Adults: Ventricular arrhythmias: the recommended starting dosage is 100 mg twice daily. The maximum daily dose is 400 mg and this is normally reserved for patients of large build or where rapid control of arrhythmia is required. After 3-5 days it is recommended that the dosage be progressively adjusted to the lowest level which maintains control of arrhythmia.
It may be possible to reduce dosage during long-term treatment.
Supraventricular arrhythmias: the recommended starting dosage is 50 mg twice daily and most patients will be controlled at this dose. If required, the dose maybe increased to a maximum of 300 mg daily.
Children: Flecainide acetate (Tambocor) is not recommended in children under 12, as there is no evidence of its use in this age group.
Elderly patients: The rate of flecainide elimination from plasma may be reduced in elderly people. An initial dose of one tablet twice daily will usually be adequate, and it may well be possible to reduce this dose for maintenance therapy after one week.
Dosage in impaired renal function: In patients with significant renal impairment (creatinine clearance of 35 mL/min./1.73 sq. m. or less) the maximum initial dosage should be 100 mg daily. When used in such patients, frequent plasma level monitoring is strongly recommended.