Drug interactions
Donepezil + Propafenone
Severity: Major
Donepezil 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
Donepezil can prolong the QT interval and cause bradycardia, and propafenone slows cardiac conduction. Together they may increase the risk of torsades de pointes, syncope and conduction block. Propafenone may also modestly raise donepezil exposure via CYP2D6 inhibition.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic QT and conduction effects, with CYP2D6 inhibition by propafenone raising donepezil levels.
What to do
Check a baseline ECG and heart rate and monitor for bradycardia, syncope and QTc prolongation. Consider an alternative antiarrhythmic if the ECG worsens.
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 Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
Frequently asked questions
Can I take Donepezil with Propafenone?
MediHelp rates the interaction as major. Donepezil 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. Donepezil can prolong the QT interval and cause bradycardia, and propafenone slows cardiac conduction. Together they may increase the risk of torsades de pointes, syncope and conduction block. Propafenone may also modestly raise donepezil exposure via CYP2D6 inhibition.
How serious is the interaction between Donepezil 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: Check a baseline ECG and heart rate and monitor for bradycardia, syncope and QTc prolongation. Consider an alternative antiarrhythmic if the ECG worsens.
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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