Propafenone

Co-administration contraindicated due to potential for cardiac arrhythmias.

Inhibits CYP2D6 metabolic pathway, increasing propafenone steady-state concentrations more than 2-fold. Concomitant use should be avoided.

Concomitant administration affects conduction and repolarization and is not recommended.

Propafenone inhibits cytochrome P450 2D6, potentially causing toxic amitriptyline levels; may require lower amitriptyline doses.

Type 1C antiarrhythmic that inhibits P450 2D6 and may increase clomipramine plasma levels, potentially causing toxicity.

CYP2D6 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

Type IC antiarrhythmic that inhibits P450 2D6; may increase desipramine concentrations and toxicity risk; dose adjustment may be needed.

Increases digoxin AUC by 60-270%. Requires monitoring and dose reduction of 30-50%.

CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

Type 1C antiarrhythmic that inhibits cytochrome P450 2D6, increasing imipramine plasma concentration. May require dose adjustment and TCA plasma level monitoring.

CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

Strong CYP2D6 inhibitor that doubles metoprolol concentrations, decreasing cardioselectivity. Close monitoring required.

Strong CYP2D6 inhibitor that doubles metoprolol concentrations, decreasing cardioselectivity and requiring close monitoring.

Strong CYP2D6 inhibitor that doubles metoprolol plasma concentrations, decreasing cardioselectivity. Close monitoring required.

Strong CYP2D6 inhibitor that doubles metoprolol concentrations, decreasing cardioselectivity. Close monitoring required.

Strong CYP2D6 inhibitor that doubles metoprolol concentrations, decreasing cardioselectivity.

Type 1C antiarrhythmic that inhibits P450 2D6, potentially increasing nortriptyline plasma concentrations to toxic levels.

Reduces propafenone concentrations; abrupt cessation has resulted in convulsions, atrioventricular block, and circulatory failure.

CYP2D6 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

Propafenone inhibits cytochrome P450 2D6, potentially causing toxic amitriptyline concentrations; dose reduction may be necessary.

AUC of propafenone is increased by more than 200% by coadministration of propranolol.

Dual CYP2D6 and CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

CYP3A4 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

CYP2D6 inhibitor that increases propafenone plasma levels, potentially causing cardiac arrhythmias and proarrhythmia risk.

CYP1A2 inhibitor antiarrhythmic; concomitant use should be avoided due to potential for hypotension, bradycardia, or excessive drowsiness.

Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate cautiously.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Propafenone inhibits P450 2D6, potentially causing abrupt toxicity in patients stable on trimipramine due to increased plasma concentrations.

CYP1A2 inhibitor that increases warfarin effect and INR; requires close INR monitoring

CYP1A2 inhibitor that increases warfarin effect and INR; requires closer INR monitoring.

Propafenone (Type 1C antiarrhythmic) inhibits cytochrome P450 2D6, which may increase amoxapine plasma concentrations and require dose adjustment.

CYP2D6 substrate; bupropion inhibits CYP2D6 and increases propafenone concentrations; consider dose reduction.

Bupropion inhibits CYP2D6 and can increase propafenone concentrations; consider dose reduction of propafenone.

CYP2D6 substrate Type 1C antiarrhythmic. Bupropion inhibits CYP2D6, increasing propafenone exposure. Dose reduction may be necessary.

CYP2D6 substrate Type 1C antiarrhythmic. Bupropion inhibits CYP2D6 and can increase propafenone concentrations. Consider dose reduction of propafenone when used with bupropion.

CYP2D6-metabolized Type 1C antiarrhythmic. Bupropion inhibits CYP2D6 and can increase propafenone concentrations. Consider dose reduction.

CYP2D6 inhibitor expected to increase blood levels of carvedilol R(+) enantiomer, potentially increasing vasodilating effects and dizziness.

Potent CYP2D6 inhibitor expected to increase carvedilol R(+) enantiomer blood levels, potentially causing dizziness and vasodilation.

Increases steady-state plasma concentrations of propafenone by 20%.

Type 1C antiarrhythmic that inhibits cytochrome P450 2D6, which may increase doxepin plasma concentrations. Concomitant use may require lower doses and monitoring.

Increases S-propafenone Cmax and AUC by 39% and 50%, and R-propafenone Cmax and AUC by 71% and 50%.

Type 1C antiarrhythmic that inhibits P450 2D6, increasing imipramine plasma concentrations. May require dose adjustment and TCA level monitoring.

Concomitant use may increase central nervous system side effects.

Strong CYP2D6 inhibitor that doubles metoprolol concentrations and decreases cardioselectivity; close monitoring required.

Decreases mexiletine metabolic clearance by about 70% in extensive CYP2D6 metabolizers; dose titration recommended.

Bupropion inhibits CYP2D6 and can increase propafenone concentrations. Consider dose reduction when using with CONTRAVE.

CYP2D6 inhibitor that may increase nebivolol levels; use caution when co-administered.

CYP2D6 inhibitor may increase nebivolol levels. Use caution when co-administered.

Paroxetine inhibits CYP2D6, increasing exposure of propafenone. Dosage reduction may be needed.

Decreases propafenone plasma concentrations by 50-67% with corresponding decreases in metabolite levels.

Propafenone is predominantly metabolized by CYP450 2D6. Coadministration requires careful monitoring and may require dose reduction.

Terbinafine inhibits CYP450 2D6, the primary metabolic pathway for propafenone. Careful monitoring and dose reduction may be required.

Propafenone is predominantly metabolized by CYP450 2D6; terbinafine inhibition may increase exposure. Careful monitoring and dose reduction may be required.

Propafenone inhibits cytochrome P450 2D6, increasing trimipramine maleate plasma concentrations and risk of toxicity.

7.5 Beta-Antagonists Concomitant use of propafenone and propranolol in healthy subjects increased propranolol plasma concentrations at steady state by 113%. The pharmacokinetics of propafenone was not affected by the coadministration of either propranolol or metoprolol.