| Flecainide |
Renal/hepatic CYP2D6; 50−100 mg twice a day, maximum dose 300−400 mg/day. |
Dizziness, headache, visual blurring |
Atrial flutter with 1:1 conduction; ventricular tachycardia; may unmask Brugada-type ST elevation; contraindicated with coronary disease |
| Sotalol |
Renal: 80−120 mg twice a day; maximum dose 240 mg twice a day. |
Bronchoconstriction |
Bradycardia, Torsades de pointes |
| Amiodarone |
Hepatic; half-life 50 day: oral load 10 g over 7−10 day, then 400 mg for 3 week, then 200 mg/day for atrial fibrillation; maintenance dose of 400 mg/day for ventricular tachycardia; dose-reduced load for bradycardia or QT prolongation; intravenous: 150−300 mg bolus, then 1 mg/min infusion for 6 h followed by 0.5 mg/min thereafter. |
Pulmonary (acute hypersensitivity pneumonitis, chronic interstitial infiltrates); hepatitis; thyroid (hypothyroidism or hyperthyroidism); photosensitivity; blue-gray skin discoloration with chronic high dose; nausea; ataxia; tremor; alopecia |
Sinus bradycardia |
| Ibutilide |
Hepatic CYP3A4; 1 mg intravenous over 10 min; repeat after 10 min if necessary. |
Nausea |
Torsades de pointes |
| Dofetilide |
Renal/hepatic CYP3A4; CrCL >60 (500 μg twice a day), CrCl 40−60 (250 μg twice a day), CrCl 20−39 (125 μg twice a day). |
None |
Torsades de pointes |
