propafenone hydrochloride at a glance
Medicine class
Class Ic anti-arrhythmic
Usual role
Specialist treatment or prevention of selected abnormal heart rhythms
Administration
Swallow the tablet whole with liquid; do not chew it
Supervision
ECG and clinical monitoring are required before and during treatment
What is propafenone hydrochloride used for?
Uses include:
Prevention and treatment of ventricular arrhythmias.
Prevention and treatment of intermittent supraventricular tachyarrhythmias, including paroxysmal atrial flutter or fibrillation and re-entry tachycardias involving the AV node or an accessory pathway, when standard therapy has failed or is contraindicated.
How does propafenone hydrochloride work?
Propafenone blocks fast sodium currents in heart muscle cells. This slows electrical activation and conduction through the atria, AV node, His–Purkinje system and accessory pathways, helping suppress abnormal impulses and re-entry rhythms. It also has some beta-blocking activity.
propafenone hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 150 mg, 300 mg
How to take propafenone hydrochloride
Follow the specialist’s instructions and do not alter treatment yourself.
Swallow film-coated tablets whole with liquid because propafenone has a bitter taste and local anaesthetic effect.
Do not chew the tablets.
Avoid grapefruit juice because it may increase propafenone exposure.
Tell healthcare professionals, including dentists and anaesthetists, that propafenone is being taken.
propafenone hydrochloride side effects
Common or expected effects
- Dizziness
- Palpitations or changes in heart conduction or rhythm
- Headache
- Taste disturbance
- Blurred vision
- Breathlessness
- Abdominal pain, nausea, vomiting, diarrhoea or constipation
- Dry mouth
- Tiredness or weakness
Get urgent medical advice
- A new or worsening arrhythmia, including a very fast rhythm
- Fainting, severe dizziness or collapse
- New or worsening heart failure, such as breathlessness or ankle swelling
- Seizure
- Severe allergic reaction
- Jaundice or other evidence of liver injury
- Fever with severe sore throat, unusual infection or unexplained bruising, which may indicate a blood-cell disorder
propafenone hydrochloride in pregnancy
Evidence in pregnancy is limited, and propafenone crosses the placenta. Use only when the expected benefit justifies the potential fetal risk. Pregnancy or pregnancy planning requires specialist cardiology and maternity review.
propafenone hydrochloride while breastfeeding
Information during breastfeeding is limited, but propafenone may pass into breast milk. Use requires an individual specialist assessment of maternal need, available alternatives and potential infant exposure.
propafenone hydrochloride interactions
Propafenone has clinically important pharmacodynamic and metabolic interactions. Check all prescribed, non-prescribed and herbal products.
Ritonavir, including ritonavir-containing antiviral combinations
May markedly increase propafenone exposure and the risk of serious arrhythmias; co-administration is contraindicated.
Warfarin and other oral anticoagulants
Propafenone may increase anticoagulant exposure and prolong clotting time, requiring closer monitoring and possible treatment adjustment.
Digoxin
Blood concentrations may rise, increasing the risk of toxicity.
Common questions about propafenone hydrochloride
Answers are fully visible for fast scanning and source review.
What is propafenone hydrochloride used for?
It is used by specialists to treat or prevent selected ventricular and intermittent supraventricular abnormal heart rhythms.
Is propafenone hydrochloride a beta blocker?
Its main action is class Ic sodium-channel blockade. It also has some beta-blocking activity, which contributes to cautions in people with obstructive airways disease or slow heart rates.
Why are ECGs needed with propafenone hydrochloride?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.