Monograph Details
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Cardiovascular System
> CHF and arrhythmias
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RYTHMOL |
| Manufacturer |
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GlaxoSmithKline Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Class IC antiarrhythmic. |
| Generic Name |
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Propafenone HCl 150mg, 225mg, 300mg; scored tabs. |
| Also |
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• RYTHMOL SR
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| Indications |
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Documented life-threatening sustained ventricular arrhythmias. To prolong recurrence of disabling paroxysmal atrial fibrillation/flutter or paroxysmal supraventricular tachycardia in patients without structural heart disease. |
| Children |
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Not recommended. |
| Adults |
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Individualize. Initially 150mg every 8 hrs. May increase at intervals of at least 3–4 days (longer for elderly or marked myocardial damage) to 225mg every 8 hrs; max 300mg every 8 hrs. Hepatic impairment: reduce dose by 20–30%. |
| Contraindications |
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Uncontrolled CHF. Cardiogenic shock. SA, AV and intraventricular disorders of impulse generation +/or conduction (eg, sick sinus syndrome, AV block), unless paced. Bradycardia. Marked hypotension. Bronchospastic disorders. Electrolyte imbalance. |
| Precautions |
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Monitor ECG, pacemakers before and during therapy. Structural heart disease. Discontinue if CHF worsens; reduce dose if 2nd- or 3rd- degree AV block or QRS widening occurs. Monitor for agranulocytosis. Hepatic or renal dysfunction. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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Local anesthetics may increase CNS effects. Avoid drugs that may prolong the QT interval (eg, antiarrhythmics, phenothiazines, cisapride, bepridil, tricyclic antidepressants, macrolides). Avoid concomitant quinidine, amiodarone. Potentiates β-blockers, warfarin, digoxin (consider reducing their doses when starting propafenone), desipramine, cyclosporine, theophylline. Antagonized by rifampin. Monitor and adjust dose with CYP2D6, CYP1A2, and CYP3A4 inhibitors. |
| Adverse Reactions |
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New or exacerbated arrhythmias, dysgeusia, GI upset, dizziness, headache, 1st degree AV block, constipation, conduction defects, palpitations, blurred vision, xerostomia, heart failure, bradycardia, elevated ANA titer, exacerbation of myasthenia gravis (immediate-release tabs), edema. |
| How Supplied |
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Tabs, caps—100 |
| Additional Resources |
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• Related Prescribing Note |
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