Propafenone interactions

Woodland C, Verjee Z, Giesbrecht E, Koren G, Ito S.The digoxin-propafenone interaction - characterization of a mechanism using renal tubular cell monolayers. J Pharmacol ExpTher 1997 283 39-45. 

Munoz CE, Ito S, Bend JK Tesoro A, Freeman D, Spence JD, Bailey DG. Propafenone interaction witii CYP3A4 inhibitors in man. Clm Pharmacol Ther (1997) 61, 154. 

Spes CH, Angermann CE, Horn K, Strasser T, Mudra H, Landgraf R, Theisen K. Ciclosporin-propafenone interaction. Klin Wochenschr 99(S) 68, 872. 

Botsch, S., Gautier, J.C., Beaune, P., Eichelbaum, M. and Kroemer, H.K. (1993) Identification and characterization of the cytochrome P450 enzymes involved in N-dealkylation of propafenone molecular base for interaction potential and variable disposition of active metabolites. Molecular Pharmacology, 43 (1), 120-126. 

Fosamprenavir plus ritonavir may interact with flecainide, propafenone, efavirenz plus ritonavir, and lopinavir plus ritonavir. Efavirenz may affect fosamprenavir with or without ritonavir. 

WARNING Co administration w/ ritonavir assoc w/ Hep hepatic decomp w/ fatalities. D/C w/ S/Sxs of H Uses HIV 1 Infxn w/ highly Tx-experienced pts or HIV 1 strains resistant to multiple protease inhibitors. Must be used w/ ritonavir 200 mg Action Antiretroviral HIV-1 protease inhibitor Dose 500 mg PO bid w/ food, administer w/ ritonavir 200 mg PO bid Caution [C, -] Sulfa aU gy, Uvct Dz Contra Mod-severe hepatic insuff concomitant use w/ amiodarone, astemizole, bepridil, cisapride, ergots, flecainide, lovastatin, midazolam, pimozide, propafenone, quinidine, rifampin, simvastatin, terfenadine, triazolam, St. John s wort Disp Caps SE HA, GI distress, rash, fati e, fat redistribution, hyperglycemia, Hep, liver Dz, lipid elevations Interactions T Effects OF anticoagulants, antipits, azole antifun-... 

As with other members of class IC, propafenone may interact in an unfavorable way with other agents that depress A-V nodal function, intraventricular conduction, or myocardial contractility. 

Lopinavir/Ritonavir (Kaletra) [Anrirelroviral/Protease Inhibitor] Uses HIV Infxn Action Protease inhibitor Dose Adults. Tx naive 2 tab PO daily or 1 tab PO bid Tx experiencedpt 1 tab PO bid (T dose if w/ amprenavir, efavirenz, fosamprenavir, nelfinavir, nevirapine) Peds. 7-15 kg 12/3 mg/kg PO bid 15-40 kg 10/2.5 mg/kg PO bid >40 kg Adult dose w/ food Caution [C, /-] Numerous interactions Contra w/drugs dependent on CYP3A/CYP2D6 (Table VI-8) Disp Tab, soln SE Avoid disulfiram (soln has EtOH), metronidazole GI upset, asthenia, T cholesterol/triglycerides, pancreatitis protease metabolic synd Interactions T Effects Wl clarithromycin, erythromycin T effects OF amiodarone, amprenavir, azole andfungals, bepridil, cisapride, cyclosporine, CCBs, ergot alkaloids, flecainide, flurazepam, HMG-CoA reductase inhibitors, indinavir, lidocaine, meperidine, midazolam, pimozide, propafenone, propoxyphene, quinidine, rifabutin, saquinavir, sildenafil, tacrolimus, terfenadine, triazolam, zolpidem 1 effects Wl barbiturates, carbamazepine, dexamethasone, didanosine, efavirenz, nevirapine, phenytoin, rifabutin, rifampin, St. John s wort 1 effects OF OCPs, warfarin EMS Use andarrhythmics and benzodiazepines... 

Drug interactions Catecholamine-depleting drugs such as reserpine may have an additive effect in combination with betablockers. Drugs that inhibit CYP2D6 (quinidine, fluoxetine, paroxetine, and propafenone) increase metoprolol concentration. 

Wagner F, Kalushce D, Trenk D, et al. Drug interaction between propafenone and metoprolol. Br J Clin Pharmacol 1987 24 213-220. 

Genetic differences can also influence the likelihood of some drug interactions. For example, coadministration of the antiarrhythmic propafenone to patients being treated with metoprolol substantially reduces metoprolol metabolic clearance in extensive... 

The calcium channel blocker mibefradil (Posicor ) was removed from the market in 1998. The headline for the Pink Sheets article describing this action was "Posicor Withdrawal Reflects Complexity of Interaction Profile" (59). Products identified as potentially dangerous in combination with mibefradil included cardiac drugs, such as amiodarone, flecainide, and propafenone oncologic products, such as tamoxifen, cyclophosphamide, etoposide, ifosfamide, and vinblastine and the immunosuppressant medications cyclosporine and tacrolimus. The sponsor s decision to withdraw mibefradil was based on the complexity of the drug interaction information that would have to be communicated to ensure safe usage. 

J, Oravcova, W. Lindner, E Szalay, L. Bohacik, and T. Trnovic, Interaction of propafenone enantiomers with human aj-acid glycoprotein, Chiralifif, 3 30, (1991). 

C. Funck-Brentano, H. K. Kroemer, H. Pavlou, R. L. Woosley and D. M. Roden, "Genetically-determined interaction between propafenone and low dose quinidine Role of active metabolites in modulating net drug effect," Br. /. Cii . Pharmacol., 27 435-444 (1989). 

Kates RE, Yee YG, Kirsten EB. Interaction between warfarin and propafenone in healthy volunteer subjects. Clin Pharmacol Ther 1987 42(3) 305-11. 

Ujhelyi MR, O Rangers EA, Fan C, Kluger J, Pharand C, Chow MS. The pharmacokinetic and pharmacodynamic interaction between propafenone and lidocaine. Clin Pharmacol Ther I993 53(I) 38-48. 

Labbe L, O Hara G, Lefebvre M, Lessard E, Gilbert M, Adedoyin A, Champagne J, Hamelin B, Turgeon J. Pharmacokinetic and pharmacodynamic interaction between mexiletine and propafenone in human beings. Clin Pharmacol Ther 2000 68(l) 44-57. 

Propafenone is both a class I antidysrhythmic drug and a beta-adrenoceptor antagonist. Its pharmacological effects, clinical pharmacology, therapeutic uses, adverse effects, and interactions have been reviewed (1-5). 

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