Drug interactions
Doxepin + Propafenone
Severity: Moderate
Doxepin and Propafenone: moderate 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 and may raise doxepin concentrations, while both drugs can slow cardiac conduction and prolong QT. This increases the risk of arrhythmia and anticholinergic or sedative effects.
What this interaction means in plain words
Doxepin and Propafenone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Doxepin belongs to Dermatology; Propafenone belongs to Cardiovascular.
Why it happens
CYP2D6 inhibition by propafenone plus additive effects on cardiac conduction and QT interval.
What to do
Use the lowest effective doxepin dose and monitor ECG, especially in patients with cardiac disease. Watch for tricyclic toxicity.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Propafenone?
MediHelp rates the interaction as moderate. Doxepin and Propafenone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Propafenone inhibits CYP2D6 and may raise doxepin concentrations, while both drugs can slow cardiac conduction and prolong QT. This increases the risk of arrhythmia and anticholinergic or sedative effects.
How serious is the interaction between Doxepin and Propafenone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doxepin dose and monitor ECG, especially in patients with cardiac disease. Watch for tricyclic toxicity.
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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