Drug interactions
Propafenone + Quinidine
Severity: Major
Propafenone and Quinidine: major interaction.
Last updated Sources: US FDA label
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
Quinidine inhibits CYP2D6 and blocks formation of the active metabolite of propafenone, raising parent drug levels. This can increase proarrhythmia, conduction delay and beta-blocking effects, and both are class I antiarrhythmics.
What this interaction means in plain words
Propafenone and Quinidine 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.
Propafenone belongs to Cardiovascular; Quinidine belongs to Anti Parasitic.
Why it happens
CYP2D6 inhibition increases propafenone concentrations, with additive sodium channel blockade.
What to do
Avoid the combination. If it cannot be avoided, use a reduced propafenone dose with ECG monitoring of QRS and PR intervals.
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 Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
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 Propafenone with Quinidine?
MediHelp rates the interaction as major. Propafenone and Quinidine 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. Quinidine inhibits CYP2D6 and blocks formation of the active metabolite of propafenone, raising parent drug levels. This can increase proarrhythmia, conduction delay and beta-blocking effects, and both are class I antiarrhythmics.
How serious is the interaction between Propafenone and Quinidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination. If it cannot be avoided, use a reduced propafenone dose with ECG monitoring of QRS and PR intervals.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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