Challenges prescribing antiarrhythmic medications for infants and children

Antiarrhythmic medications are the first-line treatment for most tachyarrhythmias occurring during infancy and childhood. However, there are fewer antiarrhythmic medications available to treat infants and children compared to the adult population because of licensing restrictions and the manufacture of preparations infants and children can swallow. Specially prepared antiarrhythmic medications supplied in liquid form suitable for small children are manufactured on an individual basis at a greater cost than tablet equivalents. Safety of therapy when prescribing antiarrhythmic medication includes the need for therapeutic drug monitoring and close observation to reduce adverse reactions. In addition, access to antiarrhythmic medication can be a challenge as many are deemed specialist medications and general practitioners will not assume responsibility for prescribing medications outside their product licence. These limitations and considerations can prove challenging when deciding the most suitable medication to prescribe.