Propafenone: uses, dosing, side effects & brands

Q: What is propafenone?

Propafenone Hydrochloride is an antiarrhythmic used to treat Atrial Fibrillation, Supraventricular Tachycardia.

Q: What kind of drug is propafenone?

The FDA classifies propafenone as an antiarrhythmic. Antiarrhythmics steady an irregular heartbeat by controlling the flow of sodium, potassium, or calcium ions through heart-cell channels (or blunting adrenaline's effect), which slows or normalizes the heart's electrical signals so it beats in a more regular rhythm. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.

Q: How long does propafenone stay in your system?

The elimination half-life of propafenone is about 2 to 10 hours (immediate-release) in the ~90% of adults who are extensive CYP2D6 metabolizers — that is how long the body takes to clear half of a dose. This is the terminal elimination half-life, not the distribution phase (the label reports a separate ~5-minute distribution half-life after IV dosing). Propafenone metabolism is genetically split: the ~90% who are extensive (rapid) metabolizers clear it with a 2-10 hour half-life, but the <10% who are slow/poor metabolizers (those who do not form the 5-hydroxy metabolite) have a much longer elimination half-life of 10 to 32 hours. The drug has two ACTIVE metabolites — 5-hydroxypropafenone (via CYP2D6) and N-depropylpropafenone/norpropafenone (via CYP3A4 and CYP1A2) — both with sodium-channel activity; the label does not state their individual half-lives, so no metabolite half-life number is given here. Liver impairment: clearance is reduced and the elimination half-life is increased in significant hepatic dysfunction (bioavailability also rises sharply). The label does not state a specific half-life change for older adults or kidney impairment in the pharmacokinetics section reviewed. Half-life is not the same as how long a drug test can detect the drug, and it varies with age, kidney and liver function.

Q: Can you take propafenone with other medicines?

It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run propafenone against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.

Q: What brand names is propafenone sold under?

We track 3 propafenone-containing products in the U.S.: Propafenone Hydrochloride, Rythmol and Rythmol SR. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.

Q: What forms does propafenone come in?

Across the brands we track, propafenone is currently marketed as capsule, extended release and tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.

Q: Is there a generic propafenone?

Yes. Our catalog lists 1 generic propafenone product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.

Q: Has propafenone been recalled?

The FDA's Enforcement database lists 4 recall records whose product description mentions propafenone. The most recent: Propafenone Hydrochloride Extended-Release Capsules USP (Mar 13, 2025). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.

Propafenone is an antiarrhythmic sold in the U.S. under 3 brand and generic names, for atrial fibrillation and supraventricular tachycardia. Below: what the FDA label says, every product that contains it, what the pills look like, and its recall record.

By the pharmaranks editorial teamReviewed against the FDA (openFDA label, NDC Directory & Enforcement) sourcesUpdated Jul 24, 2026How we research

Key facts

Drug class: Antiarrhythmic
Treats (across its forms): Atrial Fibrillation and Supraventricular Tachycardia
Available as: Capsule, extended release · Tablet
Sold as: 3 products — Propafenone Hydrochloride, Rythmol and Rythmol SR
Prescription?: Prescription only
Generic available?: Yes
Half-life: about 2 to 10 hours (immediate-release) in the ~90% of adults who are extensive CYP2D6 metabolizers
What the pharmacy pays: about $11 for a 30-count supply — not your price
Boxed warning: Boxed warning

How propafenone is dosed

From the FDA label for Propafenone Hydrochloride (application ANDA205956). Other propafenone products — different forms, different strengths — are dosed differently. Follow the label for the one you were prescribed.

Propafenone hydrochloride extended-release capsules can be taken with or without food. Do not crush or further divide the contents of the capsule. The dose of propafenone hydrochloride extended-release capsules must be individually titrated on the basis of response and tolerance. Initiate therapy with propafenone hydrochloride extended-release capsules 225 mg given every 12 hours. Dosage may be increased at a minimum of 5-day intervals to 325 mg given every 12 hours. If additional therapeutic effect is needed, the dose of propafenone hydrochloride extended-release capsules may be increased to 425 mg given every 12 hours. In patients with hepatic impairment or those with significant widening of the QRS complex or second- or third-degree AV block, consider reducing the dose. The combination of cytochrome P450 3A4 (CYP3A4) inhibition and either cytochrome P450 2D6 (CYP2D6) deficiency or CYP2D6 inhibition with the simultaneous administration of propafenone may significantly increase the concentration of propafenone and thereby increase the risk of proarrhythmia and other adverse events. Therefore, avoid simultaneous use of propafenone hydrochloride extended-release capsules with both a CYP2D6 inhibitor and a CYP3A4 inhibitor [see Warnings and Precautions (5.4) , Drug Interactions (7.1) ] . Initiate therapy with 225 mg given every 12 hours. ( 2 ) Dosage may be increased at a…

