The drug agency warns of the global shortage of a drug prescribed for heart problems. France is concerned, many pharmacies no longer have it. Possible alternatives.
A drug flecainide sustained releaseused to improve symptoms of heart rhythm disordersis currently under supply tension in the world, including in France, and may be unavailable for many patients, alerts theMedicines Agency (ANSM) in a press release dated August 31, 2023. This medicine – only available on prescription – is a antiarrhythmic, it’s Flécaïne® LP. He is able to change the speed of transmission of nerve impulses within the heart muscle and fight against its anarchic contractions. In the presence of arrhythmia, the heart tends beat too slowly (known as bradycardia), too fast (known as tachycardia) or irregularly.
What to take instead of Flecaine?
So that patients with arrhythmia can continue to be treated, the ANSM and the French Society of Cardiology have issued recommendations. In the event of immediate unavailability of the treatment initially prescribed, the drugs listed below can be dispensed replacing by the pharmacist without prior medical advice. The pharmacist must, however, inform the patient of this replacement and advise him to see his doctor in the event of the occurrence of an adverse effect or symptom that he deems unusual.
► First-line solution: if supplies are sufficient, replacement with another specialty flecainide sustained-release (PR), or immediate, should be preferred.
→ If an LP shape is availablethe different dosages of LP capsules can be replaced by the pharmacist to obtain the prescribed dosage: for example: a 150 mg LP capsule can be replaced by a 50 mg LP capsule and a 100 mg LP capsule, to be taken once a day (exemption for one month only).
→ In case of unavailability of LP formsthe LP form can be replaced by the immediate-release form by the pharmacist, respecting the same prescribed daily dose, and indicating to the patient that the dose must be divided into 2 doses per day (morning and evening): for example: 1 tablet 100 mg to be taken morning and evening, instead of 1 capsule 200 mg LP once a day (dispensed for one month only).
► Second-line solution: if the prolonged-release (LP) or immediate replacement specialties are out of stock, magistral preparations in an immediate-release form of flecainide can be produced with a raw material for pharmaceutical use. As with immediate-release tablets, magistral preparations can be replaced by the pharmacist, respecting the prescribed daily dose and indicating to the patient that the dose must be divided into 2 doses per day (morning and evening): for example: Flecaine LP 150 mg 1 capsule per day = masterful preparation of Flecainide acetate 75 mg 1 capsule in the morning and 1 capsule in the evening (dispensation for one month only)
► As a last resort: flecainide can be replaced by a drug containing propafenone, after consulting a cardiologist and upon presentation of a prescription. In this case, a medical consultation is necessary before initiating treatment, in particular to control the patient’s heart rate, due to the bradycardic properties of propafenone (slowing of the heart rate). Moreover, this substitution requires close monitoring, in particular by electrocardiogram after the 8th/10th day, to check the patient’s heart rate. The dosage must be defined by the doctor on a case-by-case basis.
I am a patient taking Flecaine, what should I do?
- Go to the pharmacy and see with your pharmacist for a delivery of another equivalent drug (according to the recommendations above)
- Consult your doctor if the pharmacist has not been able to provide an equivalent treatment and so that the doctor can adapt the treatment.
- Consult your doctor if any unusual symptoms appear when the treatment is changed.