Drug interactions
Hydroxyzine + Propafenone
Severity: Major
Hydroxyzine and Propafenone: major interaction.
Last updated Sources: Health Canada product monograph
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
Hydroxyzine has been associated with QT prolongation and torsades de pointes, and propafenone adds proarrhythmic effects on conduction. Together they raise the likelihood of serious ventricular arrhythmias, especially in older patients or those with electrolyte disorders.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Propafenone belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic QT prolongation and conduction effects.
What to do
Choose a non-QT-prolonging alternative for anxiety, pruritus or sedation. If hydroxyzine is required, use the lowest dose for the shortest time and monitor the ECG.
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 Propafenone
- Dofetilide + Propafenone Contraindicated
- Dronedarone + Propafenone Contraindicated
- Nilotinib + Propafenone Contraindicated
- Nirmatrelvir / ritonavir + Propafenone Contraindicated
- Nirmatrelvir + Propafenone Contraindicated
- Pimozide + Propafenone Contraindicated
Other interactions of Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Propafenone?
MediHelp rates the interaction as major. Hydroxyzine 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. Hydroxyzine has been associated with QT prolongation and torsades de pointes, and propafenone adds proarrhythmic effects on conduction. Together they raise the likelihood of serious ventricular arrhythmias, especially in older patients or those with electrolyte disorders.
How serious is the interaction between Hydroxyzine 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: Choose a non-QT-prolonging alternative for anxiety, pruritus or sedation. If hydroxyzine is required, use the lowest dose for the shortest time and monitor the ECG.
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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