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
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.
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.
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
Side effects
Side Effects:
- Change in taste
- Constipation
- Diarrhea
- Dizziness
- Drowsiness
- Dry mouth
- Headache
- Nausea
- Tiredness
- Abdominal pain
- Blurred vision
- Palpitations
- Shortness of breath
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.
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
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.
Therapeutic class
Membrane stabilizing agent (Sodium channel blockers)
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