Propafenone Advanced Patient Information – Drugs.com

Generic name: propafenone [ proe-PA-fen-one-hye-droe-KLOR-ide ]
Drug class: Group I antiarrhythmics

Medically reviewed by Drugs.com. Last updated on Nov 7, 2022.

Oral route(Tablet;Capsule, Extended Release)

It is prudent to consider any Class 1C antiarrhythmic to have a significant proarrhythmic risk in patients with structural heart disease. Given the lack of any evidence that these drugs improve survival, antiarrhythmic agents should generally be avoided in patients with non-life-threatening ventricular arrhythmias, even if the patients are experiencing unpleasant, but not life-threatening, symptoms or signs .

Uses for propafenone

Propafenone is used to prevent irregular heartbeats such as atrial fibrillation (AF) from occurring again in patients who do not have structural heart disease.

Propafenone belongs to the group of medicines known as antiarrhythmics. It works directly on the heart tissue and will slow the nerve impulses in the heart. This helps keep the heart rhythm normal.

There is a chance that propafenone may cause new or make worse existing heart rhythm problems when it is used. Since it has been shown to cause severe problems in some patients, propafenone is only used to treat serious heart rhythm problems. Discuss this possible effect with your doctor.

This medicine is available only with your doctor’s prescription.

Before using propafenone

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of propafenone in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of propafenone in the elderly.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Bepridil
• Cisapride
• Dronedarone
• Fluconazole
• Ketoconazole
• Levoketoconazole
• Levomethadyl
• Mesoridazine
• Nelfinavir
• Nirmatrelvir
• Pimozide
• Piperaquine
• Posaconazole
• Ritonavir
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Tipranavir
• Vernakalant
• Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acecainide
• Adagrasib
• Ajmaline
• Alfuzosin
• Amiodarone
• Amisulpride
• Amitriptyline
• Amoxapine
• Anagrelide
• Apomorphine
• Aprindine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Artemether
• Asenapine
• Astemizole
• Azimilide
• Azithromycin
• Boceprevir
• Bretylium
• Buprenorphine
• Bupropion
• Buserelin
• Ceritinib
• Chloral Hydrate
• Chloroquine
• Chlorpromazine
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clofazimine
• Clomipramine
• Clothiapine
• Clozapine
• Cobicistat
• Crizotinib
• Dabrafenib
• Dasabuvir
• Dasatinib
• Degarelix
• Delamanid
• Delavirdine
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Dibenzepin
• Digoxin
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Droperidol
• Duloxetine
• Efavirenz
• Encorafenib
• Enflurane
• Entrectinib
• Erythromycin
• Escitalopram
• Etravirine
• Fedratinib
• Fexinidazole
• Fingolimod
• Flecainide
• Fluoxetine
• Formoterol
• Foscarnet
• Fostemsavir
• Gatifloxacin
• Gemifloxacin
• Glasdegib
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Halothane
• Histrelin
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imipramine
• Inotuzumab Ozogamicin
• Isoflurane
• Isradipine
• Ivabradine
• Ivosidenib
• Lacosamide
• Lapatinib
• Lefamulin
• Lenvatinib
• Leuprolide
• Levofloxacin
• Lidocaine
• Lidoflazine
• Lofexidine
• Lopinavir
• Lorcainide
• Lumefantrine
• Macimorelin
• Mefloquine
• Methadone
• Metronidazole
• Mifepristone
• Mirabegron
• Mirtazapine
• Mobocertinib
• Moxifloxacin
• Nafarelin
• Nilotinib
• Norfloxacin
• Nortriptyline
• Octreotide
• Ombitasvir
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Ozanimod
• Pacritinib
• Paliperidone
• Panobinostat
• Paritaprevir
• Paroxetine
• Pasireotide
• Pazopanib
• Pentamidine
• Phenobarbital
• Pimavanserin
• Pirmenol
• Pitolisant
• Ponesimod
• Prajmaline
• Prilocaine
• Primidone
• Probucol
• Procainamide
• Prochlorperazine
• Promethazine
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Ranolazine
• Relugolix
• Ribociclib
• Risperidone
• Selpercatinib
• Sematilide
• Sertindole
• Sertraline
• Sevoflurane
• Simeprevir
• Siponimod
• Sodium Phosphate
• Sodium Phosphate, Dibasic
• Sodium Phosphate, Monobasic
• Solifenacin
• Sorafenib
• Sotalol
• Spiramycin
• Sulfamethoxazole
• Sulpiride
• Sultopride
• Sunitinib
• Tacrolimus
• Tedisamil
• Telaprevir
• Telithromycin
• Tetrabenazine
• Tizanidine
• Toremifene
• Trazodone
• Triclabendazole
• Trifluoperazine
• Trimethoprim
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Venlafaxine
• Vilanterol
• Vinflunine
• Voclosporin
• Voriconazole
• Zolmitriptan
• Zotepine
• Zuclopenthixol

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Cyclosporine
• Metoprolol
• Rifampin
• Rifapentine
• Theophylline
• Tolterodine
• Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice
• Tobacco

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Bronchitis or
• Emphysema—Propafenone can increase trouble in breathing.

• AV block (type of abnormal heart rhythm), with no pacemaker or
• Bradycardia (slow heartbeat) or
• Breathing problems or lung disease (eg, bronchospasm, severe obstructive pulmonary disease) or
• Brugada syndrome (a genetic heart rhythm disorder) or
• Cardiogenic shock (shock caused by heart attack) or
• Heart failure or
• Hypotension (low blood pressure) or
• Mineral imbalance or
• Sick sinus node syndrome (type of abnormal heart rhythm), with no pacemaker—Should not be used in patients with these conditions.

• Blood or bone marrow problems (eg, agranulocytosis, granulocytopenia) or
• Coronary artery disease or
• Heart rhythm problems (eg, QT prolongation) or
• Myasthenia gravis (severe muscle weakness) or
• Torsade de pointes or
• Ventricular fibrillation or tachycardia—Use with caution. May make these conditions worse.

• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• If you have a permanent pacemaker—Use with caution. Propafenone may interfere with the pacemaker and require more careful follow-up by the doctor.

Proper use of propafenone

Take this medicine exactly as directed by your doctor. Do not take more or less of this medicine, and do not take it more often than your doctor ordered.

This medicine comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

For patients taking the extended-release capsules:

• Swallow the capsules whole. Do not crush, break, or chew them.
• This medicine may be taken with or without food.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take each dose at evenly spaced times day and night. For example, if you are to take 3 doses a day, doses should be spaced about 8 hours apart. If you need help in planning the best times to take your medicine, check with your doctor.

Your doctor may want you to carry a medical identification card or bracelet stating that you are using this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• The number of extended-release capsules or tablets that you take depends on the strength of the medicine.
• For atrial fibrillation (AF):
  • For oral dosage form (extended-release capsules):
    • Adults—At first, 225 milligrams (mg) every 12 hours. Your doctor may adjust your dose as needed. However, the dose is usually not more than 425 mg every 12 hours.
    • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (tablets):
    • Adults—150 milligrams (mg) every 8 hours. Your doctor may increase your dose if needed.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using propafenone

It is important that your doctor check your progress at regular visits to make sure the medicine is working properly. This will allow for changes to be made in the amount of medicine you are taking, if necessary.

This medicine can cause changes in your heart rhythm, such as conditions called PR, QRS, or QT prolongation. It may cause fainting or serious side effects in some patients. Contact your doctor right away if your symptoms do not improve or if they get worse.

Check with your doctor right away if you develop any of the following: chest pain, shortness of breath, swelling of your hands, ankles, or feet, or weight gain. These may be symptoms of heart failure.

This medicine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Propafenone may cause some people to become dizzy or lightheaded. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy.

If you have been using this medicine regularly for several weeks, do not suddenly stop using it. Check with your doctor for the best way to gradually reduce the amount you are taking before stopping completely.

