Propafenone (Rythmol) Uses, Side Effects & Dosage

What are the uses for propafenone?

• Propafenone is an anti-arrhythmic agent approved
  for use in patients with life-threatening ventricular arrhythmias, such as
  ventricular tachycardia.
• Propafenone is also effective in suppressing the
  recurrence of
  atrial fibrillation and supra-ventricular tachycardia once normal
  sinus rhythm has been restored.
• Propafenone is at least as effective as any
  other type I agent in converting
  atrial fibrillation to normal sinus rhythm.
• Propafenone is effective in
  atrial tachycardia, AV nodal tachycardia, and
  bypass
  tract tachycardias.

What brand names are available for propafenone?

Rythmol, Rythmol SR

Is propafenone available as a generic drug?

Yes

Do I need a prescription for propafenone?

Yes

What are the side effects of propafenone?

Common side effects of propafenone are:

• Dizziness

• Blurred vision

• Anorexia

• Unusual taste

• Fatigue

• Constipation
• Headache
• Reduced cardiac conduction

• Nausea and vomiting

Serious side effects of propafenone include:

• Chest pain
• Heart palpitations
• Increased rate of cardiac arrest
• Abnormal heart beats
• Aggravation of myasthenia gravis
• Increased rate of death

• Congestive heart failure

Because of its beta blocking activity, propafenone must be used with caution in patients with weak
heart muscle (congestive heart failure), slow heart rate, any form of heart
electrical conduction block, low blood pressure, or asthma.

The most serious
side effect of propafenone is the causing of serious life- threatening irregular
heart rhythms (ventricular arrhythmias or pro-arrhythmia) or heart block. It is
for this reason that propafenone is started and doses increased while patients
are hospitalized in a monitored setting.

What is the dosage for propafenone?

• The initial dose is 150 mg every 8 hours of immediate release
  tablets.
• The dose may be increased at 3 to 4 day intervals to 225 mg every 8
  hours and, if needed, to 300 mg every 8 hours.
• When using extended release
  capsules the initial dose is 225 mg every 12 hours. The dose may be increased at
  minimum 5 day intervals to 325 every 12 hours and if necessary to 425 mg every
  12 hours.
• The dose should be reduced in patients with
  liver failure.
• Propafenone
  is given with or without food.

Which drugs or supplements interact with propafenone?

• Quinidine
  (Quinidine Gluconate,
  Quinidine Sulfate) and
  fluoxetine (Prozac) inhibit the
  metabolism of propafenone. Therefore, they should not be combined with
  propafenone.
• Propafenone increases the levels of
  digoxin (Lanoxin),
  warfarin
  (Coumadin), and
  beta blockers (for example,
  metoprolol
  [Lopressor,
  Toprol XL],
  propranolol
  [Inderal, InnoPran]). The dose
  of the interacting
  drugs may need to be reduced.
• Rifampin increases the
  metabolism of propafenone, decreasing blood levels of propafenone.
• Orlistat (Xenical)
  may reduce the absorption of propafenone. Stopping orlistat in patients
  stabilized on propafenone may result in propafenone toxicity because more
  propafenone will be absorbed after discontinuation of orlistat.
• Propafenone may
  alter pacing and sensing thresholds of pacemakers and defibrillators. These
  devices should be re-programmed and closely monitored. Safety and efficacy in
  children has not been established.

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Is propafenone safe to take if I’m pregnant or breastfeeding?

• Safety and efficacy in
  pregnant women has not been
  established.
• Propafenone is excreted in
  breast-milk. Mothers
  should decide whether to stop
  nursing or discontinue propafenone.

What else should I know about propafenone?

What preparations of propafenone are available?

• Tablets: 150, 225, and 300 mg.
• Capsules (extended
  Release): 225, 325, and 425 mg

How should I keep propafenone stored?

Tablets should be stored at room temperature 15 C to 30 C (59 F to 86 F) in a tightly closed, light-resistant container.