Propafenone

What is propafenone?

Propafenone (proe-pa-FEEN-none) is a medication in an antiarrhythmic class of medicines. It can help people who have certain kinds of heart rhythm issues or arrhythmias.

Propafenone comes in tablet or capsule form. The prescription label tells you how many tablets to take each time you take your medication. Take only that amount. You can take propafenone with or without food. If you have any questions about propafenone or refilling your prescription, ask your pharmacist.

What is propafenone used for?

Propafenone helps people who have irregular heartbeats (arrhythmias). It affects your heart muscle to keep your heart beating normally. It can help you if you have supraventricular tachycardia (a fast heart rhythm that starts in your heart’s upper chambers). This drug may help you if you have:

• Atrial fibrillation (Afib), a common type of abnormal heart rhythm.
• Atrial flutter, which can lead to blood clots.
• Paroxysmal supraventricular tachycardia (PSVT), which can start and stop abruptly.

In some cases, propafenone can be helpful for abnormal heart rhythms that start in your heart’s lower chambers (ventricular arrhythmias).

Propafenone dosage

The propafenone dosage is 450 to 900 milligrams (mg) per day, split into three doses. People usually take it three times a day. There’s also a sustained release form of this medication that you take twice a day instead of three times a day. You should clarify with your cardiologist whether you’re taking the sustained release form or not.

You may start taking this medication in the hospital so your healthcare team can closely watch how the medication affects you.

It’s important to carefully follow the instructions on the prescription label. Ask your pharmacist or healthcare provider to explain anything about the medication that you don’t understand. Take the medication exactly as your provider tells you to.

You have about 50% of your dose left in your body five to seven hours after taking it. You’ll need to keep a steady level of propafenone in your body. Take the medication at the same times each day. Never stop taking this drug without first talking with your provider. If you suddenly stop taking propafenone, your heartbeat may become irregular.

Risks/Benefits

What are the advantages of propafenone?

Propafenone can help you have more time between symptoms of atrial fibrillation and PSVT.

What are the side effects of propafenone?

Propafenone side effects — which aren’t common — may include:

• Nausea.
• Vomiting.
• Heartburn.
• Gas.
• Loss of appetite.
• Stomach cramps.
• Constipation.
• Diarrhea.
• Anxiety.
• Headache.
• Weakness.
• Changes in sleep habits.
• Muscle aches.
• Sweating.
• Dry mouth.
• Tremors.
• Metallic taste in your mouth.

Call your provider if the above symptoms continue or are severe.

If you have dizziness or drowsiness, get up slowly after you’ve been sitting or lying down. Use extra caution when driving or performing activities that require you to be alert until you know how propafenone affects you.

Recovery and Outlook

How can I take care of myself when taking propafenone?

Care for yourself in these ways:

• Keeping all your appointments with your provider and the lab. You may need exams, electrocardiograms (EKGs) and blood tests to see how well the medication is working. Your provider may change your dose, especially if you have side effects.
• Making sure you always have enough medication. Check your supply before holidays, vacations and other times when you may not be able to get a refill.
• Asking your doctor if it’s OK to drink alcohol while you’re taking propafenone.

When to Call the Doctor

When should I see my healthcare provider?

If you have excessive drowsiness, slow heartbeat or irregular heartbeat, immediately stop taking propafenone and call your provider.

Call your provider right away if you have:

• Chest pain.
• Rapid heartbeat.
• Fainting.
• Blurred vision.
• Swollen feet or ankles.
• Unusual bleeding or bruising.
• Skin rash.
• Fever.
• Sore throat.
• Chills.
• Trouble breathing.
• Worse symptoms like a faster or more irregular heartbeat.

Do I need to eat special foods if I’m taking propafenone?

Foods and salt substitutes that contain potassium can affect the way propafenone works in your body. Ask your provider about changes you may need to make to what you eat.

How should I store propafenone?

• Keep propafenone in the original bottle and keep the lid tightly closed.
• Keep the medication at room temperature. Don’t keep the bottle near sunlight or moisture. Don’t keep the medication in the bathroom.
• Keep this and all medications out of the reach of children.
• Never use expired medications. Many prescription bottles list an expiration date. If you don’t know how old your medication is or when it expires, call your pharmacy.

What if I forget to take a dose of propafenone?

Take the missed dose if you remember it within four hours. If four or more hours pass after your scheduled dose, skip the missed dose and take your next regular dose. Don’t take a double dose of propafenone.

What should I tell my provider before I start taking propafenone?

Before you start taking propafenone, tell your provider:

• If you’re pregnant or nursing.
• If you have kidney disease, congestive heart failure, a pacemaker, liver disease, diabetes or respiratory disease.
• What other medications and supplements you take. This includes nonprescription drugs, vitamins and herbal or dietary supplements.
• If you take digoxin, beta-blockers, cimetidine, anticoagulants (“blood thinners”), cyclosporine, quinidine or rifampin. If you take any of these medications, also tell your pharmacist.

If you need to have surgery, including surgery in your mouth, tell your surgeon that you take propafenone.

A note from Cleveland Clinic

Having an abnormal heart rhythm is unsettling. For specific kinds of heart rhythm issues, propafenone can help. When taking this medicine, do yourself a favor and ask your healthcare provider or pharmacist about anything that isn’t clear. Being informed about side effects that can happen may help you avoid unwelcome surprises later.