Skip to Content

Propafenone Dosage

Medically reviewed on July 19, 2016.

Applies to the following strengths: 150 mg; 300 mg; 225 mg; 325 mg; 425 mg

Usual Adult Dose for Atrial Fibrillation

Initial dose:
Immediate release: 150 mg orally every 8 hours.
Extended release: 225 mg every 12 hours.

Maintenance dose:
Immediate release: May be increased at a minimum of 3 to 4 day intervals to 225 mg every 8 hours and, if necessary, to 300 mg every 8 hours.
Extended release: May be increased after 5 days of therapy to 325 mg every 12 hours. Doses up to 425 mg every 12 hours are necessary for some patients.

Usual Adult Dose for Atrial Flutter

Initial dose:
Immediate release: 150 mg orally every 8 hours.
Extended release: 225 mg every 12 hours.

Maintenance dose:
Immediate release: May be increased at a minimum of 3 to 4 day intervals to 225 mg every 8 hours and, if necessary, to 300 mg every 8 hours.
Extended release: May be increased after 5 days of therapy to 325 mg every 12 hours. Doses up to 425 mg every 12 hours are necessary for some patients.

Usual Adult Dose for Ventricular Tachycardia

Initial dose:
Immediate release: 150 mg orally every 8 hours.
Extended release: 225 mg every 12 hours.

Maintenance dose:
Immediate release: May be increased at a minimum of 3 to 4 day intervals to 225 mg every 8 hours and, if necessary, to 300 mg every 8 hours.
Extended release: May be increased after 5 days of therapy to 325 mg every 12 hours. Doses up to 425 mg every 12 hours are necessary for some patients.

Usual Adult Dose for Wolff-Parkinson-White Syndrome

Initial dose:
Immediate release: 150 mg orally every 8 hours.
Extended release: 225 mg every 12 hours.

Maintenance dose:
Immediate release: May be increased at a minimum of 3 to 4 day intervals to 225 mg every 8 hours and, if necessary, to 300 mg every 8 hours.
Extended release: May be increased after 5 days of therapy to 325 mg every 12 hours. Doses up to 425 mg every 12 hours are necessary for some patients.

Renal Dose Adjustments

No specific dose adjustment guidelines have been suggested; however, caution is recommended in dose selection.

Liver Dose Adjustments

In general, maintenance doses will be 20% to 30% of the usual recommended dose.

Dose Adjustments

In patients in whom significant widening of the QRS complex or second or third degree AV block occurs, dose reduction should be considered.

Precautions

US BOXED WARNING:
-MORTALITY: An increased rate of death or reversed cardiac arrest rate was seen in patients treated with encainide or flecainide (Class IC antiarrhythmics) compared with that seen in patients assigned to placebo. At present it is prudent to consider any IC antiarrhythmic to have a significant risk of provoking proarrhythmic events in patients with structural heart disease. Given the lack of any evidence that these drugs improve survival, antiarrhythmic agents should generally be avoided in patients with non-life-threatening ventricular arrhythmias, even if the patients are experiencing unpleasant, but not life-threatening, signs or symptoms.

In the elderly or in patients with marked previous myocardial damage, the dose should be increased more gradually during the initial phase of treatment.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

The usefulness and safety of dosages exceeding 900 mg per day have not been established.

Further information

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

Hide