Drug interactions
Propafenone + Risperidone
Severity: Major
Propafenone and Risperidone: major interaction.
Last updated Sources: UK SmPC
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 inhibits CYP2D6, the main enzyme that converts risperidone to its active metabolite, so exposure to the parent drug rises. Both drugs can affect cardiac conduction and repolarisation, and higher risperidone exposure increases the risk of QT prolongation, arrhythmia and extrapyramidal or sedative effects.
What this interaction means in plain words
Propafenone and Risperidone 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; Risperidone belongs to Central Nervous System.
Why it happens
Propafenone inhibits CYP2D6-mediated metabolism of risperidone, with additive pharmacodynamic effects on cardiac conduction.
What to do
Avoid the combination where possible and choose an antipsychotic less dependent on CYP2D6. If unavoidable, start risperidone at a low dose, monitor ECG and watch for adverse effects.
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
- Okedi 100mg powder and solvent for prolonged-release suspension for injection pre-filled syringes - SmPC sections 4.3/4.5 (names the partner; "hen prescribing OKEDI with medicinal products known to prolong the QT interval, such as antiarrhythmics (e.g., quinidine, disopyramide, procainamide, propaf… — electronic medicines compendium (UK SmPC)
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 Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
Frequently asked questions
Can I take Propafenone with Risperidone?
MediHelp rates the interaction as major. Propafenone and Risperidone 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 inhibits CYP2D6, the main enzyme that converts risperidone to its active metabolite, so exposure to the parent drug rises. Both drugs can affect cardiac conduction and repolarisation, and higher risperidone exposure increases the risk of QT prolongation, arrhythmia and extrapyramidal or sedative effects.
How serious is the interaction between Propafenone and Risperidone?
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 and choose an antipsychotic less dependent on CYP2D6. If unavoidable, start risperidone at a low dose, monitor ECG and watch for adverse effects.
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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