Class Ic antiarrhythmic
Propafenone hydrochloride
Brand names: Arythmol
Adult dose
Dose: 150mg PO TDS initially, increase to 300mg TDS (max 900mg/day). 'Pill in pocket' for AF: 450–600mg single
Route: PO
Frequency: TDS
Clinical pearls
- Paroxysmal AF (no structural heart disease) — 'pill in pocket'
- Specialist initiation; ECG mandatory
Contraindications
- Heart failure
- Cardiogenic shock
- Severe bradycardia/AV block
- Recent MI
- Structural heart disease
- Severe COPD
- Myasthenia gravis
Side effects
- Pro-arrhythmia
- Bradycardia
- Heart block
- Bronchospasm
- Metallic taste
- Hepatotoxicity
Interactions
- Digoxin
- Warfarin
- β-blockers
- Strong CYP2D6 inhibitors
- QT-prolonging drugs
Monitoring
- ECG
- LFTs
- FBC
Reference: BNF; NICE NG196; ESC; https://bnf.nice.org.uk/drugs/propafenone-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines