- 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.
- 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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