Propafenone

Brand names of propafenone

• Apo-Propafenone
• PMS-Propafenone
• Rythmol

Usage

To correct heartbeat irregularities (cardiac arrhythmias).

How it works

Propafenone slows the conduction of nerve impulses in the heart and reduces the sensitivity of heart tissue to specific nerve impulses, which helps to stabilize heartbeat. It also has weak beta blocking properties.

Side effects

Serious

• chest pain
• fast or irregular heartbeat
• fatigue
• fever
• malaise
• shortness of breath
• swelling of lower legs or feet

Common

• change in taste
• constipation
• dizziness
• metallic or bitter taste
• vomiting or nausea

Less common

• blurred vision
• diarrhea
• dry mouth
• fatigue
• headache
• skin rash

Possible interactions

Other medicaments:

Propafenone may increase the effects of:

• amitriptyline (Elavil, others) and perhaps other tricyclic antidepressants.
• antihypertensive medicaments and cause excessive lowering of blood pressure.
• beta blockers.
• cyclosporine (Sandimmune), leading to toxicity.
• quinidine (Quinaglute, various).
• theophylline (Theo-Dur, others), leading to theophylline toxicity and seizures.
• warfarin (Coumadin, others); more frequent INR tests and dose adjustments are needed.

Propafenone taken concurrently with:

• amiodarone (Cordarone) may lead to excessive propafenone levels and toxicity; reduced doses may be required.
• digoxin (Lanoxin, others) increases digoxin levels and can cause toxicity.
• medicaments that inhibit or are removed by CYP 2D6 (talk to your doctor) may increase propafenone effects.
• fluoxetine (Prozac) may lead to increased propafenone blood levels and toxicity if doses are not adjusted.
• paroxetine (Paxil) may lead to increased propafenone blood levels and toxicity if doses are not adjusted.
• quinidine (Quinaglute) may increase propafenone levels and lead to toxicity if doses are not adjusted.
• ritonavir (Norvir) and perhaps other protease inhibitors may lead to propafenone toxicity.
• sertraline (Zoloft) may lead to propafenone toxicity.

The following medicaments may decrease the effects of propafenone:

• carbamazepine (Tegretol).
• phenobarbital (various).
• rifampin (Rifadin, Rimactane).

Foods:

Ask your physician about the need for salt restriction.

Herbal medicines or minerals:

Kola, St. John's wort, ma huang and yohimbe may cause additive heart rate or rhythm problems. Using St. John's wort, ma huang, or kola while taking this medicine may result in unacceptable heart stimulation. Belladonna, henbane, scopolia, pheasant's eye extract or lily of the valley or squill powdered extracts should not be taken if you have abnormal heart rhythms.

Beverages:

Caffeine may have an effect on heart rate and may not be desirable. Talk to your doctor about caffeine.

Alcohol:

Alcohol can increase the blood-pressure-lowering effects of this medicament.

Tobacco smoking:

Nicotine may irritate the heart, reducing medicament effectiveness.

Occurrence of unrelated illness:

Vomiting, diarrhea or dehydration can affect this medicament's action adversely. Report such developments promptly.

Discontinuation:

Should not be stopped abruptly after long-term use. Ask your doctor about slowly reducing the dose.

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