Name: PROPAFENONE (RytmonormR)
Classification: antiarrhythmic:Class IC;  emergency special access agent
  • prolongs refractory period in atria and ventricles thus effective for arrhythmias of various origins
  • has weak beta receptor antagonist and calcium channel blocking activity 
Dose:
  • Loading Dose:
    • 0.5-2.5 mg/kg IV direct over a minimum of 3-5 minutes
  • Maintenance Dose:
    • 0.5-2.5 mg/kg IV direct q8h (maximum 560 mg/day)
    OR
    • continuous infusion up to 23 mg/hr
  • may need to reduce dose in renal or hepatic failure
Administration:
  • IV Direct:
    • administer undiluted over at least 3-5 minutes into the tubing of a freely flowing compatible IV
  • IV Infusion:
    • concentration 70 mg/70 ml D5W (remove volume from 100 mL minibag)
Adverse Effects:
  • bradycardia, SA or AV block
  • heart failure 
  • arrhythmias
  • fatigue, headache
  • allergic skin reactions
  • anorexia, nausea/vomiting, bitter taste
  • cholestasis
  • blurred vision or vertigo
  • agranulocytosis (rare)
Drug Interactions:
  • propafenone + digoxin = increased digoxin levels
  • propafenone + theophylline = increased theophylline levels
  • propafenone + warfarin = increased warfarin effect
  • propafenone + beta blockers = increased negative inotropic effect
  • propafenone + calcium channel blockers = increased negative inotropic effect
Monitoring Therapy:
  • ECG, rhythm, QRS complex
  • cardiac index
  • breath sounds, chest xray
  • WBC
  • liver enzymes
CCTC Protocol:
  • Must be administered IV and titrated by a physician.
  • Continuous infusion must be administered via an infusion pump.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: August 7, 2006

LHSCHealth Professionals

Last Updated March 24, 2009 | © 2007, LHSC, London Ontario Canada