Uses

Class IC antiarrhythmic agent indicated to prolong the time to recurrence of symptomatic paroxysmal atrial fibrillation in patients without structural heart disease. Also used for ventricular and supraventricular arrhythmias.

Do not use if

Contraindicated in heart failure, cardiogenic shock, sinoatrial or atrioventricular block without a pacemaker, known Brugada syndrome, bradycardia, severe hypotension, bronchospastic disorders, and electrolyte imbalance.

Side effects

Common side effects include dizziness, palpitations, chest pain, dyspnoea, taste disturbances (metallic taste), nausea, fatigue, and constipation. Pro-arrhythmic effects are a serious concern.

Warnings

Carries a serious warning regarding increased mortality risk in patients with non-life-threatening ventricular arrhythmias post-myocardial infarction (CAST study). Avoid use in structural heart disease. Monitor ECG and electrolytes during therapy.

How it works

Propafenone is a Class IC antiarrhythmic with local anaesthetic properties. It reduces the upstroke velocity (Phase 0) of the myocardial action potential by blocking fast sodium channels, slowing conduction velocity in the His-Purkinje system and ventricular myocardium. It has weak beta-blocking and calcium channel-blocking activity.

Storage

Store at 20–25°C (68–77°F) in a tightly closed container, away from moisture and heat.