Drug interactions
Propafenone + Quinine
Severity: Major
Propafenone and Quinine: 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
Propafenone is a class 1C antiarrhythmic that slows conduction and can prolong QT, and quinine adds further proarrhythmic potential. Quinine may also inhibit CYP2D6 and raise propafenone concentrations.
What this interaction means in plain words
Propafenone and Quinine 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; Quinine belongs to Anti Parasitic.
Why it happens
Additive QT and conduction effects, with quinine inhibition of CYP2D6 metabolism of propafenone.
What to do
Avoid the combination where possible; if used, monitor ECG for QRS and QT changes and consider reducing propafenone dose.
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 Quinine
- Arsenic trioxide + Quinine Contraindicated
- Dofetilide + Quinine Contraindicated
- Dronedarone + Quinine Contraindicated
- Ibutilide + Quinine Contraindicated
- Mefloquine + Quinine Contraindicated
- Nilotinib + Quinine 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 Quinine?
MediHelp rates the interaction as major. Propafenone and Quinine 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 is a class 1C antiarrhythmic that slows conduction and can prolong QT, and quinine adds further proarrhythmic potential. Quinine may also inhibit CYP2D6 and raise propafenone concentrations.
How serious is the interaction between Propafenone and Quinine?
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 where possible; if used, monitor ECG for QRS and QT changes and consider reducing propafenone dose.
What other medicines interact with Quinine?
MediHelp also lists interactions of Quinine with, for example, Arsenic trioxide, Dofetilide, Dronedarone. The full list is on the Quinine page.
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