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Medical and Pharmacy Editor:

Brand Name: Tambocor

Generic Name: Flecainide

Drug Class: Antidysrhythmics, lc

What Is Flecainide and How Does It Work?

Flecainide is a prescription medication used to treat paroxysmal supraventricular tachycardias (PSVT), including atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia and other supraventricular tachycardias of unspecified mechanism associated with disabling symptoms, paroxysmal atrial fibrillation/flutter (PAF) associated with disabling symptoms and documented ventricular arrhythmias, such as sustained ventricular tachycardia (sustained VT), that in the judgment of the physician are life-threatening.

Flecainide is available under the following different brand names: Tambocor.

Dosage of Flecainide:

Adult and Pediatric Dosages


  • 50 mg
  • 100 mg
  • 150 mg

Dosage Considerations – Should be Given as Follows:


Adult Dosages

  • PSVT and paroxysmal atrial fibrillation
  • 50 mg orally twice daily; may increase by 50 mg every 4 days; do not exceed 300 mg/day
  • Sustained VT
  • 100 mg orally twice daily initiated in hospital; may increase by 50 mg every 4 days; do not exceed 400 mg/day

Pediatric Dosages

  • Infants under 6 months: 50 mg/mē/day orally divided every 8-12 hours
  • Infants 6 months or older: 100 mg/mē/day orally divided every 8-12 hours
  • Not to exceed 200 mg/mē/day

Dosing considerations

Adults and Pediatric Dosages:

  • Pediatric only: Usual therapeutic level: 200-500 ng/ml; some may require under 800 ng/ml for adequate control
  • Steady-state plasma levels not achieved for 3-5 days, so increases in dosage should not be made less than every 4 days
  • Loading dose not recommended, due to increased incidence of proarrhythmic events and chronic heart failure
  • Patients intolerant to twice daily dosing may require 8 hour dosing
  • Once adequate control of arrhythmia has been achieved, may reduce dose, provided there is no loss of efficacy
  • After 5 doses/steady state, obtain ECG after initiation or change of dose; obtain plasma trough flecainide levels 1 hour pre-dose
  • Usual trough plasma levels: 0.2-1 mcg/mL
  • When given concomitantly with amiodarone, reduce flecainide dose by 50% and monitor closely
  • Dose cautiously in patients with history of heart attach (myocardial infarction) or chronic heart failure
  • When switching from another antiarrhythmic to flecainide, allow over 2-4 plasma half-lives to elapse before starting flecainide; if discontinuation of previous drug may produce life-threatening arrhythmias, consider hospitalizing patient

Dosage Modifications

Adult and Pediatric Dosages:

Renal impairment

  • Severe (under 35 ml/min): 100 mg orally once daily or 50 mg orally twice daily
  • Higher than 25 ml/min: 100 mg orally twice daily

Hepatic impairment

  • Use only if benefits outweigh risk; monitor plasma levels regularly; reduce dose as necessary
Medically Reviewed by a Doctor on 6/7/2017

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