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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?
Do I need a prescription for propafenone?
What are the side effects of propafenone?
Common side effects of propafenone are:
- Blurred vision
- Unusual taste
- 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.
Propafenone (Rythmol, Rythmol SR) is an anti-arrhythmic agent prescribed for the treatment of life-threatening arrhythmias. Side effects include fatigue, unusual taste, dizziness, blurred vision, and anorexia. Drug interactions, dosage, and pregnancy and breastfeeding safety should be reviewed prior to taking this medication.
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Related Disease Conditions
How the Heart Works (Sides, Chambers, and Function)
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
An arrhythmia is an abnormal heart rhythm. With an arrhythmia, the heartbeats may be irregular or too slow (bradycardia), to rapid (tachycardia), or too early. When a single heartbeat occurs earlier than normal, it is called a premature contraction.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Atrial Flutter (Symptoms, Causes, ECG, and Treatments)
Atrial flutter is a problem with the atria of the heart. In atrial flutter the atria of the heart rapidly and repeatedly beat due to an anomaly in the electrical system of the heart. It is a type of arrhythmia and can be dangerous because complications can develop easily. Signs and symptoms of atrial flutter include near fainting, palpitations, mild shortness of breath, and fatigue. While the exact cause of atrial flutter is not clearly understood, it's most likely related to your health, what medical conditions you certainly have, poor diet, lack of exercise, and drinking too much alcohol. Atrial flutter is diagnosed by physical examination, medical history, and a sawtooth ECG wave pattern.
Abnormal Heart Rhythms (Heart Rhythm Disorders)
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
Atrial Fibrillation (AFib, AF)
Atrial fibrillation (AF or AFib) is an abnormality in the heart rhythm, which involves irregular and often rapid beating of the heart. Symptoms may include heart palpitations, dizziness, fainting, fatigue, shortness of breath, and chest pain. Atrial fibrillation treatment may include medication or procedures like cardioversion or ablation to normalize the heart rate.
Atrial Fibrillation Symptoms (AFib Warning Signs)
Atrial fibrillation or AFib is a type of hear rhythm abnormality. Early warning signs and symptoms of atrial fibrillation include chest pain, palpitations, shortness of breath, and lightheadedness. Treatment for atrial fibrillation includes medical procedures, surgery, and medication.
Atrial Fibrillation (AFib) Treatment Drugs
Atrial fibrillation (AFib) is a heart rhythm disorder that causes irregular and often rapid heartbeat. The medications to treat AFib include beta-blockers, blood thinners, and heart rhythm drugs. Atrial fibrillation drugs can cause serious side effects like seizures, vision changes, shortness of breath, fainting, other abnormal heart rhythms, excessive bleeding while coughing or vomiting, blood in the stool, and bleeding into the brain.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
Wolff-Parkinson-White syndrome is a condition in which abnormal electrical pathways in the heart cause arrhythmias. Symptoms of Wolff-Parkinson-White syndrome include: tachycardia, dizziness, palpitations, fainting, and shortness of breath. Wolff-Parkinson-White syndrome is a common cause of paroxysmal supraventricular tachycardia. Wolff-Parkinson-White syndrome is caused by mutations in the PRKAG2 gene.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
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