Medications
Propafenone - Rythmol
RYTHMOL is an antiarrhythmic indicated to:
• prolong the time to recurrence of symptomatic atrial fibrillation (AF) in patients with episodic (most likely paroxysmal or persistent) AF who do not have structural heart disease.
• prolong the time to recurrence of paroxysmal supraventricular tachycardia (PSVT) associated with disabling symptoms in patients who do not have structural heart disease.
• treat documented life-threatening ventricular arrhythmias.
Usage Considerations:
• Use in patients with permanent atrial fibrillation or with atrial flutter or PSVT has not been evaluated. Do not use to control ventricular rate during atrial fibrillation.
• In patients with atrial fibrillation and atrial flutter, use RYTHMOL with drugs that increase the atrioventricular nodal refractory period.
• Because of proarrhythmic effects, use with lesser ventricular arrhythmias is not recommended, even if patients are symptomatic.
• The effect of propafenone on mortality has not been determined.
The most commonly reported adverse events with propafenone (>5%) included: unusual taste, nausea and/or vomiting, dizziness, constipation, headache, fatigue, first degree AV block, and intraventricular conduction delay.
• Inhibitors of CYP2D6, 1A2, and 3A4 increase propafenone exposure.
• Propafenone may increase digoxin or warfarin levels.
• Orlistat may reduce propafenone exposure. Taper orlistat withdrawal.
• Lidocaine may increase central nervous system side effects.
• May cause new or worsened arrhythmias. Evaluate patients via ECG prior to and during therapy.
• RYTHMOL may unmask Brugada or Brugada-like Syndrome.
• Avoid use with other drugs that prolong the QT interval. (5.3)
• Avoid simultaneous use of propafenone with both a cytochrome P450 2D6 inhibitor and a 3A4 inhibitor.
• May provoke overt heart failure.
• May cause dose-related first degree AV block or other conduction disturbances. Only use in patients with conduction disorders who have pacemakers.
• May affect artificial pacemakers.Monitor pacemaker function.
• Agranulocytosis: Patients should report signs of infection.
• May exacerbate myasthenia gravis.
