Drug interactions
Asenapine + Propafenone
Severity: Major
Asenapine and Propafenone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Asenapine can prolong the QT interval, and propafenone is a class 1C antiarrhythmic that slows conduction and can be proarrhythmic. Combined use may raise the risk of serious ventricular arrhythmia, particularly with structural heart disease or electrolyte disturbance.
What this interaction means in plain words
Asenapine and Propafenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Asenapine belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic effects on cardiac repolarization and conduction.
What to do
Prefer an antipsychotic with lower QT liability, or avoid propafenone in this setting. If both are required, check a baseline and follow-up ECG and keep potassium and magnesium within normal range.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Other interactions of Asenapine
- Asenapine + Pimozide Contraindicated
- Asenapine + Thioridazine Contraindicated
- Asenapine + Vandetanib Contraindicated
- Adagrasib + Asenapine Major
- Alfentanil + Asenapine Major
- Alfuzosin + Asenapine Major
Frequently asked questions
Can I take Asenapine with Propafenone?
MediHelp rates the interaction as major. Asenapine and Propafenone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Asenapine can prolong the QT interval, and propafenone is a class 1C antiarrhythmic that slows conduction and can be proarrhythmic. Combined use may raise the risk of serious ventricular arrhythmia, particularly with structural heart disease or electrolyte disturbance.
How serious is the interaction between Asenapine and Propafenone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antipsychotic with lower QT liability, or avoid propafenone in this setting. If both are required, check a baseline and follow-up ECG and keep potassium and magnesium within normal range.
What other medicines interact with Propafenone?
MediHelp also lists interactions of Propafenone with, for example, Dofetilide, Dronedarone, Nilotinib. The full list is on the Propafenone page.
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