Propafenone

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Propafenon, Rytmonorma; Belgium: Rytmonorm; Bulgaria: Propafenon, Propastad, Rytmocard; Czech Republic: Prolekofen, Propafenon, Propanorm, Rytmonorm; Denmark: Rytmonorm; Estonia: Propanorm, Rytmonorm; Finland: Rytmonorm; France: Rythmol; Germany: Cuxafenon, Propafenon, Rytmonorm, Rytmo-Puren; Greece: Propafenone, Rytmonorm; Ireland: Arythmol; Italy: Rytmonorm; Lithuania: Propanorm, Rytmonorm; Luxembourg: Prorynorm, Rytmonorm; Netherlands: Propafenon, Rytmonorm; Poland: Polfenon, Rytmonorm; Portugal: Arythmol, Rytmonorm; Romania: Propafe, Propafenon, Propafenona, Propanorm, Rytmonorm; Slovakia: Prolekofen, Propanorm, Rytmonorm; Spain: Rytmonorm; Slovenia: Propafenon, Rytmonorm; Spain: Rytmonorm; Sweden: Rytmonorm; UK: Arythmol.

North America

Canada: Propafenone, Rythmol; USA: Propafenone, Rythmol.

Latin America

Argentina: Normorytmin; Brazil: Ritmonorm; Mexico: Biopafén, Nistakén, Norfenón, Propafenona.

Asia

Japan: Pronon, Ropaful, Sobiral.

Drug combinations

Chemistry

Propafenone Hydrochloride: C~21~H~27~NO~3~ HCl. Mw: 377.90. (1) 1-Propanone, 1-[2-[2-hydroxy-3-(propylamino)propoxy]phenyl]-3-phenyl-, hydrochloride; (2) 2′-[2-Hydroxy-3-(propylamino)propoxy]-3-phenylpropiophenone hydrochloride. CAS-34183-22-7; CAS-54063-53-5 (propafenone)(1988).

Pharmacologic Category

Class Ic Antiarrhythmics. (ATC-Code: C01BC03).

Mechanism of action

Possesses local anesthetic properties, blocks fast inward sodium current, and slows rate of increase of action potential. Prolongs effective refractory period, reduces spontaneous automaticity and exhibits some β-blockade activity.

Therapeutic use

Treatment of life-threatening ventricular arrhythmias. Maintenance of normal sinus rhythm in symptomatic atrial fibrillation.

Pregnancy and lactiation implications

There are no adequate, well-controlled studies in pregnant women. Use only if potential benefit to mother justifies potential risk to fetus. Enters breast milk (use caution).

Unlabeled use

Supraventricular tachycardias, including Wolff-Parkinson-White syndrome.

Contraindications

Hypersensitivity to propafenone or any component of the formulation. Sinoatrial, AV, and intraventricular disorders of impulse generation and/or conduction (except in patients with functioning artificial pacemaker). Sinus bradycardia. Cardiogenic shock. Uncompensated cardiac failure. Hypotension. Bronchospastic disorders. Uncorrected electrolyte abnormalities. Concurrent use of ritonavir.

Warnings and precautions

Can cause or unmask a variety of conduction disturbances. Proarrhythmic effects (QTc prolongation) might occur. Patients with bronchospastic disease should generally not receive this drug. Electrolyte imbalance should be corrected, especially hypokalemia or hypomagnesemia, prior to use and throughout therapy. Use with caution in heart failure (may precipitate or exacerbate condition), in hepatic impairment, in myasthenia gravis (may be exacerbated), and with concurrent use of any drug which can prolong QT interval. Antiarrhythmic agents should be reserved for patients with life-threatening ventricular arrhythmias. May alter pacing and sensing thresholds of artificial pacemakers.

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