Flecainide, Tocainide (No longer sold in US)
- An excessive mortality or non fatal cardiac arrest rate was observed in patients with non life threatening ventricular arrhythmias who had a recent MI.
- Effects have been observed in patients with atrial fibrillation/flutter.
- This drug is not recommended in patients with chronic atrial fibrillation
- Agrangulocytosis, bone marrow depression, leukopenia, neutropenia, aplastic/hypoplastic anemia and septic shock have been reported when used within therapeutic dose ranges, typically within first 12 wks of therapy.
- Use with caution in patients with pre-existing marrow failure or cytopenia.
- Interstitial pneumonitis, fibrosing alveolitis, pulomnary edema, and pneumonitis have been reported.
Tocainide no longer sold in the United States
MONITORING RECOMMENDATIONS RELATED TO BLACK BOX DATA
- Concurrent negative chronotherapy (e.g., digoxin, beta-blockers) may decrease risk
- Perform CBC with white blood cell, differential, and platelet counts at weekly intervals for first three months of therapy and periodically thereafter.
- CBC should be performed if patient develops signs of infection.
- Reports signs of pulmonary symptoms, perform chest x-rays
Updated January 2018