Drug interactions
Perhexiline + Propafenone
Severity: Major
Perhexiline 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
Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic window. Propafenone inhibits CYP2D6 and may raise perhexiline levels, increasing the risk of hepatotoxicity, neuropathy and hypoglycemia.
What this interaction means in plain words
Perhexiline 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.
Why it happens
Propafenone inhibition of CYP2D6-mediated perhexiline metabolism.
What to do
Monitor perhexiline plasma concentrations and liver function, and reduce the perhexiline dose as needed. Avoid the combination if therapeutic monitoring is unavailable.
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
Frequently asked questions
Can I take Perhexiline with Propafenone?
MediHelp rates the interaction as major. Perhexiline 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. Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic window. Propafenone inhibits CYP2D6 and may raise perhexiline levels, increasing the risk of hepatotoxicity, neuropathy and hypoglycemia.
How serious is the interaction between Perhexiline 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: Monitor perhexiline plasma concentrations and liver function, and reduce the perhexiline dose as needed. Avoid the combination if therapeutic monitoring is unavailable.
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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