Propafenone side effects

The most commonly reported adverse events with propafenone (greater than 5% and greater than placebo) excluding those not reasonably associated with the use of the drug included the following: dizziness, palpitations, chest pain, dyspnea, taste disturbance, nausea, fatigue, anxiety, constipation, upper respiratory tract infection, edema, and influenza. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Rising Pharma Holdings, Inc. at 1-844-874-7464 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice. The data described below reflect exposure to propafenone hydrochloride extended-release capsules 225 mg twice daily in 126 patients, to propafenone hydrochloride extended-release capsules 325 mg twice daily in 135 patients, to propafenone hydrochloride extended-release capsules 425 mg twice daily in 136 patients, and to placebo in 126 patients for up to 39 weeks (mean: 20 weeks) in a placebo- controlled trial (RAFT) conducted in the U.S. The most commonly reported adverse events with propafenone (greater than 5% and greater than placebo) excluding those not reasonably associated with the…

Who shouldn’t take propafenone

Propafenone hydrochloride extended-release capsules are contraindicated in the following circumstances: Heart failure Cardiogenic shock Sinoatrial, atrioventricular, and intraventricular disorders of impulse generation or conduction (e.g., sick sinus node syndrome, AV block) in the absence of an artificial pacemaker Known Brugada Syndrome Bradycardia Marked hypotension Bronchospastic disorders or severe obstructive pulmonary disease Marked electrolyte imbalance Heart failure ( 4 ) Cardiogenic shock ( 4 ) Sinoatrial, atrioventricular, and intraventricular disorders of impulse generation and/or conduction in the absence of pacemaker ( 4 ) Known Brugada Syndrome ( 4 ) Bradycardia ( 4 ) Marked hypotension ( 4 ) Bronchospastic disorders and severe obstructive pulmonary disease ( 4 ) Marked electrolyte imbalance ( 4 )

Propafenone drug interactions

Inhibitors of CYP2D6, 1A2, and 3A4 may increase propafenone levels which may lead to cardiac arrhythmias. Simultaneous use with both a CYP3A4 and CYP2D6 inhibitor (or in patients with CYP2D6 deficiency) should be avoided. ( 7.1 ) Propafenone may increase digoxin or warfarin levels. ( 7.2 , 7.3 ) Orlistat may reduce propafenone concentrations. Abrupt cessation of orlistat in patients stable on propafenone hydrochloride extended-release capsules has resulted in convulsions, atrioventricular block, and circulatory failure. ( 7.4 ) Concomitant use of lidocaine may increase central nervous system side effects. ( 7.6 ) 7.1 CYP2D6 and CYP3A4 Inhibitors Drugs that inhibit CYP2D6 (such as desipramine, paroxetine, ritonavir, sertraline) and CYP3A4 (such as ketoconazole, ritonavir, saquinavir, erythromycin, grapefruit juice) can be expected to cause increased plasma levels of propafenone. The combination of CYP3A4 inhibition and either CYP2D6 deficiency or CYP2D6 inhibition with administration of propafenone may increase the risk of adverse reactions, including proarrhythmia. Therefore, simultaneous use of propafenone hydrochloride extended-release capsules with both a CYP2D6 inhibitor and a CYP3A4 inhibitor should be avoided [see Warnings and Precautions (5.4) , Dosage and Administration (2) ]. Amiodarone Concomitant administration of propafenone and amiodarone can affect conduction and repolarization and is not recommended. Cimetidine Concomitant administration of propafenone immediate-release tablets and cimetidine in 12 healthy subjects resulted in a 20% increase in steady-state plasma concentrations of propafenone. Fluoxetine Concomitant administration of propafenone and fluoxetine in extensive metabolizers increased the S-propafenone C max and AUC by 39% and 50%, respectively, and the R-propafenone C max and AUC by 71% and 50%, respectively. Quinidine Small doses of quinidine completely inhibit the CYP2D6 hydroxylation metabolic pathway, making all patients, in effect, slow metabolizers [see Clinical Pharmacology (12.3) ] . Concomitant administration of quinidine (50 mg 3 times daily) with 150-mg immediate-release propafenone 3 times daily decreased the clearance of propafenone by 60% in extensive metabolizers, making them poor metabolizers. Steady-state plasma concentrations increased by more than 2-fold for propafenone and decreased 50% for 5-OH-propafenone. A 100-mg dose of quinidine increased steady-state concentrations of propafenone 3-fold. Avoid concomitant use of propafenone and quinidine. Rifampin Concomitant administration of rifampin and propafenone in extensive metabolizers decreased the plasma concentrations of propafenone by 67% with a corresponding decrease of 5-OH- propafenone by 65%. The concentrations of norpropafenone increased by 30%. In poor metabolizers, there was a 50% decrease in propafenone plasma concentrations and an increase in the AUC and C max of norpropafenone by 74% and 20%, respectively. Urinary excretion of propafenone and its metabolites decreased significantly. Similar results were noted in elderly patients: Both the AUC and C max of propafenone decreased by 84%, with a corresponding decrease in AUC and C max of 5-OH-propafenone by 69% and 57%, respectively. 7.2 Digoxin Concomitant use of propafenone and digoxin increased steady-state serum digoxin exposure (AUC) in patients by 60% to 270% and decreased the clearance of digoxin by 31% to 67%. Monitor plasma digoxin levels of patients receiving propafenone and adjust digoxin dosage as needed. 7.3 Warfarin The concomitant administration of propafenone and warfarin increased warfarin plasma concentrations at steady state by 39% in healthy volunteers and prolonged the prothrombin time (PT) in patients taking warfarin. Adjust the warfarin dose as needed by monitoring INR (international normalized ratio). 7.4 Orlistat Orlistat may limit the fraction of propafenone available for absorption. In postmarketing reports, abrupt cessation of orlistat in patients stabilized on propafenone has resulted in severe adverse events including convulsions, atrioventricular block, and acute circulatory failure. 7.5 Beta-Antagonists Concomitant use of propafenone and propranolol in healthy subjects increased propranolol plasma concentrations at steady state by 113%. In 4 patients, administration of metoprolol with propafenone increased the metoprolol plasma concentrations at steady state by 100% to 400%. The pharmacokinetics of propafenone was not affected by the coadministration of either propranolol or metoprolol. In clinical trials using propafenone immediate-release tablets, patients who were receiving beta-blockers concurrently did not experience an increased incidence of side effects. 7.6 Lidocaine No significant effects on the pharmacokinetics of propafenone or lidocaine have been seen following their concomitant use in patients. However, concomitant use of propafenone and lidocaine has been reported to increase the risks of central nervous system side effects of lidocaine.

