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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
    tract tachycardias.

What brand names are available for propafenone?

Rythmol, Rythmol SR

Is propafenone available as a generic drug?


Do I need a prescription for propafenone?


What are the side effects of propafenone?

Common side effects of propafenone are:

Serious side effects of propafenone include:

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.


In the U.S., 1 in every 4 deaths is caused by heart disease.
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What is the dosage for propafenone?

  • The initial dose is 150 mg every 8 hours of immediate release
  • 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 increases the levels of
    digoxin (Lanoxin),
    (Coumadin), and
    beta blockers (for example,
    Toprol XL],
    [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
  • 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.


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