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GENERIC NAME: propafenoneBRAND NAME: RythmolDRUG CLASS AND MECHANISM: Propafenone is used to treat heart rhythm abnormalities (antiarrhythmic agent). The primary mechanism of action is blocking channels which transport sodium across cell borders, which prolongs the beginning of the phase during which heart muscle cells become electrically stimulated (action potential).Propafenone slows conduction throughout the heart and is referred to as a type IC antiarrhythmic. Propafenone also has some beta adrenergic receptor blocking properties, and, to a lesser extent, calcium channel blocking effect. These are class II and class IV properties , respectively. Propafenone also blocks electrical conduction through accessory pathways, such as seen in WPW syndrome. PRESCRIPTION: yes GENERIC AVAILABLE: yes PREPARATIONS: Propafenone triangular tablets (150, 225, 300 mg). STORAGE: Tablets should be stored at room temperature in a tightly closed, light-resistant container. PRESCRIBED FOR: Propafenone is an antiarrhythmic agent and is only 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 once sinus rhythm has been restored. Propafenone is at least as effective as any other type I agent in converting atrial fibrillation to sinus rhythm. Propafenone is effective in atrial tachycardia, AV nodal tachycardia, and bypass tract tachycardias. DOSING: Propafenone is given with or without food every eight hours. In most patients propafenone is metabolized, primarily by the liver, and excreted in the urine over 2 to 10 hours. In up to 10% of patients this metabolism is slow and occurs over 12 to 32 hours. Doses may need to be lowered in these patients, and those with reduced liver and kidney function. DRUG INTERACTIONS: 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 proarrhythmia). It is for this reason that propafenone is started and doses increased while patients are hospitalized in a monitored setting. Quinidine inhibits the metabolism of propafenone and, therefore, their combined use should be avoided. Propafenone increases the levels of digoxin (Lanoxin), warfarin (Coumadin), and beta blockers which may require dose reductions. The electrical safety margins of artificial pacemakers can be compromised by the effects of propafenone and should be closely monitored. Safety and efficacy in children has not been established. PREGNANCY: Safety and efficacy in pregnant women has not been established. NURSING MOTHERS: It is not known whether propafenone enters breast milk. SIDE EFFECTS: Common side effects include dizziness , blurred vision, anorexia, unusual taste, fatigue, nausea and vomiting. |
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