Drug interactions
Flecainide + Rilpivirine
Severity: Moderate
Flecainide and Rilpivirine: moderate 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
Rilpivirine at supratherapeutic doses prolongs the QT interval, and flecainide can add to proarrhythmic risk through its effects on cardiac conduction. The combination may raise the chance of ventricular arrhythmia, especially in patients with structural heart disease or electrolyte disturbances.
What this interaction means in plain words
Flecainide and Rilpivirine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Flecainide belongs to Cardiovascular; Rilpivirine belongs to Anti Virals.
Why it happens
Additive effects on cardiac repolarization and conduction (QT prolongation and sodium channel blockade).
What to do
Obtain a baseline ECG and monitor QTc and QRS during co-therapy. Correct potassium and magnesium abnormalities and avoid adding further QT-prolonging drugs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Flecainide with Rilpivirine?
MediHelp rates the interaction as moderate. Flecainide and Rilpivirine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rilpivirine at supratherapeutic doses prolongs the QT interval, and flecainide can add to proarrhythmic risk through its effects on cardiac conduction. The combination may raise the chance of ventricular arrhythmia, especially in patients with structural heart disease or electrolyte disturbances.
How serious is the interaction between Flecainide and Rilpivirine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor QTc and QRS during co-therapy. Correct potassium and magnesium abnormalities and avoid adding further QT-prolonging drugs.
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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