PROPAFENONE HYDROCHLORIDE

Indications & Dose:

Ventricular arrhythmias (specialist supervision in hospital) | Paroxysmal supraventricular tachyarrhythmias which include paroxysmal atrial flutter or fibrillation and paroxysmal re-entrant tachycardias involving the AV node or accessory pathway, where standard therapy ineffective or contraindicated (specialist supervision in hospital) % BY MOUTH % Adult: Initially 150 mg 3 times a day, dose to be taken after food, monitor ECG and blood pressure, if QRS interval prolonged by more than 20%, reduce dose or discontinue until ECG returns to normal limits; increased if necessary to 300 mg twice daily (max. per dose 300 mg 3 times a day), dose to be increased at intervals of at least 3 days, reduce total daily dose for patients under 70 kg % Elderly: Initially 150 mg 3 times a day, dose to

be taken after food, monitor ECG and blood pressure, if QRS interval prolonged by more than 20%, reduce dose or discontinue until ECG returns to normal limits; increased if necessary to 300 mg twice daily (max. per dose 300 mg 3 times a day), dose to be increased at intervals of at least 5 days, reduce total daily dose for patients under 70 kg 

Contraindications:

Atrial conduction defects (unless adequately paced) . Brugada syndrome . bundle branch block (unless adequately paced) . cardiogenic shock (except arrhythmia induced) . distal block (unless adequately paced) . electrolyte disturbances . marked hypotension . myasthenia gravis . myocardial infarction within last 3 months . second degree or greater AV block (unless adequately paced) . severe bradycardia . severe obstructive pulmonary disease (due to weak betablocking activity) . sinus node dysfunction (unless adequately paced) . uncontrolled congestive heart failure with left ventricular ejection fraction less than 35% 

Side Effects:

% Common or very common Bradycardia . abdominal pain . anxiety . atrioventricular block . blurred vision . chest pain . constipation . diarrhoea . dizziness . dry mouth . dyspnoea . headache . intraventricular blocks . malaise . nausea . palpitation . sino-atrial block . sleep disorders . tachycardia . taste disturbance . vomiting % Uncommon Abdominal distension . anorexia . ataxia . erectile dysfunction . flatulence . hypotension . paraesthesia . pro-arrhythmic effects . rash . syncope . thrombocytopenia . vertigo % Frequency not known Agranulocytosis . cholestasis . confusion . convulsions . extrapyramidal symptoms . granulocytopenia . hepatitis . jaundice . leucopenia . lupus erythematosus-like syndrome . reduced sperm count (reversible on withdrawal) . restlessness PREGNANCY Use only if potential benefit outweighs risk. BREAST FEEDING Use with caution—present in milk. 

Cautions:

Elderly . great caution in mild to moderate obstructive airways disease owing to beta-blocking activity . heart failure . pacemaker patients . potential for conversion of paroxysmal atrial fibrillation to atrial flutter with 2:1 or 1:1 conduction block 

Precautions:

Interaction:

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: