Propafenone

Administration

• Type:Antiarrhythmics
• Dosage Forms: Oral cap, Oral tablet
• Routes of Administration: PO
• Common Trade Names: Rhythmol

Adult Dosing

Sustained Ventricular Tachycardia

• 150 mg PO q 8 hrs
• Dosage may be increased at 3-4 days to 225 mg PO q 8 hrs
• Max dosage: 300 mg PO q 8 hrs

New Onset Atrial fibrillation

• 450 to 600 mg PO as a single dose

Sinus Rhythm Maintenance in Atrial fibrillation or Atrial flutter

• See sustained VT dosing

PSVT Prophylaxis in AVRT including WPW

• 300 mg q 8 hrs for 48 hrs (max 900 mg q 8 hrs)
• Limited data regarding dosing

Pediatric Dosing

PSVT Prophylaxis in AVRT including WPW

• 8 to 10 mg/kg/day PO in 3 divided doses.
• Increase by 2 to 3 mg/kg/day every 2 to 3 days
• Max 15 mg/kg/day PO in 3 divided doses.

Special Populations

Renal Dosing

• Adult:
• Pediatric:

Hepatic Dosing

• Adult:
• Pediatric:

Contraindications

• Allergy to class/drug
• Significant QRS widening
• High Grade Heart Block
• Heart Failure
• Left Ventricular Dysfunction
• Bradycardia
• Cardiogenic Shock
• Electrolyte Imbalance
• Hypotension
• Sick Sinus Syndrome
• Long QT Syndrome
• Brugada Syndrome
• Renal failure (relative)
• Hepatic failure (relative)
• Asthma
• COPD
• Bronchospasm
• SLE

Pharmacology

• Half-life:
• Metabolism:
• Excretion:

Mechanism of Action

Propafenone is a class 1c antiarrhythmic agent which possesses local anesthetic properties, blocks the fast inward sodium current, and slows the rate of increase of the action potential. Prolongs conduction and refractoriness in all areas of the myocardium, with a slightly more pronounced effect on intraventricular conduction; it prolongs effective refractory period, reduces spontaneous automaticity and exhibits some beta-blockade activity