vernakalant hydrochloride at a glance
Medicine class
Antiarrhythmic that acts preferentially on electrical activity in the atria.
Usual use
Rapid conversion of recent-onset atrial fibrillation to sinus rhythm in adults.
Administration
A diluted intravenous infusion given only by a qualified healthcare professional.
Monitoring
Continuous heart-rhythm monitoring and repeated blood-pressure and clinical checks are required.
What is vernakalant hydrochloride used for?
Licensed uses in adults are:
Rapid conversion of atrial fibrillation lasting no more than 7 days in people who have not recently had cardiac surgery.
Rapid conversion of atrial fibrillation lasting no more than 3 days after cardiac surgery.
How does vernakalant hydrochloride work?
Vernakalant blocks several sodium and potassium ion currents, with preferential effects in the atria. This prolongs atrial refractoriness and slows abnormal electrical conduction, helping to interrupt the electrical activity sustaining atrial fibrillation.
vernakalant hydrochloride preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
How to take vernakalant hydrochloride
Vernakalant is not taken by mouth. A healthcare professional dilutes the concentrate and gives it into a vein using a controlled infusion device; it must not be given as an intravenous push or bolus. Heart rhythm, blood pressure, pulse, breathing and clinical condition are monitored.
Tell the clinical team about all medicines and recent antiarrhythmic treatment.
Report dizziness, faintness, breathing difficulty or new palpitations immediately.
Avoid driving or operating machinery if dizziness occurs after treatment.
vernakalant hydrochloride side effects
Common or expected effects
- Taste disturbance
- Sneezing
- Tingling or numbness
- Dizziness
- Nausea or vomiting
- Low blood pressure or slow heartbeat
- Cough or nasal discomfort
- Itching or increased sweating
- Pain or tingling at the infusion site
Get urgent medical advice
- Marked low blood pressure, fainting or collapse
- Significant slow heartbeat, heart block or another important ECG change
- Ventricular arrhythmia or a markedly fast heartbeat
- Atrial flutter, rarely with rapid one-to-one conduction
- Severe breathing difficulty
vernakalant hydrochloride in pregnancy
There are no adequate data from pregnant women, and animal studies found malformations after repeated oral exposure. As a precaution, vernakalant is preferably avoided during pregnancy; an urgent need for cardioversion should be assessed by the specialist team.
vernakalant hydrochloride while breastfeeding
It is unknown whether vernakalant or its metabolites enter human milk, and risk to a breastfed infant cannot be excluded. Cardiology and maternity teams should assess use and feeding options for the individual clinical situation.
vernakalant hydrochloride interactions
Formal interaction studies are limited. Recent antiarrhythmic treatment is particularly important.
Intravenous class I or III antiarrhythmics, including intravenous flecainide or amiodarone
Use close to vernakalant administration is contraindicated because combined cardiac electrical effects may increase rhythm and conduction risks.
Oral class I or III antiarrhythmics
Experience is limited and class I treatment may increase the risk of conversion to atrial flutter, so specialist review is required.
CYP2D6 inhibitors or substrates
A clinically meaningful pharmacokinetic interaction is not expected from the short intravenous exposure, although the full medication list should still be reviewed.
Common questions about vernakalant hydrochloride
Answers are fully visible for fast scanning and source review.
What is vernakalant hydrochloride used for?
It restores sinus rhythm in adults with recently started atrial fibrillation, including eligible people who recently had cardiac surgery.
Is vernakalant hydrochloride the same as electrical cardioversion?
No. It is pharmacological cardioversion using an antiarrhythmic infusion; electrical cardioversion uses a controlled electrical shock.
Can vernakalant hydrochloride treat atrial flutter?
It has not been shown to convert typical primary atrial flutter effectively. Atrial flutter can also occur temporarily after treatment and requires monitoring.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.