Classifications: antiarrhythmic class ic; Therapeutic: antiarrhythmic class ic
Pregnancy Category: C
150 mg, 225 mg, 300 mg tablets
Class IC antiarrhythmic drug with a direct stabilizing action on myocardial membranes. Reduces spontaneous automaticity.
Exerts a negative inotropic effect on the myocardium.
Appropriate dose and concentration decreases rate of single and multiple PVCs; additionally, it suppresses ventricular arrhythmias.
Atrial tachyarrhythmias, reentrant arrhythmias, Wolff-Parkinson-White syndrome.
Uncontrolled CHF, cardiogenic shock, sinoatrial, AV or intraventricular disorders (e.g., sick sinus node syndrome, AV block)
without a pacemaker; cardiogenic shock; bradycardia, QT prolongation; marked hypotension; bronchospastic disorders; electrolyte
imbalances; hypersensitivity to propafenone; nonlife-threatening arrhythmias; chronic bronchitis, emphysema; pregnancy (category
C). Safety and efficacy in children are not established.
CHF, AV block; hepatic/renal impairment; older adult patients; lactation.
Route & Dosage
Adult: PO Initiate with 150 mg q8h, may be increased at 34 d intervals (max: 300 mg q8h)
- Dosage increments gradually are usually made with older adults or those with previous extensive myocardial damage.
- Significant dose reduction is warranted with severe liver dysfunction. Consult physician.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS: Blurred vision, dizziness,
, somnolence, vertigo, headache. CV:
Arrhythmias, ventricular tachycardia, hypotension, bundle branch block, AV block, complete heart block,
sinus arrest, CHF. Hematologic: Leukopenia
, granulocytopenia (both rare). GI:
Nausea, abdominal discomfort, constipation
, vomiting, dry mouth, taste alterations,
InteractionsDrug: Amiodarone, quinidine
increases the levels and toxicity
of propafenone. May increase levels and toxicity
of tricyclic antidepressants
, cyclosporine, digoxin, beta blockers
may increase levels of both propafenone
and diltiazem. Phenobarbital
decreases levels of propafenone.
Readily from GI tract. Peak:
3.5 h. Distribution:
97% protein bound, highest concentrations in the lung. Crosses placenta, distributed into breast milk. Metabolism:
Extensively metabolized in the liver. Elimination:
18.538% of dose excreted in urine as metabolites. Half-Life:
Assessment & Drug Effects
- Monitor cardiovascular status frequently (e.g., ECG, Holter monitor) to determine effectiveness of drug and development
of new or worsened arrhythmias.
- Monitor patients with preexisting CHF closely for worsening of this condition. Monitor for digoxin toxicity with concurrent
use, because drug may increase serum digoxin levels.
- Report development of second- or third-degree AV block or significant widening of the QRS complex. Dosage adjustment may
Patient & Family Education
- Report to physician any of following: Chest pain, palpitations, blurred or abnormal vision, dyspnea, or signs and symptoms
- Be aware when taking concurrent warfarin of possible increase in plasma levels that increase bleeding risk. Report unusual
bleeding or bruising.
- Monitor radial pulse daily and report decreased heart rate or development of an abnormal heartbeat.
- Be aware of possibility of dizziness and need for caution with walking, especially in older adult or debilitated patients.