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Can you take Flecainide with Propofol?

1 drug interaction and 22 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

flecainide propofol

Applies to: flecainide and propofol

Using propofol together with flecainide 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

propofol Food/Lifestyle

Applies to: propofol

Alcohol can increase the nervous system side effects of propofol such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with propofol. Do not use more than the recommended dose of propofol, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

flecainide Nicotine

Applies to: flecainide

As you stop smoking during treatment with nicotine, your dosage requirement of flecainide may need to be changed. 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 by your doctor 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.

Disease interactions

20 potential interactions Applies to: 17 conditions, including High Cholesterol, Heart Failure, Seizures, Diarrhea, and Hypokalemia.

Burns, External

Moderate:

propofol

Propofol has a moderate potential interaction with Burns, External.

Reports of mean urinary zinc loss during propofol therapy was approximately 2.5 to 3.0 mg/day in adult patients and 1.5 to 2.0 mg/day in pediatric patients. Practitioners should consider the administration of supplemental zinc during prolonged therapy with propofol in patients who are predisposed to zinc deficiency, such as those with burns, diarrhea, and/or major sepsis. Monitoring is recommended in these patients.

Cerebral Vascular Disorder

Major:

propofol

Propofol has a major potential interaction with Cerebral Vascular Disorder.

Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

Diarrhea

Moderate:

propofol

Propofol has a moderate potential interaction with Diarrhea.

Reports of mean urinary zinc loss during propofol therapy was approximately 2.5 to 3.0 mg/day in adult patients and 1.5 to 2.0 mg/day in pediatric patients. Practitioners should consider the administration of supplemental zinc during prolonged therapy with propofol in patients who are predisposed to zinc deficiency, such as those with burns, diarrhea, and/or major sepsis. Monitoring is recommended in these patients.

Heart Block

Major:

flecainide

Flecainide has a major potential interaction with Heart Block.

Flecainide is contraindicated in patients with pre-existing second- or third-degree AV block, or with right bundle branch block when associated with a left hemiblock (bifascicular block), unless a pacemaker is present to sustain the cardiac rhythm should complete heart block occur. Flecainide is also contraindicated in the presence of cardiogenic shock

Major:

propofol

Propofol has a major potential interaction with Heart Block.

Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

Heart Failure

Major:

flecainide

Flecainide has a major potential interaction with Heart Failure.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

High Cholesterol

Moderate:

propofol

Propofol has a moderate potential interaction with High Cholesterol.

Propofol is formulated in an oil-and-water emulsion and elevated triglycerides can occur during extended therapy. Propofol should be administered cautiously in patients with lipid disorders such as primary hyperlipoproteinemia, diabetic hyperlipemia, and pancreatitis. Each milliliter of propofol contains 0.1g of fat (1.1 kcal).

Hyperkalemia

Moderate:

flecainide

Flecainide 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:

flecainide

Flecainide 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:

flecainide

Flecainide has a major potential interaction with Hypotension.

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

Major:

propofol

Propofol has a major potential interaction with Hypotension.

Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

Ischemic Heart Disease

Major:

propofol

Propofol has a major potential interaction with Ischemic Heart Disease.

Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

Liver Disease

Moderate:

flecainide

Flecainide has a moderate potential interaction with Liver Disease.

Since flecainide elimination from plasma can be markedly slower in patients with significant hepatic impairment, flecainide should not be used in such patients unless the potential benefits clearly outweigh the risks. If used, frequent and early plasma level monitoring is required to guide dosage. Additionally, dosage increases should be made very cautiously when plasma levels have plateaued (after more than four days).

Magnesium Imbalance

Moderate:

flecainide

Flecainide 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:

flecainide

Flecainide has a moderate potential interaction with Renal Dysfunction.

Flecainide is primarily eliminated by the kidney. Approximately 30% (10% to 50%) of flecainide is excreted in the urine unchanged. The serum concentration of flecainide is increased and the half-life prolonged in patients with renal impairment. Rare conditions such as a strict vegetarian diet or renal tubular acidosis that significantly increase the urinary pH slow the urinary elimination of flecainide. Adjustment of dosage is necessary and modification should be based on the degree of renal impairment. Clinical monitoring of cardiac function (ECG) and renal function is recommended.

Moderate:

propofol

Propofol has a moderate potential interaction with Renal Dysfunction.

At high doses (2-3 grams per day), EDTA has been reported, on rare occasions, to be toxic to the renal tubules. Studies to-date, in patients with normal or impaired renal function have not shown any alteration in renal function with propofol Injectable Emulsion containing 0.005% disodium edetate. In patients at risk for renal impairment, urinalysis and urine sediment should be checked before initiation of sedation and then be monitored on alternate days during sedation.

Seizures

Moderate:

propofol

Propofol has a moderate potential interaction with Seizures.

Patients with seizure disorders are at increased risk of seizure activity during the recovery phase of sedation or anesthesia following administration of propofol. Clinical monitoring of seizure activity is recommended in patients with or predisposed to seizure disorders.

Sepsis

Moderate:

propofol

Propofol has a moderate potential interaction with Sepsis.

Reports of mean urinary zinc loss during propofol therapy was approximately 2.5 to 3.0 mg/day in adult patients and 1.5 to 2.0 mg/day in pediatric patients. Practitioners should consider the administration of supplemental zinc during prolonged therapy with propofol in patients who are predisposed to zinc deficiency, such as those with burns, diarrhea, and/or major sepsis. Monitoring is recommended in these patients.

Tachyarrhythmia

Major:

propofol

Propofol has a major potential interaction with Tachyarrhythmia.

Propofol can induce severe hypotension and/or cardiovascular depression, particularly during the induction phase of sedation or anesthesia. Use of propofol infusions for both adult and pediatric ICU sedation has been associated with a constellation of metabolic derangements and organ system failures, referred to as Propofol Infusion Syndrome, that have resulted in death. The syndrome is characterized by severe metabolic acidosis, hyperkalemia, lipemia, rhabdomyolysis,hepatomegaly, renal failure, ECG changes (ST segment elevation similar to that in Brugada syndrome) and/or cardiac failure. Therapy with propofol should be administered cautiously in patients with preexisting cardiovascular disorders, hemodynamic impairment, increased intracranial pressure, or impaired cerebral circulation.

Zinc Deficiency

Moderate:

propofol

Propofol has a moderate potential interaction with Zinc Deficiency.

Reports of mean urinary zinc loss during propofol therapy was approximately 2.5 to 3.0 mg/day in adult patients and 1.5 to 2.0 mg/day in pediatric patients. Practitioners should consider the administration of supplemental zinc during prolonged therapy with propofol in patients who are predisposed to zinc deficiency, such as those with burns, diarrhea, and/or major sepsis. Monitoring is recommended in these patients.

More resources

flecainide

A total of 392 drugs are known to interact with flecainide.

propofol

A total of 402 drugs are known to interact with propofol.

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.