Can you take Akynzeo for Injection with Propafenone?
2 drug interactions and 17 additional warnings found for the following 2 drugs:
- Akynzeo for Injection (fosnetupitant/palonosetron)
- propafenone
Drug interactions
Moderate drug interactions
Moderate:
propafenone palonosetron
Applies to: propafenone and Akynzeo for Injection (fosnetupitant / palonosetron)
Using propafenone together with palonosetron can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
propafenone fosnetupitant
Applies to: propafenone and Akynzeo for Injection (fosnetupitant / palonosetron)
Fosnetupitant may significantly increase the blood levels of propafenone in some patients. This can increase serious side effects such as: new or worsening irregular heart rhythm or heart failure; chest pain; difficulty breathing; fluid retention and swelling; and slow heart rate and pulse. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
propafenone Food/Lifestyle
Applies to: propafenone
Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with propafenone as they may increase the blood levels of propafenone in some patients. This can cause serious side effects such as new or worsening irregular heart rhythm or heart failure; chest pain; difficulty breathing; fluid retention and swelling; and slow heart rate and pulse. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
16 potential interactions Applies to: 11 conditions, including Heart Failure, Asthma, COPD, Hypokalemia, and Hypotension.
Asthma
Major:
propafenone
Propafenone has a major potential interaction with Asthma.
The use of propafenone is contraindicated in patients with bronchospastic disorders or severe obstructive pulmonary disease. Propafenone has beta-adrenergic blocking properties.
COPD
Major:
propafenone
Propafenone has a major potential interaction with COPD.
The use of propafenone is contraindicated in patients with bronchospastic disorders or severe obstructive pulmonary disease. Propafenone has beta-adrenergic blocking properties.
Heart Block
Major:
propafenone
Propafenone has a major potential interaction with Heart Block.
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.
Major:
propafenone
Propafenone has a major potential interaction with 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.
Heart Failure
Major:
propafenone
Propafenone has a major potential interaction with 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.
Hyperkalemia
Moderate:
propafenone
Propafenone has a moderate potential interaction with Hyperkalemia.
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.
Hypokalemia
Moderate:
propafenone
Propafenone has a moderate potential interaction with Hypokalemia.
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.
Hypotension
Major:
propafenone
Propafenone has a major potential interaction with Hypotension.
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.
Liver Disease
Moderate:
Akynzeo for Injection
The palonosetron in Akynzeo for Injection has a moderate potential interaction with Liver Disease.
No dosage adjustment for palonosetron is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8). Limited data are available in patients with severe hepatic impairment (Child-Pugh score greater than 9). It is recommended to avoid use of palonosetron in patients with severe hepatic impairment.
Moderate:
Akynzeo for Injection
The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Liver Disease.
Limited data are available with fosnetupitant (only available in combination with palonosetron in the US) in patients with severe hepatic impairment (Child-Pugh score greater than 9), therefore, its use should be avoided in these patients. No dosage adjustment is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8).
Moderate:
propafenone
Propafenone has a moderate potential interaction with Liver Disease.
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.
Lupus Erythematosus
Moderate:
propafenone
Propafenone has a moderate potential interaction with 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.
Magnesium Imbalance
Moderate:
propafenone
Propafenone has a moderate potential interaction with 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.
Renal Dysfunction
Moderate:
Akynzeo for Injection
The palonosetron in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.
Mild to moderate renal impairment does not significantly affect palonosetron pharmacokinetic parameters. However, total systemic exposure increased approximately 28% in patients with severe renal impairment. Additionally, the pharmacokinetics of palonosetron have not been studied in patients with end-stage renal disease. Caution is advised.
Moderate:
Akynzeo for Injection
The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.
No dosage adjustment for netupitant/fosnetupitant (only available in combination with palonosetron in the US), is necessary in patients with mild to moderate renal impairment (creatinine clearance of 30 to 60 mL/min). The pharmacokinetics and safety of netupitant/fosnetupitant have not been studied in patients with severe renal impairment. Severe renal impairment (creatinine clearance < 30 mL/min) did not substantially affect pharmacokinetics of palonosetron. The pharmacokinetics for netupitant and palonosetron were not studied in patients with end-stage renal disease requiring hemodialysis, therefore, avoid the use of this drug in patients with severe renal impairment or end-stage renal disease.
Moderate:
propafenone
Propafenone has a moderate potential interaction with Renal Dysfunction.
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.
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Akynzeo for Injection
A total of 588 drugs are known to interact with Akynzeo for Injection.
- Akynzeo for injection is in the drug class miscellaneous antiemetics.
- Akynzeo for injection is used to treat Nausea/Vomiting, Chemotherapy Induced.
propafenone
A total of 461 drugs are known to interact with propafenone.
- Propafenone is in the drug class group I antiarrhythmics.
- Propafenone is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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