Drug interactions
Atomoxetine + Propafenone
Severity: Major
Atomoxetine 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
Propafenone inhibits CYP2D6, the main enzyme clearing atomoxetine, so atomoxetine concentrations may rise substantially. Higher exposure increases heart rate and blood pressure and may add to arrhythmic risk, as atomoxetine has some QT-prolonging potential at high concentrations.
What this interaction means in plain words
Atomoxetine 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.
Atomoxetine belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by propafenone reduces atomoxetine clearance, with possible additive cardiac effects.
What to do
Start atomoxetine at a reduced dose and titrate slowly, monitoring heart rate, blood pressure and ECG. Consider an alternative to one of the agents if cardiac adverse effects appear.
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 Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Atomoxetine with Propafenone?
MediHelp rates the interaction as major. Atomoxetine 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. Propafenone inhibits CYP2D6, the main enzyme clearing atomoxetine, so atomoxetine concentrations may rise substantially. Higher exposure increases heart rate and blood pressure and may add to arrhythmic risk, as atomoxetine has some QT-prolonging potential at high concentrations.
How serious is the interaction between Atomoxetine 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: Start atomoxetine at a reduced dose and titrate slowly, monitoring heart rate, blood pressure and ECG. Consider an alternative to one of the agents if cardiac adverse effects appear.
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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