Vernakalant, sold under the brand name Brinavess, is a class III antiarrhythmic drug for the acute conversion of atrial fibrillation, a kind of irregular heartbeat, in form of an intravenous infusion.

[1] The most common adverse effects in studies were dysgeusia (taste disturbance, in 18% of patients), sneezing (13%) and paraesthesia (abnormal skin sensations, 7%); they were transient and rarely led to an abortion of the treatment.

[1] There is a single case report of a person receiving an infusion of the full vernakalant dose in half the recommended time, resulting in tachycardia (fast heartbeat) without lasting adverse effects.

While the drug itself is a moderate CYP2D6 inhibitor, it is not expected to have a relevant impact on other pharmaceuticals that are broken down by this enzyme, because it only remains in the body for a short time.

[1] Like other class III antiarrhythmics, vernakalant blocks atrial potassium channels, thereby prolonging repolarization.

The differences between poor and extensive metabolizers regarding peak concentrations, AUC and half-life are not clinically relevant.

The SRR-form (with the hydroxyl group in S configuration) is a minor metabolite that is formed in the human body, mainly in poor metabolizers.