Drug interactions
Bupropion + Propafenone
Severity: Major
Bupropion and Propafenone: major interaction.
Last updated Sources: US FDA label
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 is metabolized by CYP2D6 and has a narrow therapeutic index; bupropion may raise its concentrations. This can cause proarrhythmia, conduction abnormalities and neurological effects.
What this interaction means in plain words
Bupropion 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.
Bupropion belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by bupropion reduces propafenone clearance.
What to do
Monitor ECG and clinical status and reduce the propafenone dose if QRS widening or toxicity develops. Consider an alternative antiarrhythmic if bupropion is required.
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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References
Other interactions of Bupropion
- Bupropion + Isocarboxazid Contraindicated
- Bupropion + Linezolid Contraindicated
- Bupropion + Phenelzine Contraindicated
- Bupropion + Rasagiline Contraindicated
- Bupropion + Selegiline Contraindicated
- Bupropion + Selegiline transdermal Contraindicated
Other interactions of Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Frequently asked questions
Can I take Bupropion with Propafenone?
MediHelp rates the interaction as major. Bupropion 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 is metabolized by CYP2D6 and has a narrow therapeutic index; bupropion may raise its concentrations. This can cause proarrhythmia, conduction abnormalities and neurological effects.
How serious is the interaction between Bupropion 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: Monitor ECG and clinical status and reduce the propafenone dose if QRS widening or toxicity develops. Consider an alternative antiarrhythmic if bupropion is required.
What other medicines interact with Bupropion?
MediHelp also lists interactions of Bupropion with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Bupropion page.
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