Propafenone SSRIs

PROPAFENONE SSRIs Levels of both may be t Both SSRIs and propafenone are substrates for and inhibitors of CYP2D6 Monitor PR and BP closely... 

T effects OF amiodarone, astemizole, atorvastadn, barbiturates, bepridil, bupropion, cerivastatin, cisapride, clorazepate, clozapine, clarithromycin, desipramine, diazepam, encainide, ergot alkaloids, estazolam, flecainide, flurazepam, indinavir, ketoconazole, lovastatin, meperidine, midazolam, nelfinavir, phenytoin, pimozide, piroxicam, propafenone, propoxyphene, quinidine, rifabutin, saquinavir, sildenafil, simvastatin, SSRIs, TCAs, terfenadine, triazolam, troleandomycin, zolpidem X effects W/ barbiturates, carbamazepine, phenytoin, rifabutin, rifampin, St. John s wort, tobacco X effects OF didanosine, hypnotics, methadone, OCPs, sedatives, theophylline, warfarin EMS T Effects of amiodarone, diazepam, midazolam and BBs, may need X- doses concurrent use of Viagra-type drugs can lead to hypotension X- effects of warfarin concurrent EtOH use can T adverse effects T glucose ODs May cause an extension of adverse SEs symptomatic and supportive Rivasrigmine (Exelon) [Cholinesterase Inhibitor/Anri ... 

In a study in healthy subjects fluoxetine 20 mg daily for 10 days decreased the oral clearance of a single 400-mg dose of propafenone by 34% for both the R- and 5-enantiomers. The peak plasma levels increased by 39% for 5-propafenone and by 71% forR-propafenone. However, there were no differences in the changes to the PR and QRS intervals. Fluoxetine is an inhibitor of the cytochrome P450 isoenzyme C YP2D6, which is responsible for the metabolism of propafenone to its primary active metabolite 5-hydroxypropafenone (for more detail see mechanism under Propafenone -i- Quinidine , above). In vitro data have shown that, of the SSRIs, fluoxetine is the most potent inhibitor of propafenone 5-hydroxylation, and that paroxetine would also be expected to interact. As with... 

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