This medicine may decrease the amount of sperm men make. Talk to your doctor if you have concerns about this.

Grapefruits and grapefruit juice may increase the effects of propafenone by increasing the amount of this medicine in your body. You should not eat grapefruit or drink grapefruit juice while you taking this medicine.

Tell your doctor if you are smoking tobacco.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of propafenone

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

• Chest pain
• fast, irregular, or slow heartbeat
• lightheadedness, dizziness, or fainting
• shortness of breath
• swelling of the feet or lower legs
• weight gain

Rare

• Chills
• fever
• joint pain
• trembling or shaking
• weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Change in taste or bitter or metallic taste

Less common

• Blurred vision
• constipation
• diarrhea
• dryness of the mouth
• headache
• nausea or vomiting
• skin rash
• unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

More about propafenone

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• Compare alternatives
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• Reviews (68)
• Drug images
• Side effects
• Dosage information
• During pregnancy
• Drug class: group I antiarrhythmics
• Breastfeeding
• En español

Patient resources

• Drug Information
• Propafenone Tablets

Other brands

Rythmol, Rythmol SR

Professional resources

• Prescribing Information

Related treatment guides

• Atrial Fibrillation
• Atrial Flutter
• Wolff-Parkinson-White Syndrome
• Ventricular Tachycardia

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

pms-Propafenone – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Propafenone belongs to the class of medications known as antiarrhythmics. It is used to treat certain abnormal heart rhythms. It works by slowing down the rate of nerve impulses causing the heart to beat, and by making the heart less likely to respond to abnormal impulses.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

pms-Propafenone is no longer being manufactured for sale in Canada. For brands that may still be available, search under propafenone. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The recommended starting dose of propafenone for adults is 150 mg taken every 8 hours. This dose may be changed by your doctor according to your particular needs. The maximum daily dose is 900 mg per day.

Propafenone should be taken with food. Swallow the tablets whole. Do not crush or chew this medication.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take propafenone if you:

• are allergic to propafenone or any ingredients of the medication
• are taking the medication “ritonavir”
• have a very low heart rate (less than 50 beats per minute)
• have breathing disorders such as asthma or obstructive pulmonary disease
• have cardiogenic shock
• have certain types of heart rhythm disorders not managed with a pacemaker (i.e., sino-atrial, atrioventricular, and intraventricular disorders of impulse conduction and sinus node dysfunction)
• have had a heart attack in the last 3 months
• have myasthenia gravis
• have severe disorders of electrolytes (e.g., potassium) balance
• have severe liver failure
• have severe or uncontrolled congestive heart failure
• have very low blood pressure
• have been diagnosed with Brugada Syndrome (a type of heart rhythm disorder)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain or cramping
• bitter or metallic taste, or changes in taste
• blurred vision
• constipation
• dizziness
• drowsiness
• dry mouth
• gas
• headache
• heartburn
• increased sweating
• insomnia
• lightheadedness
• loss of appetite
• nausea
• rash
• tiredness
• upset stomach
• vomiting
• weakness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal muscle control and movement
• anxiety
• fainting
• fast, slow, or irregular heartbeat
• joint pain
• shaking or trembling
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of decreased heart function (e.g., shortness of breath, swelling of feet or lower legs, unusual tiredness or weakness)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• swelling of feet or lower legs

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• seizures
• signs of a serious allergic reaction (e. g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Abnormal heart rhythms: Certain medications used to treat abnormal heart rhythms, including propafenone, may cause new abnormal heart rhythms or worsen existing ones. Your doctor will monitor you closely while you are taking propafenone. If you experience a fast, slow, or irregular heartbeat; fainting; heart palpitations; or dizziness while taking this medication, contact your doctor immediately.

Asthma or bronchitis: Propafenone can worsen breathing problems for people with asthma or bronchitis. If you have asthma or other breathing disorders, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Propafenone may cause blurred vision, dizziness, and fatigue. Do not drive or operate machinery until you know how this medication affects you.

