Drug interactions
Paroxetine + Propafenone
Severity: Major
Paroxetine 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
Paroxetine is a strong CYP2D6 inhibitor and can markedly raise propafenone concentrations, increasing the risk of conduction slowing, bradycardia and ventricular arrhythmia. Propafenone may in turn raise paroxetine levels, and both agents can affect the QT interval.
What this interaction means in plain words
Paroxetine 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.
Paroxetine belongs to Central Nervous System; Propafenone belongs to Cardiovascular.
Why it happens
Mutual CYP2D6 inhibition with additive effects on cardiac conduction.
What to do
Prefer an antidepressant with minimal CYP2D6 inhibition, such as sertraline at a low dose. If combined, start propafenone at a lower dose and monitor heart rate and ECG for PR, QRS and QTc changes.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Paroxetine with Propafenone?
MediHelp rates the interaction as major. Paroxetine 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. Paroxetine is a strong CYP2D6 inhibitor and can markedly raise propafenone concentrations, increasing the risk of conduction slowing, bradycardia and ventricular arrhythmia. Propafenone may in turn raise paroxetine levels, and both agents can affect the QT interval.
How serious is the interaction between Paroxetine 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: Prefer an antidepressant with minimal CYP2D6 inhibition, such as sertraline at a low dose. If combined, start propafenone at a lower dose and monitor heart rate and ECG for PR, QRS and QTc changes.
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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