Every propafenone product we track (3)

Same active ingredient — different manufacturer, form, price and FDA recall record. That last one is what our independent score measures.

Propafenone products
#	Drug	Rating	Type	Form	Generic?	Pharmacy pays
1	Propafenone Hydrochloride Boxed warning	72/100	Prescription	Capsule	Generic	$11	View →
2	Rythmol	70/100	Prescription	Tablet	Generic	$11	View →
3	Rythmol SR	70/100	Prescription	Capsule	Generic	$11	View →

What propafenone pills look like

Imprint codes, colour and shape from the FDA’s labelling data. Match the imprint on your pill — or search any imprint.

Propafenone pill imprints
Imprint	Strength	Colour	Shape	Maker
408;G	225 mg	white, white	capsule	—
409;G	325 mg	white, white	capsule	—
410;G	425 mg	white, white	capsule	—
par;210	325 mg	orange	capsule	—
par;211	425 mg	red	capsule	—
par;209	225 mg	white	capsule	—
1;L	150 mg	white	round	—
2;L	225 mg	white	round	—
4;L	300 mg	white	round	—
PR;OT;225	225 mg	white	round	—
PR;OT;300	300 mg	white	round	—

Propafenone recalls

From the FDA Enforcement database. A recall covers specific lots — not the drug as a whole.

Can you crush or split propafenone?

At least one propafenoneproduct is labelled to be swallowed whole — crushing an extended-release tablet releases the whole day’s dose at once. Which applies depends on the form you were given.

What each propafenone label says about crushing, splitting and chewing

How long propafenone keeps

No propafenone label we read sets a separate limit for after opening, but they do specify how it must be stored — and the stability behind any date assumes those conditions.

Does propafenone expire? The in-use limits and storage rules from its labels

Propafenone and breastfeeding

From LactMed, the US National Library of Medicine’s Drugs and Lactation Database — quoted, not rewritten.

Limited information indicates that maternal doses of propafenone up to 900 mg daily produce low levels in milk. If propafenone is required by the mother it is not a reason to discontinue breastfeeding. Until more data become available, propafenone should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.

