Generic
Propafenone Hydrochloride
1 brands available in the market
At a glance
Propafenone Hydrochloride is a class 1C antiarrhythmic drug used for the treatment of paroxysmal atrial fibrillation/flutter, paroxysmal supraventricular tachycardia, and documented ventricular arrhythmias.
Description
Propafenone is a class 1C antiarrhythmic drug with local anesthetic effects and a direct stabilizing action on myocardial membranes. It slows sodium ion influx into cardiac muscle cells, decreasing cell excitability. It differs from prototypical class 1C antiarrhythmics in having additional beta-adrenergic blocking activity which can cause bradycardia and bronchospasm.
Indications
- Paroxysmal atrial fibrillation/flutter (PAF)
- Paroxysmal supraventricular tachycardia (PSVT)
- Documented ventricular arrhythmias
Therapeutic class
Membrane stabilizing agent (Sodium channel blockers)
Pharmacological class
Class 1C Antiarrhythmic
Pharmacology
Propafenone slows sodium ion influx into cardiac muscle cells, decreasing cell excitability. It is more selective for cells with a high rate, but also blocks normal cells more than class Ia or Ib. It has additional beta-adrenergic blocking activity which can cause bradycardia and bronchospasm.
Mechanism of action
Controls arrhythmias by blocking sodium channels and reducing cardiac cell excitability.
Dosage
Adult Dose (Oral):
- Initial dose: 150 mg three times daily (450 mg/day)
- May increase at 3-4 day intervals to 225 mg three times daily (675 mg/day); if needed, to 300 mg three times daily (900 mg/day)
- Max dose: 900 mg/day
- Patients <70 kg: Dose reduction recommended
- Elderly and hepatic impairment: Dose reduction recommended
Administration
- Take with food
- Swallow tablet whole; do not chew, crush, or break
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Side Effects:
- Change in taste
- Constipation
- Diarrhea
- Dizziness
- Drowsiness
- Dry mouth
- Headache
- Nausea
- Tiredness
- Abdominal pain
- Blurred vision
- Palpitations
- Shortness of breath
Precautions & warnings
- May affect driving ability; do not drive if tired, dizzy, or have blurred vision
- Do not stop abruptly
- Monitor liver function
- Monitor potassium and sodium levels
Contraindications
- Uncontrolled congestive heart failure
- Cardiogenic shock
- Sinoatrial, atrioventricular, and intraventricular impulse generation and/or conduction disorders
- Bradycardia
- Marked hypotension
- Bronchospastic disorders
- Electrolyte imbalance
- Hypersensitivity to the drug
Drug interactions
- CYP2D6, CYP1A2, CYP3A4 inhibitors (desipramine, paroxetine, ritonavir, sertraline, amiodarone, ketoconazole, erythromycin, grapefruit juice): Increased plasma levels
- CYP2D6 substrates (desipramine, imipramine, haloperidol, venlafaxine): Increased plasma concentrations
- Beta-blockers, TCAs: Effects potentiated
- Propranolol, metoprolol, desipramine, cyclosporin, digoxin, theophylline: Increased plasma levels
- Cimetidine, quinidine: Increased plasma concentrations
- Phenobarbital, rifamycin: Decreased plasma concentrations
Food interactions
It is not known whether it is safe to consume alcohol with Propafenone Hydrochloride.
Use in pregnancy
Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; use only if benefit outweighs risk.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably safe; limited human data suggests no significant risk; unknown if excreted in human milk.
Pediatric use
Safety and effectiveness not established in pediatric patients.
Geriatric use
Elderly patients require cautious dose selection; dose reduction recommended.
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; no dose adjustment needed; consult your doctor.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed (20-30% of normal dose); consult your doctor.
Overdose effects
No overdose information available; consult your doctor if taken in excess.
Storage conditions
Store at 25°C; store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Propafenone Hydrochloride