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Propafenone Disease Interactions

There are 8 disease interactions with propafenone:

Major

Antiarrhythmics (applies to propafenone) proarrhythmic effects

Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias, Abnormal Electrocardiogram

Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.

References

  1. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
  2. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  3. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
  4. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  5. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals, Wilmington, DE.
  6. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  7. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
  8. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  9. Lo KS, Gantz KB, Stetson PL, et al "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
  10. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  11. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
  12. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
  13. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7
  14. Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
  15. Hii JT, Wyse DG, Gillis AM, et al "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
  16. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
  17. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
  18. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7
  19. Damle R, Levine J, Matos J, et al "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
  20. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
  21. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
  22. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  23. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
  24. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
  25. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
  26. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  27. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
  28. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  29. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  30. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  31. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
  32. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
  33. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  34. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  35. Au PK, Bhandari AK, Bream R, et al "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
  36. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
  37. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  38. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
  39. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
  40. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
  41. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
  42. Bauman JL, Bauernfeind RA, Hoff JV, et al "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
  43. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
  44. Strasberg B, Sclarovsky S, Erdberg A, et al "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
  45. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
  46. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
  47. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
  48. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
  49. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  50. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
  51. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
  52. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
  53. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
  54. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
  55. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
  56. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
  57. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
  58. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
  59. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
  60. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
  61. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
  62. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
View all 62 references
Major

Propafenone (applies to propafenone) bronchospastic disorder

Major Potential Hazard, Moderate plausibility. Applicable conditions: Asthma, Chronic Obstructive Pulmonary Disease

The use of propafenone is contraindicated in patients with bronchospastic disorders or severe obstructive pulmonary disease. Propafenone has beta-adrenergic blocking properties.

References

  1. Olm M, Munne P, Jimenez MJ "Severe reactive airways disease induced by propafenone." Chest 95 (1989): 1366-7
  2. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
Major

Propafenone (applies to propafenone) cardiac dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Heart Block, Hypotension, Congestive Heart Failure

The use of propafenone is contraindicated in patients with uncontrolled congestive heart failure, cardiogenic shock, bradycardia, or marked hypotension. Propafenone can exacerbate congestive heart failure by beta blockade of sympathetic stimulation necessary for circulatory support. Propafenone also has negative inotropic activity that can depress cardiac output and cardiac index.

References

  1. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
  2. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
Major

Propafenone (applies to propafenone) sinus (applies to propafenone) AV node dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Heart Block

The use of propafenone is contraindicated in patients with conduction disorders such as second- or third-degree AV block, right bundle-branch block when associated with a left hemiblock(bifascicular block), sick sinus syndrome, or bradycardia-tachycardia syndrome in the absence of a functional artificial pacemaker.

References

  1. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. Lee PK, Kerr CR, Vorderbrugge S, Qi AZ, Yeung-Lai-Wah JA "Symptomatic sinus node dysfunction associated with the use of propafenone." Am J Cardiol 62 (1988): 480-1
Moderate

Antiarrhythmics (applies to propafenone) electrolyte imbalance

Moderate Potential Hazard, High plausibility. Applicable conditions: Hypokalemia, Hyperkalemia, Magnesium Imbalance

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

References

  1. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  3. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  5. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  6. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  7. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  8. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  11. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  12. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  13. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 13 references
Moderate

Propafenone (applies to propafenone) (+) ANA titer

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Lupus Erythematosus

Reversible (+) ANA titers have been reported during administration of propafenone. Therapy with propafenone should be administered cautiously in patients with established systemic lupus erythematosus (SLE). Clinical monitoring, including ANA titers, is recommended. Patients without a previous history of (+) ANA titer or SLE who develop a (+) ANA while receiving propafenone should be evaluated and, if ANA titers persist or worsen, discontinuation of therapy should be considered.

References

  1. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
Moderate

Propafenone (applies to propafenone) liver disease

Moderate Potential Hazard, High plausibility.

Propafenone is extensively metabolized by the liver. The bioavailability of propafenone in patients with normal hepatic function is approximately 3% to 40%, but increases to approximately 70% in patients with severe hepatic impairment. Therapy with propafenone should be administered cautiously and the dosage reduced to 20% to 30% of that given patients with normal hepatic function. Clinical monitoring of cardiac function (ECG) and hepatic function is recommended.

References

  1. Mondardini A, Pasquino P, Bernardi P, Aluffi E, Tartaglino B, Mazzucco G, Bonino F, Verme G, Negro F "Propafenone-induced liver injury: report of a case and review of the literature." Gastroenterology 104 (1993): 1524-6
  2. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  3. Spinler SA, Elder CA, Kindwall KE "Propafenone-induced liver injury." Ann Pharmacother 26 (1992): 926-8
Moderate

Propafenone (applies to propafenone) renal dysfunction

Moderate Potential Hazard, Low plausibility.

Propafenone is partially eliminated by the kidney and approximately 50% of its metabolites are excreted in the urine. Therapy with propafenone should be administered cautiously in patients with renal impairment, monitoring for signs of overdosage.

References

  1. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  2. Burgess ED, Duff HJ "Hemodialysis removal of propafenone." Pharmacotherapy 9 (1989): 331-3
  3. Burgess E, Duff H, Wilkes P "Propafenone disposition in renal insufficiency and renal failure." J Clin Pharmacol 29 (1989): 112-3
  4. Chan GL, Axelson JE, Price JD, et al "In vitro protein binding of propafenone in normal and uraemic human sera." Eur J Clin Pharmacol 36 (1989): 495-9
View all 4 references

Propafenone drug interactions

There are 378 drug interactions with propafenone

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.