Active Ingredients

Propafenone – Effect, Application & Risks


Propafenon ist ein bekannter Wirkstoff, der zur Bekämpfung von Herzrhythmusstörungen eingesetzt wird. Aufgrund seiner chemischen und pharmakologischen Eigenschaften wird Propafenon der Wirkstoffklasse der Antiarrhythmika zugeordnet. Der Arzneistoff ist bereits seit einigen Jahren im Einsatz und gilt als sehr wirksam.

What is propafenone?

Propafenone is a well-known drug that is used to treat various cardiac arrhythmias. In Germany, Austria and Switzerland, the drug is sold under the trade names Cuxafenon® and Prorynorm®.

There is an indication for tachyarrhythmia (cardiac arrhythmia that occurs in combination with a heartbeat that is too fast) as well as for ventricular tachycardia (cardiac arrhythmia that coincides with an increased heart rate ) and atrial fibrillation . It should be noted that the dose administered depends on the underlying disease requiring treatment.

In chemistry, propafenone is described by the empirical formula C 21 – H 27 – N – O 3 . This corresponds to a moral mass of about 341.44 g/mol. Due to its chemical and pharmacological properties, propafenone is assigned to the group of so-called antiarrhythmics. These are not necessarily related drugs that affect heart rhythm .

In accordance with the classification of E. Vaughan Williams, which is common in the medical and pharmacological literature, a distinction can be made between four classes of antiarrhythmic drugs. According to this classification, propafenone falls into the first class, under which various sodium channel blockers are summarized. Propafenone is a member of class Ic, which also includes the related drug flecainide .

Pharmacological effect on body & organs

The pharmacological properties of propafenone largely correspond to those of a typical antiarrhythmic drug. The medical drug is considered a sodium channel antagonist. As such, it slows the influx of sodium ions. After taking propafenone, these can no longer get undisturbed into the myocardium , the layer of heart muscle tissue located between the inner and outer skin. This leads to a noticeable decrease in the excitability of the heart. The mechanism of action of propafenone is therefore described as bathmotropic.

In addition to slowing down the influx of sodium ions, propafenone also blocks beta-receptors. This also influences the speed of the heart rate.

After proper and continuous intake, up to 97% of propafenone in the blood is bound to plasma proteins . The plasma half-life of propafenone is reported in studies to be between three and six hours on average. Propafenone is primarily metabolised in the liver .

Medicinal Application & Use for Treatment & Prevention

Propafenone is used exclusively to combat cardiac arrhythmia. However, unlike some other drugs, propafenone can be used in a variety of forms. There is an indication for both tachyarrhythmia and ventricular tachycardia. Ingestion is also conceivable for the treatment of atrial fibrillation.

Propafenone is sold under different trade names in Germany, Austria and Switzerland because there is more than one manufacturer. The most common preparations include Cuxafenon® and Prorynorm®. It is only given as a film-coated tablet. In addition, propafenone is subject to pharmacy and prescription requirements. It can therefore only be taken as prescribed by a doctor and is only available in pharmacies .

As a class Ic antiarrhythmic, multiple doses of propafenone are necessary to achieve consistent efficacy. In general, it is recommended that propafenone be taken orally two to three times a day (depending on dosage). This dosage recommendation is typical for Class Ic.

Risks & side effects

Propafenone should not be taken if there is a contraindication. This technical term describes a circumstance in which, from a medical point of view, the intake should be avoided due to the existence of a contraindication. This is the case when there is a known hypersensitivity or allergy , an AV or sinus node disorder , cardiac insufficiency or hypotension .

In addition, there is a contraindication during pregnancy and lactation . Severe asthmatics should also not take propafenone. This also applies to people who suffer from severe liver damage, as this is primarily responsible for breaking down the active ingredient. Propafenone is also contraindicated in potassium balance disorders and in the first three months after a heart attack .

Undesirable side effects can also occur when propafenone is taken properly. However, this is not necessarily the case. The majority of the intake remains free from side effects. Also, all of the symptoms under consideration never appear at once.

In studies, pain in the chest area , dry mouth and disorders of the gastrointestinal tract ( constipation , nausea or vomiting ) were associated with the intake of propafenone.

Other typical side effects include headaches and dizziness as well as changes in the already existing cardiac arrhythmias.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.