Formulary
Propafenone hydrochloride: Indications, Dosing, Side Effects and Interactions
Propafenone hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Propafenone hydrochloride: Indications, Dosing, Side Effects and Interactions
Propafenone hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Ventricular arrhythmias (specialist supervision in hospital),Paroxysmal supraventricular tachyarrhythmias which include paroxysmal atrial flutter or fibrillation and paroxysmal re-entrant tachycardias involving the AV node or accessory pathway, where standard therapy ineffective or contra-indicated (specialist supervision in hospital)**
- **Adult** (By Mouth): Initially 150 mg 3 times a day, dose to be taken after food, monitor ECG and blood pressure, if QRS interval prolonged by more than 20%, reduce dose or discontinue until ECG returns to normal limits; increased if necessary to 300 mg twice daily (max. per dose 300 mg 3 times a day), dose to be increased at intervals of at least 3 days, reduce total daily dose for patients under 70 kg.
- **Elderly** (By Mouth): Initially 150 mg 3 times a day, dose to be taken after food, monitor ECG and blood pressure, if QRS interval prolonged by more than 20%, reduce dose or discontinue until ECG returns to normal limits; increased if necessary to 300 mg twice daily (max. per dose 300 mg 3 times a day), dose to be increased at intervals of at least 5 days, reduce total daily dose for patients under 70 kg.
Cautions
Elderly; heart failure; mild to moderate obstructive airways disease owing to beta-blocking activity; pacemaker patients; potential for conversion of paroxysmal atrial fibrillation to atrial flutter with 2:1 conduction block or 1:1 conduction
Contraindications
Atrial conduction defects (unless adequately paced); Brugada syndrome; bundle branch block (unless adequately paced); cardiogenic shock (except arrhythmia induced); distal block (unless adequately paced); electrolyte disturbances; marked hypotension; myasthenia gravis; myocardial infarction within last 3 months; second degree or greater AV block (unless adequately paced); severe bradycardia; severe obstructive pulmonary disease (due to weak beta-blocking activity); sinus node dysfunction (unless adequately paced); uncontrolled congestive heart failure with left ventricular ejection fraction less than 35%
Side effects
Common or very common Anxiety; arrhythmias; asthenia; cardiac conduction disorder; chest pain; constipation; diarrhoea; dizziness; dry mouth; dyspnoea; fever; gastrointestinal discomfort; headache; hepatic disorders; nausea; palpitations; sleep disorders; taste altered; vision blurred; vomiting Uncommon Appetite decreased; erectile dysfunction; gastrointestinal disorders; hypotension; movement disorders; paraesthesia; skin reactions; syncope; thrombocytopenia; vertigo Frequency not known Agranulocytosis; confusion; granulocytopenia; heart failure; leucopenia; lupus-like syndrome; seizure
Interactions
**Other interactions (10):**
- Potential increase in adverse reactions may occur when propafenone is taken in conjunction with local anaesthetics (e.g., pacemaker implantation, surgery or dental work) and other medicinal products...
- Increased plasma levels and/or blood levels of propranolol, metoprolol, desipramine, ciclosporin, theophylline and digoxin have been reported during propafenone therapy.
- Elevated levels of plasma propafenone may occur when propafenone is used concomitantly with SSRIs, such as fluoxetine and paroxetine.
- Concomitant administration of propafenone and fluoxetine in extensive metabolisers increases the S-propafenone C max and AUC by 39 and 50% and the R-propafenone C max and AUC by 71 and 50%.
- Close monitoring of the clotting status in patients receiving concomitant oral anticoagulants (e.g., phenprocoumon, warfarin) is recommended as propafenone may enhance the plasma levels of these...
- Coadministration of propafenone hydrochloride with drugs metabolised by CYP2D6 (such as venlafaxine) might lead to increased levels of these drugs.
Pregnancy
Use only if potential benefit outweighs risk.
Breast feeding
Use with caution-present in milk.
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Propafenone hydrochloride in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

