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.

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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.