Drug interactions
Propafenone + Rifampin
Severity: Major
Propafenone and Rifampin: 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
Rifampin is a strong inducer of metabolic enzymes and markedly lowers propafenone concentrations. This can lead to loss of antiarrhythmic efficacy.
What this interaction means in plain words
Propafenone and Rifampin 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
Rifampin induces CYP3A4 and CYP1A2, increasing propafenone clearance.
What to do
Monitor rhythm control and ECG, and increase propafenone dose based on response or choose an alternative antiarrhythmic. Re-adjust when rifampin is stopped.
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
Frequently asked questions
Can I take Propafenone with Rifampin?
MediHelp rates the interaction as major. Propafenone and Rifampin 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. Rifampin is a strong inducer of metabolic enzymes and markedly lowers propafenone concentrations. This can lead to loss of antiarrhythmic efficacy.
How serious is the interaction between Propafenone and Rifampin?
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 rhythm control and ECG, and increase propafenone dose based on response or choose an alternative antiarrhythmic. Re-adjust when rifampin is stopped.
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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