Propafenone

A to Z Drug Facts

Propafenone

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions

Rythmol

Class: Antiarrhythmic

Action Reduces fast inward current carried by sodium ion in the Purkinje fibers, and to a lesser extent myocardial fibers.

Indications Treatment of documented life-threatening ventricular arrhythmias (eg, sustained ventricular tachycardia). unlabeled use(s): Treatment of supraventricular tachycardias including atrial fibrillation and flutter and arrhythmias associated with Wolff-Parkinson-White syndrome.

Contraindications Uncontrolled CHF; cardiogenic shock; sinoatrial, atrioventricular and intraventricular disorders of impulse generation and conduction (eg, sick sinus node syndrome, atrioventricular block) in the absence of an artificial pacemaker; bradycardia; marked hypotension; bronchospastic disorders; manifest electrolyte imbalance; coadministration of cisapride; and known hypersensitivity to the drug.

Route/Dosage

Individually titrate dose based on response and tolerance. ADULTS: PO 150 mg q 8 hr initially, increasing at a min of 3- to 4-day intervals to 225 mg q 8 hr and, if necessary, to 300 mg q 8 hr.

Interactions

Cisapride: Contraindicated because of increase risk of life-threatening cardiac arrhythmias. Cyclosporine, desipramine, digoxin, metoprolol, propranolol, theophylline, warfarin: Propafenone may increase plasma concentrations of these agents, increasing the risk of side effects and toxicity. Cimetidine, quinidine, ritonavir: May increase propafenone plasma concentrations, potentially increasing pharmacologic and adverse effects. Rifamycins (ie, rifabutin, rifapentine): May decrease propafenone plasma concentrations, decreasing the therapeutic effect. Local anesthetics: May increase the risk of CNS side effects.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Angina; atrial fibrillation; bradycardia; bundle branch block; chest pain; CHF; first and second degree AV block; hypotension; increased QRS duration; intraventricular conduction delay; palpitations; premature ventricular contractions; tremor; wide complex tachycardia. CNS: Anxiety; ataxia; drowsiness; dizziness; fatigue; headache; insomnia; loss of balance; weakness. DERM: Rash. EENT: Blurred vision; dry mouth; tinnitus; unusual taste. GI: Abdominal pain and cramps; anorexia; constipation; diarrhea; flatulence; nausea; vomiting. HEMA: Agranulocytosis; granulocytopenia; thrombocytopenia. hepa: Hepatocellular injury. META: Edema. RESP: Dyspnea. OTHER: Diaphoresis; fever; joint pain; syncope.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Elderly: Because of the increased risk of impaired renal and hepatic function, use with caution. Arrhythmias: Avoid propafenone in patients with non-life-threatening ventricular arrhythmias. Cardiovascular effects: Has proarrhythmic effect; evaluate patients electrocardiographically and clinically prior to and during therapy to determine if response supports continued use. CHF: Since propafenone exerts beta blockade and a negative inotropic effect, fully compensate patients before giving propafenone. Hepatic dysfunction: Use with caution. Renal dysfunction: Use with caution.

OVERDOSAGE: SIGNS & SYMPTOMS
	Hypotension, somnolence, bradycardia, intra-atrial and intraventricular conduction disturbances, convulsions, high-grade ventricular arrhythmias