Heart failure: Propafenone can cause or worsen heart failure and should not be used by people with severe or untreated heart failure. If you have heart failure and are taking this medication, your doctor will monitor you closely during treatment. If you notice shortness of breath; weight gain; or swelling in the hands, feet, or lower legs while taking propafenone, contact your doctor immediately.

If you have a heart condition, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: Propafenone can reduce the number of cells that fight infection in the body (white blood cells). This usually occurs within 4 to 6 weeks of starting this medication. If you experience fever, sore throat, fatigue, weakness, or a general feeling of being unwell while taking propafenone, contact your doctor immediately.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: The liver removes most of this medication from the body. Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Pregnancy: Propafenone crosses the placenta and may affect the developing baby if it is taken during pregnancy. This medication should not be taken during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking propafenone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may experience more dizziness while taking propafenone and may require lower doses.

What other drugs could interact with this medication?

There may be an interaction between propafenone and any of the following:

• abiraterone
• aliskiren
• alpha-agonists (e.g., clonidine, methyldopa)
• antiarrythmics (e.g., amiodarone, disopyramide, dronedarone, flecainide, procainamide, quinidine, sotalol)
• anticancer medications (e.g., brentuximab, daunorubicin, docetaxel, doxorubicin, etoposide, irinotecan, mitomycin, paclitaxel, tamoxifen, vinblastine, vincristine)
• antihistamines (e. g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, pimozide, paliperidone, risperidone)
• apalutamide
• aprepitant
• “azole” antifungals (e.g., ketoconazole, fluconazole, voriconazole)
• beta-adrenergic blockers (e.g., metoprolol, propranolol)
• BCG
• bicalutamide
• bupropion
• calcium channel blockers (e.g., diltiazem, verapamil)
• chloroquine
• cimetidine
• cinacalcet
• cobicistat
• colchicine
• conivaptan
• cyclosporine
• dabigatran
• darifenacin
• digoxin
• domperidone
• donepezil
• doxepin
• edoxaban
• enzalutamide
• everolimus
• fentanyl
• fingolimod
• galantamine
• “gliptin” diabetes medications (e.g., linagliptin, saxagliptin, sitagliptin)
• grapefruit juice
• guanfacine
• HIV protease inhibitors (e. g., fosamprenavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir)
• hydrocortisone
• ivabradine
• ivermectin
• ledipasvir
• lanreotide
• letermovir
• lidocaine
• loperamide
• lovastatin
• lumacaftor and ivacaftor
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• methadone
• methotrexate
• mifepristone
• mirabegron
• morphine
• naloxegol
• octreotide
• ondansetron
• orlistat
• pasireotide
• prucalopride
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, moxifloxacin)
• ranitidine
• rifampin
• rifaximin
• riociguat
• rivastigmine
• romidepsin
• St. John’s wort
• seizure medications (e.g., carbamazepine, lacosamide, phenobarbital, phenytoin, primidone)
• selective serotonin reuptake inhibitors (SSRIs; citalopram, escitalopram, fluvoxamine, fluoxetine, paroxetine, sertraline)
• silodosin
• siponimod
• sofosbuvir
• tacrolimus
• terbinafine
• theophylline medications (e. g., aminophylline, oxtriphylline, theophylline)
• tizanidine
• tofacitinib
• tolvaptan
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine)
• tyrosine kinase inhibitors (e.g., dasatinib, imatinib, nilotinib, sunitinib)
• venlafaxine
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/pms-Propafenone

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Atrial fibrillation is the most common heart rhythm disorder. Its main complications are stroke and heart failure. The insidiousness of this disease lies in the fact that the patient either does not feel it, or simply feels a rapid heartbeat, not associating it with heart problems.

At the same time, the symptoms associated with arrhythmias – fatigue, dizziness, chest pain and shortness of breath – are often attributed to a common malaise. Meanwhile, atrial fibrillation increases the risk of stroke by five times.

