Formulary
Vernakalant: Indications, Dosing, Side Effects and Interactions
Vernakalant is an anti-arrhythmic drug that blocks potassium and sodium channels in the atria, thereby restoring normal heart rhythm.
MedNext Academy | 3 min read
Vernakalant: Indications, Dosing, Side Effects and Interactions
Vernakalant is an anti-arrhythmic drug that blocks potassium and sodium channels in the atria, thereby restoring normal heart rhythm.
Drug action
Vernakalant is an anti-arrhythmic drug that blocks potassium and sodium channels in the atria, thereby restoring normal heart rhythm.
Indications and dose
**Rapid conversion of recent onset atrial fibrillation to sinus rhythm (specialist supervision in hospital)**
- **Adult** (By Intravenous Infusion): Initially 3 mg/kg (max. per dose 339 mg), followed by 2 mg/kg (max. per dose 226 mg), if conversion to sinus rhythm does not occur within 15 minutes after the end of initial infusion, maximum 5 mg/kg per 24 hours; maximum 565 mg per day.
Cautions
Haemodynamically stable patients with congestive heart failure (increased risk of hypotension and ventricular arrhythmia); patients receiving oral anti-arrhythmics (class I or III) (risk of atrial flutter); valvular heart disease (increased incidence of ventricular arrhythmia)
Contraindications
Acute coronary syndrome within the last 30 days; baseline QT interval 440 milliseconds or greater; congestive heart failure with left ventricular ejection fraction 35%; heart failure (New York Heart Association class III/IV); second- or third-degree heart block (unless pacemaker fitted); severe aortic stenosis; severe bradycardia; sinus node dysfunction; systolic blood pressure less than 100 mmHg
Side effects
Common or very common Arrhythmias; cough; dizziness; feeling hot; headache; hypotension; nasal complaints; nausea; oral disorders; sensation abnormal; skin reactions; sweat changes; taste altered; vomiting Uncommon Altered smell sensation; cardiac conduction disorders; cardiogenic shock; chest discomfort; choking sensation; defaecation urgency; diarrhoea; drowsiness; dry mouth; dyspnoea; excessive tearing; eye irritation; fatigue; malaise; pain in extremity; pallor; palpitations; QT interval prolongation; suffocation feeling; syncope; throat irritation; vasodilation; visual impairment Side-effects, further information Discontinue and initiate appropriate treatment if hypotension, bradycardia, ECG changes, or a sudden drop in blood pressure or heart rate occur.
Pregnancy
Manufacturer advises avoid-no information available.
Breast feeding
Manufacturer advises caution-no information available.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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