Drug interactions
Propafenone + Rolapitant
Severity: Major
Propafenone and Rolapitant: 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 CYP2D6 substrate with a narrow therapeutic index. Rolapitant can raise propafenone concentrations for weeks, increasing the risk of conduction abnormalities, proarrhythmia and CNS effects.
What this interaction means in plain words
Propafenone and Rolapitant 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; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Rolapitant inhibits CYP2D6, reducing propafenone clearance and shifting metabolism away from active 5-hydroxypropafenone formation.
What to do
Avoid the combination if possible, or monitor ECG and clinical status closely. Reduce the propafenone dose as needed, noting the persistent effect after rolapitant.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
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 Rolapitant?
MediHelp rates the interaction as major. Propafenone and Rolapitant 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 CYP2D6 substrate with a narrow therapeutic index. Rolapitant can raise propafenone concentrations for weeks, increasing the risk of conduction abnormalities, proarrhythmia and CNS effects.
How serious is the interaction between Propafenone and Rolapitant?
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 possible, or monitor ECG and clinical status closely. Reduce the propafenone dose as needed, noting the persistent effect after rolapitant.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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