Propafenone: Uses, Dosage, Side Effects & Interactions

Summary of Key Points

Propafenone is a prescription medication used to manage certain abnormal heart rhythms (arrhythmias), such as atrial fibrillation, atrial flutter, and ventricular tachycardia. It works by stabilizing the heart’s electrical activity, helping to maintain a regular heartbeat. Propafenone is available in different forms and strengths, with dosing tailored to the specific condition being treated. Always consult your healthcare provider before making any changes to your medication regimen.

Names of Medication

US Brand Name: Rythmol (Propafenone)

The generic name refers to the chemical name of the active ingredient. In this case, Propafenone is the generic name, listed in parentheses.

Pharmacologic Category

Antiarrhythmic Agent, Class Ic

Propafenone Dosage

Propafenone is used to treat various heart rhythm disorders. The dose and frequency depend on the specific condition being managed. Always follow your doctor’s instructions carefully and consult them before making any adjustments to your dose. If needed, you can schedule a telemedicine appointment with one of our doctors for further guidance.

Propafenone for Atrial Fibrillation

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Propafenone for Atrial Flutter

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Propafenone for Ventricular Tachycardia

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Paroxysmal Supraventricular Tachycardia (PSVT)

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Wolff-Parkinson-White Syndrome

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Tachyarrhythmias

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Supraventricular Tachycardia

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Heart Rhythm Disorders

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Cardiac Arrhythmias

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Premature Ventricular Contractions

Initial dose: 150 mg orally every 8 hours.

Maintenance dose: May be increased to 225 mg every 8 hours, depending on your response and tolerance.

Dosage Forms and Strengths of Propafenone

Tablet: 150 mg, 225 mg, 300 mg

Extended-release capsule: 225 mg, 325 mg, 425 mg

Administration Instructions for Propafenone

Take Propafenone orally, with or without food, as directed by your healthcare provider. Swallow the tablets or capsules whole; do not crush or chew them. It is important to take this medication at the same time each day to maintain consistent blood levels. If you miss a dose, take it as soon as you remember unless it is close to your next scheduled dose. In that case, skip the missed dose and continue with your regular schedule. Do not double up on doses.

Contraindications for Propafenone

A contraindication is a specific situation where a drug should not be used because it may be harmful. If you have any of the conditions listed below, Propafenone may not be safe for you. Always consult your healthcare provider before starting any new medication. If you are unsure, you can speak with one of our providers through telemedicine.

1. Severe heart failure: Propafenone can worsen heart function in patients with severe heart failure, as it may reduce the heart’s ability to pump blood effectively.
2. Bradycardia (slow heart rate): Propafenone can further slow the heart rate, which can be dangerous in individuals with an already slow heartbeat.
3. Severe hypotension (low blood pressure): Propafenone can lower blood pressure further, leading to dizziness, fainting, or even shock.
4. Cardiogenic shock: This condition occurs when the heart suddenly cannot pump enough blood to meet the body’s needs. Propafenone can exacerbate this condition.
5. Bronchospastic disorders (e.g., asthma): Propafenone can narrow the airways, worsening breathing problems in people with asthma or other lung conditions.
6. Electrolyte imbalances: Low potassium or magnesium levels can increase the risk of dangerous heart rhythms when taking Propafenone.
7. Known hypersensitivity to Propafenone: If you have had an allergic reaction to Propafenone, you should not take this medication.

Propafenone Drug Interactions

Propafenone can interact with other medications, increasing the risk of side effects or reducing the effectiveness of either drug. Always inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Propafenone:

1. Digoxin (Lanoxin): Propafenone can increase digoxin levels in your blood, potentially leading to toxicity.
2. Warfarin (Coumadin): Propafenone can enhance the effects of warfarin, raising the risk of bleeding.
3. Beta-blockers (e.g., Metoprolol, Atenolol): Taking Propafenone with beta-blockers can excessively slow your heart rate and lower blood pressure.
4. Amiodarone (Pacerone): Combining these antiarrhythmic drugs can increase the risk of side effects, including heart rhythm problems.
5. Fluoxetine (Prozac): Fluoxetine can raise Propafenone levels in your blood, increasing the risk of side effects.
6. Ritonavir (Norvir): Ritonavir, used to treat HIV, can elevate Propafenone levels, leading to potential toxicity.

