Drug interactions
Chlorpromazine + Propafenone
Severity: Major
Chlorpromazine 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, which contributes to chlorpromazine metabolism, so chlorpromazine levels may rise. Chlorpromazine itself prolongs the QT interval and propafenone is proarrhythmic, so the combination increases the risk of ventricular arrhythmia, hypotension and sedation.
What this interaction means in plain words
Chlorpromazine 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.
Chlorpromazine belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition raising chlorpromazine levels, plus additive QT and conduction effects.
What to do
Avoid the combination where possible. If used together, monitor the ECG for QTc and QRS widening, check electrolytes, and reduce the chlorpromazine dose if adverse effects emerge.
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 Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Frequently asked questions
Can I take Chlorpromazine with Propafenone?
MediHelp rates the interaction as major. Chlorpromazine 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, which contributes to chlorpromazine metabolism, so chlorpromazine levels may rise. Chlorpromazine itself prolongs the QT interval and propafenone is proarrhythmic, so the combination increases the risk of ventricular arrhythmia, hypotension and sedation.
How serious is the interaction between Chlorpromazine 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: Avoid the combination where possible. If used together, monitor the ECG for QTc and QRS widening, check electrolytes, and reduce the chlorpromazine dose if adverse effects emerge.
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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