What are the causes of atrial fibrillation? Among the risk factors are not only heart disease, high blood pressure, obesity and thyroid disease. It seems that the recent discovery of South Korean scientists will add to this list. It turned out that even small doses of alcohol affect the violation of the heart rhythm.

This was found out during the large-scale long-term national health screening program in South Korea. Scientists were able not only to assess how common heart disease is among the population, but also to understand the causes of their occurrence. Including doctors managed to establish how seriously alcohol affects the heart rhythm.

The fact that the risk of atrial fibrillation is associated with the amount of alcohol consumed has long been known. Doctors know “a linear correlation between alcohol and atrial fibrillation: every 12 g of alcohol per week (one drink) increases the likelihood of developing the disease by 8%. But it was not clear what had a greater effect – the total amount of alcohol consumed or the frequency of use.

The study answered this question: those who drink little but regularly are more at risk.

Scientists analyzed the data 9776,956 people who did not have arrhythmia at the beginning of observations. For eight years, they were observed by a cardiologist – until the second passage of the program in 2017.

Based, among other things, on the data of the questionnaire, the authors of the work calculated how many times a week the patients consumed alcohol, what was the average dose of alcohol per day and per week.

“Our study shows that frequent drinking is more dangerous,” said Dr. Chen Il Choi of Korea University College of Medicine in Seoul. “In order to protect yourself from atrial fibrillation, it is important to drink as little as possible. In addition, drinking alcohol can trigger sleep disturbance, which is a known risk factor for atrial fibrillation.”

Scientists noted that those who drank a little, but daily, atrial fibrillation occurred 1.41 times more often than those who drank twice a week (age and gender did not matter).

Thus, the best protection against arrhythmia, Dr. Choi believes, is the occasional alcohol consumption: “Atrial fibrillation is associated with a deterioration in the quality of life and can lead to various complications. Therefore, it is better to prevent the disease than to treat it later. Alcohol is one of the risk factors that is easy to eliminate, and it is important not only to reduce the total dose of alcohol, but also to reduce the frequency of its use. ”

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Free metanephrine and free normetanephrine in urine

Free metanephrine and free normetanephrine in urine is one of the breakdown products of adrenaline. It is used in the diagnosis of a tumor of the adrenal glands – pheochromocytoma.

Synonyms English

Free metanephrine urine, Fractionated metanephrine urine.

Test method

High performance liquid chromatography with tandem mass spectrometry.

Units

µg/day (micrograms per day).

What biomaterial can be used for research?

Daily urine.

How to properly prepare for an examination?

• Eliminate alcohol from the diet for 24 hours prior to the study.
• Eliminate avocados, bananas, eggplants, pineapples, plums, tomatoes, walnuts from the diet within 72 hours prior to the study.
• Exclude (in agreement with the doctor) taking tetracycline antibiotics, quinidine, reserpine, tranquilizers, adrenoblockers, MAO inhibitors within 4 days before the study.
• Exclude (in agreement with the doctor) the use of diuretics within 48 hours before urine collection.
• The study is not recommended during menstruation.
• Exclude physical and emotional overstrain during the collection of daily urine (during the day).

General information about the study

Metanephrines are the end products of the breakdown of catecholamines: adrenaline and norepinephrine.

Catecholamines are hormones produced in the adrenal glands, small triangular organs located at the upper poles of both kidneys. There are three types of catecholamines: dopamine, epinephrine (epinephrine), and norepinephrine. These hormones are released into the blood in response to physical stress or emotional stress. They are involved in the transmission of nerve impulses in the brain, help release glucose and fatty acids (which are used as a source of energy), enlarge the small bronchi in the lungs, and also help dilate the pupils. Norepinephrine also constricts blood vessels, resulting in a rise in blood pressure, while epinephrine increases heart rate and speeds up metabolism.

After fulfilling their function in the body, catecholamines are converted into inactive forms: dopamine into homovanillic acid, norepinephrine into normetanephrine and vanillylmandelic acid, and adrenaline into metanephrine and vanillylmandelic acid. Both the hormones themselves and their metabolites are then excreted in the urine. At the same time, modern analyzers make it possible to distinguish between free and bound forms of metanephrines in urine.