Propafenone in Pregnancy

Is it safe to take Propafenone during pregnancy?

There is limited information regarding the use of Propafenone during pregnancy. While animal studies suggest there may be some risk to the fetus, there is not enough data from human studies to confirm whether Propafenone is safe for pregnant individuals. If you are pregnant or planning to become pregnant, it is essential to discuss the potential risks and benefits of taking Propafenone with your healthcare provider. They can help you weigh the risks and determine the most appropriate course of action for your specific situation. If you need guidance, we offer telemedicine consultations to support you in making an informed decision.

Propafenone while Breastfeeding

Is it safe to take Propafenone while breastfeeding?

Propafenone does pass into breast milk, but its effects on a nursing infant are not well understood. Due to the potential for serious side effects in the baby, it is generally recommended to avoid using Propafenone while breastfeeding. If you are currently breastfeeding or planning to breastfeed, it is important to consult your healthcare provider about alternative treatments or to discuss whether it is safe to continue breastfeeding while taking Propafenone. You can also schedule a telemedicine appointment with one of our providers to explore your options.

Estimated Cost of Propafenone Medication

The estimated cost of a 30-day supply of Propafenone (150 mg tablets) without insurance typically ranges from $30 to $50 when using a GoodRx coupon. Prices may vary depending on the pharmacy and location. Be sure to check GoodRx or similar services for the most up-to-date pricing and available discounts.

Possible Alternatives to Propafenone

If Propafenone is not suitable for you, or if you are exploring other treatment options, there are alternative medications and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also speak with one of our telemedicine providers for personalized advice.

Alternatives for Atrial Fibrillation and Atrial Flutter

Alternative medications include Amiodarone, Dronedarone, or Sotalol. In some cases, catheter ablation may be an option. Additionally, lifestyle changes such as reducing alcohol consumption, managing stress, and maintaining a healthy weight can help improve symptoms.

Alternatives for Ventricular Tachycardia

Other antiarrhythmic medications, such as Amiodarone or Lidocaine, may be considered. In certain cases, an implantable cardioverter-defibrillator (ICD) may be recommended to help manage the condition.

Alternatives for Paroxysmal Supraventricular Tachycardia (PSVT)

Vagal maneuvers, such as holding your breath and bearing down, may help stop an episode. Medications like Adenosine or Verapamil may also be prescribed to manage PSVT.

Alternatives for Wolff-Parkinson-White Syndrome

Catheter ablation is often the preferred treatment for Wolff-Parkinson-White Syndrome. Medications such as Flecainide or Amiodarone may also be used to control heart rate in some cases.

Alternatives for Tachyarrhythmias and Supraventricular Tachycardia

Beta-blockers (e.g., Metoprolol) or calcium channel blockers (e.g., Diltiazem) may be considered as alternatives. Additionally, reducing caffeine intake and managing stress can help alleviate symptoms.

Alternatives for Heart Rhythm Disorders and Cardiac Arrhythmias

Depending on the type of arrhythmia, medications such as Amiodarone, Sotalol, or Dofetilide may be appropriate. Lifestyle changes, including quitting smoking and reducing alcohol consumption, can also contribute to better heart health.

Alternatives for Premature Ventricular Contractions (PVCs)

Beta-blockers or calcium channel blockers may be prescribed to manage PVCs. Additionally, reducing caffeine intake and managing stress can help decrease the frequency of these irregular heartbeats.

Recent Updates on Propafenone Research

Recent studies have explored the long-term safety and effectiveness of Propafenone in treating various arrhythmias. A 2022 study published in the Journal of Cardiovascular Electrophysiology found that Propafenone remains an effective treatment for atrial fibrillation and atrial flutter, particularly in patients who cannot tolerate other antiarrhythmic medications. However, researchers emphasize the importance of regular monitoring for potential side effects, especially in patients with underlying heart conditions.

Ongoing research is also investigating the use of Propafenone in combination with other medications to improve outcomes in patients with complex arrhythmias. Staying informed about new developments is crucial, and you should discuss any concerns with your healthcare provider. If you have questions about your treatment plan, our telemedicine providers are available to help you stay updated with the latest research and recommendations.

James Kingsley

Learn More