Mirabegron
Severity: Major
Flecainide and Mirabegron: 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
Flecainide is cleared substantially by CYP2D6 and has a narrow therapeutic index. Mirabegron inhibition may raise flecainide levels, increasing risk of conduction slowing and proarrhythmia.
What this interaction means in plain words
Flecainide and Mirabegron 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; Mirabegron belongs to Genitourinary.
Why it happens
Mirabegron inhibits CYP2D6, decreasing flecainide clearance.
What to do
Monitor ECG (PR and QRS duration) and flecainide plasma levels when starting or stopping mirabegron. Reduce the flecainide dose if conduction prolongation occurs.
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 Mirabegron
- Digoxin + Mirabegron Major
- Mirabegron + Propafenone Major
- Mirabegron + Thioridazine Major
- Amitriptyline + Mirabegron Moderate
- Amoxapine + Mirabegron Moderate
- Atomoxetine + Mirabegron Moderate
Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Flecainide with Mirabegron?
MediHelp rates the interaction as major. Flecainide and Mirabegron 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 is cleared substantially by CYP2D6 and has a narrow therapeutic index. Mirabegron inhibition may raise flecainide levels, increasing risk of conduction slowing and proarrhythmia.
How serious is the interaction between Flecainide and Mirabegron?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor ECG (PR and QRS duration) and flecainide plasma levels when starting or stopping mirabegron. Reduce the flecainide dose if conduction prolongation occurs.
What other medicines interact with Mirabegron?
MediHelp also lists interactions of Mirabegron with, for example, Digoxin, Propafenone, Thioridazine. The full list is on the Mirabegron page.
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