This assay is much more sensitive and specific than epinephrine, as adrenaline is degraded within minutes of being released from cells. Moreover, the test for free metanephrine is more valuable in the diagnosis of pheochromocytoma than the determination of the total content of metanephrines.

Normal urine contains a small amount of free metanephrine, which increases significantly during and after stress. Pheochromocytoma and other neuroendocrine tumors can produce huge amounts of catecholamines, which leads to an increase in the concentration of these hormones in the blood and urine. Excessive production of catecholamines, in turn, causes a persistent increase in blood pressure (and / or episodes of its sharp increase). Other symptoms of the effect of catecholamines on the body: headache, sweating, nausea, anxiety and tingling in the limbs.

Most pheochromocytomas are located in the adrenal glands. As a rule, they are benign – they do not spread beyond the place where they formed, although they continue to grow slowly. If a pheochromocytoma is left untreated, the symptoms gradually become more pronounced as it grows: high blood pressure – hypertension – damages various organs, including the kidneys and heart, and also increases the risk of heart attack and stroke.

Although pheochromocytoma is a fairly rare disease, it is extremely important to diagnose and treat this tumor in a timely manner, because it causes a form of arterial hypertension that can be treated. In most cases, the tumor can be surgically removed and/or treated with medication, which can reduce the amount of catecholamines in the blood, relieve symptoms of the disease, and prevent complications.

Usually this test is ordered together with the determination of urine normetanephrines. Since the level of catecholamines in the blood changes during the day, a urine sample collected during the day is used for analysis.

What is research used for?

• To diagnose pheochromocytoma for those who have characteristic symptoms of this tumor.
• To evaluate the effectiveness of the treatment of pheochromocytoma.

When is the test scheduled?

• If pheochromocytoma is suspected. It can be assumed by the following symptoms: persistent increase in blood pressure (and / or episodes of its sharp increase), increased heart rate, hot flashes, sweating.
• For arterial hypertension that is difficult to treat.
• If a tumor of the adrenal glands or other neuroendocrine tumor was incidentally detected during an ultrasound or MRI examination, or such a tumor was in the immediate family of the patient.

What do the results mean?

Reference values ​​

• Metanephrine free

• Normetanephrine free

Causes of changes in metanephrine levels

Given that the test result for metanephrine is sensitive to various factors and that pheochromocytoma is quite rare, it must be remembered that false positive results are possible. However, when the patient has characteristic symptoms and there is a significant increase in urinary metanephrine, further investigation is required. For greater reliability of the results, together with free metanephrine in the urine, total metanephrines in the urine, as well as normetanephrines, can be investigated. If they are also elevated, then an MRI of the adrenal region is performed to confirm the diagnosis of pheochromocytoma.

An increase in metanephrine in a patient with a previously diagnosed pheochromocytoma may indicate that the treatment was not effective enough or that the tumor has recurred.

The normal values ​​obtained as a result of this analysis are a strong argument against the diagnosis of “pheochromocytoma”: if the level of free metanephrine is not elevated, then it can be excluded with a high probability.

In addition to pheochromocytoma, metanephrine may be elevated in paraganglioma or neuroblastoma, tumors of the nervous tissue.

An increase in the concentration of metanephrine is also noted in sepsis.

What can influence the result?

Metanephrine levels can be increased by:

• strenuous exercise,
• coffee, tea, caffeine,
• alcohol, nicotine,
• adelfan, insulin, diuretics, paracetamol, propafenone, antibiotic tetracycline, tricyclic antidepressants, vasoconstrictor nasal drops and sprays, eufillin.

Important notes

• The metanephrine test detects the presence of a pheochromocytoma, but it does not tell how large the tumor is, whether it is benign or not, how many tumor nodes are in total. Even small pheochromocytomas can produce a lot of catecholamines.
• The patient should discuss with the doctor which of the medications taken should be excluded during the analysis.