Adult Dosing
Recurrence of paroxysmal atrial fibrillation/flutter (PAF) and paroxysmal supraventricular tachycardia (PSVT)
- Immediate release
- Start 150 mg PO tid
- Increase dose to 225-300 mg PO in 3-4 days
- Max: 900 mg/day
Recurrence of symptomatic atrial fibrillation
- Extended release
- Start 225 mg PO bid
- Increase dose q5 days interval to 425 mg PO q12 hrs
- Max: 900 mg/day
Note:
- Do not crush or further divide the contents of the capsule
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
- Therapy may induce new or worsened arrhythmias including premature ventricular contractions or supraventricular arrhythmias. It may also prolong the QT interval. Proarrhythmic effects include sudden death and life-threatening ventricular arrhythmias such as ventricular fibrillation, ventricular tachycardia, asystole, and torsade de pointes may occur with therapy. Evaluate ECG before and during therapy
- Cardiac arrhythmias and exaggerated beta-adrenergic blocking activity may occur with increased exposure to propafenone. Avoid use of propafenone with CYP450 2D6 inhibitor and 3A4 inhibitor
- Avoid use of propafenone with Class IA and III antiarrhythmic agents and with drugs that prolongs QT interval
- Therapy may provoke overt heart failure. Proarrhythmic effects have occurred in patients with heart failure or severe myocardial ischemia after receiving propafenone
- Propafenone decreases AV conduction and may cause dose-related first degree AV block, PR interval prolongation and increases in QRS duration. Avoid giving propafenone in patients with atrioventricular and intraventricular conduction defects in the absence of a pacemaker
- Therapy may alter pacing and sensing thresholds of implanted pacemakers and defibrillators. Monitor pacemakers during and after therapy
- Some patients have reported agranulocytosis after receiving propafenone and after discontinuation of propafenone. Advise patient to report if signs of infection such as fever, sore throat, or chills occur
- Use cautiously in patients with impaired hepatic and renal function and also monitor patients with impaired hepatic function for excessive pharmacological effects
- Worsening of myasthenia gravis has been reported during propafenone treatment
- Patients receiving propafenone have reported positive ANA titers, consider discontinuation of therapy if such condition occurs. Carefully examine the patient if abnormal ANA test and persistent or worsening elevation of ANA titers is detected
- Brugada syndrome may be unmasked after exposure to therapy, perform ECG after starting the treatment and discontinue the medication if changes indicate Brugada syndrome
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- MI within 2 yrs
- QT prolongation
- Myasthenia gravis
- Pacemaker
- Poor CYP2D6 metabolizer
- Smoking habit changes
Pregnancy Category:C
Breastfeeding: Limited information indicates that maternal doses of propafenone up to 900 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 8 April 2011). Manufacturer advises use with caution.
Pricing data from www.DrugStore.com in U.S.A.
- Rythmol SR 225 MG CP12 [Bottle] (GLAXO SMITH KLINE)
30 mg = $189.99
90 mg = $539.99 - Rythmol 150 MG TABS [Bottle] (GLAXO SMITH KLINE)
30 mg = $134.99
90 mg = $389.97 - Propafenone HCl 225 MG TABS [Bottle] (WATSON LABS)
90 mg = $123
270 mg = $363.97 - Rythmol 225 MG TABS [Bottle] (GLAXO SMITH KLINE)
30 mg = $170.99
90 mg = $485.99 - Rythmol SR 425 MG CP12 [Bottle] (GLAXO SMITH KLINE)
60 mg = $512.97
180 mg = $1483.92 - Propafenone HCl 150 MG TABS [Bottle] (WATSON LABS)
90 mg = $115.99
270 mg = $316.96 - Rythmol SR 325 MG CP12 [Bottle] (GLAXO SMITH KLINE)
30 mg = $247.78
90 mg = $693.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
