[Iatrogenic acute renal failure caused by overdosage of flecainide acetate].

BACKGROUND: Rapid degradation of renal function may occur in patients given drug regimens combining a converting enzyme inhibitor, a diuretic and a nonsteroidal anti-inflammatory drug. CASE REPORT: A patient given flecainide and an enalapril /hydrochlorothiazide combination in a well-tolerated long-term regimen suddenly developed acute renal failure when a nonsteroidal anti-inflammatory drug was introduced leading to an overdose of the anti-arrhythmic drug. DISCUSSION: A poor understanding of the elimination routes for anti-arrhythmic drugs and the risks involved when combined with nonsteroidal anti-inflammatory drugs modifying glomerular hemodynamics can lead to dangerous prescriptions and life-threatening situations in patients on multiple drug regimens.