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2021 AF Symposium

New Technologies and Drugs―Flecainide Inhaler by InCarda Therapeutics

Jeremy Ruskin, MD, Mass. General Hospital and AF Symposium

Jeremy Ruskin, MD

Dr. Jeremy Ruskin of Massachusetts General Hospital gave a 5-minute Spotlight Session talk on InCarda Therapeutics’ flecainide inhaler. InCarda is a privately held biopharmaceutical company in Newark, CA.

Dr. Ruskin described the InCarda inhaler which uses flecainide, a well-established antiarrhythmic agent.

Flecainide Inhaler from Carda Therapeutics

When a patient with recent onset A-Fib self-administers the breath-activated inhaler, it produces a flecainide-containing aerosol when the patient inhales. This results in a rapid absorption of flecainide via the lungs into the heart. An A-Fib attack can be terminated in as little as 8 minutes.

By contrast, if flecainide is taken as a pill-in-the-pocket, it often takes much longer for the pill to work (20-30 minutes).

Aside from the problems associated with flecainide, this inhaler is generally safe and well tolerated.

“Cmax ” is a pharmacology term meaning the peak serum concentration of a therapeutic drug. 
It’s “Cmax dependent” which means its peak plasma concentration is a function of dose and speed of administration, but primarily determined by dose.

According to Dr. Ruskin, “Inhaled Flecainide has the potential to be a practical, cost effective option for rapid conversion of AF to sinus rhythm.”

Editor’s Comments

The InCarda flecainide inhaler is already in FDA Phase II trials. But it will probably still be a couple of years before it’s generally available to doctors and patients.
InCarda Inhaler Better Than Pill-In-The-Pocket: The InCarda flecainide inhaler is or will be a welcome addition to Pill-In-The-Pocket therapy where patients only take a drug when it’s needed, not all the time. Today’s antiarrhythmic drugs can have bad side effects and be poorly tolerated if taken all the time. Think of how  liberating it would be to just use an inhaler to quickly get out of an A-Fib attack.

One wonders if the InCarda inhaler can be developed for anticoagulants as well. Anticoagulants are high risk drugs especially for older patients. 

f you find any errors on this page, email us. Y Last updated: Monday, April 19, 2021

Return to 2021 AF Symposium Reports

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