Full LactMed record for propafenone: levels in milk, effects in breastfed infants, and the drugs it would consider instead

National Institute of Child Health and Human Development, record revised July 15, 2024. LactMed states its information is not a substitute for professional judgement.

What people report to the FDA about propafenone

The FDA Adverse Event Reporting System (FAERS) collects reports from patients and clinicians. It holds 1,004 reports naming propafenone, and the FDA flagged 78% of those reports as serious. The effects reported most often — leaving out reports about overdose, misuse or the condition being treated, which dominate the raw list for common medicines:

atrial fibrillation101 reports
dizziness57 reports
dyspnoea55 reports
nausea55 reports
hypotension44 reports
asthenia40 reports
palpitations40 reports
arrhythmia39 reports

Read these as a signal, not a rate. A report does not mean propafenone caused the effect — anyone can file one, and many describe people taking several medicines for several conditions. Crucially there is no denominator: FAERS does not record how many people took the drug, so these counts cannot be turned into “X% of patients” — a bigger number often just means a more widely used or more talked-about drug. Duplicates exist, and publicity drives reporting. For what is actually established, read the FDA label section above.

Source: openFDA drug/event (FAERS), retrieved July 26, 2026.

How long propafenone stays in your system

The elimination half-life of propafenone is about 2 to 10 hours (immediate-release) in the ~90% of adults who are extensive CYP2D6 metabolizers. This is the terminal elimination half-life, not the distribution phase (the label reports a separate ~5-minute distribution half-life after IV dosing). Propafenone metabolism is genetically split: the ~90% who are extensive (rapid) metabolizers clear it with a 2-10 hour half-life, but the <10% who are slow/poor metabolizers (those who do not form the 5-hydroxy metabolite) have a much longer elimination half-life of 10 to 32 hours. The drug has two ACTIVE metabolites — 5-hydroxypropafenone (via CYP2D6) and N-depropylpropafenone/norpropafenone (via CYP3A4 and CYP1A2) — both with sodium-channel activity; the label does not state their individual half-lives, so no metabolite half-life number is given here. Liver impairment: clearance is reduced and the elimination half-life is increased in significant hepatic dysfunction (bioavailability also rises sharply). The label does not state a specific half-life change for older adults or kidney impairment in the pharmacokinetics section reviewed.

Propafenone Hydrochloride Tablet — DailyMed FDA Label, Section 12.3 Pharmacokinetics ↗

Half-life is how long the body takes to clear half a dose. It is not the same as how long a drug test can detect it, and it varies with age, kidney and liver function.

Related calculators

How long it stays in your system →

Frequently asked questions

What is propafenone?

Propafenone Hydrochloride is an antiarrhythmic used to treat Atrial Fibrillation, Supraventricular Tachycardia.

What kind of drug is propafenone?

The FDA classifies propafenone as an antiarrhythmic. Antiarrhythmics steady an irregular heartbeat by controlling the flow of sodium, potassium, or calcium ions through heart-cell channels (or blunting adrenaline's effect), which slows or normalizes the heart's electrical signals so it beats in a more regular rhythm. If you are checking whether it is safe to combine with something else, the class is what matters — two drugs from the same class usually should not be stacked.

How long does propafenone stay in your system?

The elimination half-life of propafenone is about 2 to 10 hours (immediate-release) in the ~90% of adults who are extensive CYP2D6 metabolizers — that is how long the body takes to clear half of a dose. This is the terminal elimination half-life, not the distribution phase (the label reports a separate ~5-minute distribution half-life after IV dosing). Propafenone metabolism is genetically split: the ~90% who are extensive (rapid) metabolizers clear it with a 2-10 hour half-life, but the <10% who are slow/poor metabolizers (those who do not form the 5-hydroxy metabolite) have a much longer elimination half-life of 10 to 32 hours. The drug has two ACTIVE metabolites — 5-hydroxypropafenone (via CYP2D6) and N-depropylpropafenone/norpropafenone (via CYP3A4 and CYP1A2) — both with sodium-channel activity; the label does not state their individual half-lives, so no metabolite half-life number is given here. Liver impairment: clearance is reduced and the elimination half-life is increased in significant hepatic dysfunction (bioavailability also rises sharply). The label does not state a specific half-life change for older adults or kidney impairment in the pharmacokinetics section reviewed. Half-life is not the same as how long a drug test can detect the drug, and it varies with age, kidney and liver function.

Can you take propafenone with other medicines?

It depends on the medicine. We check it against the FDA labels rather than guessing: our interaction checker searches each drug's own label for the other and quotes what it says, naming the section it came from. Run propafenone against whatever else you take — and remember that a label not naming a drug is not the same as that combination being safe.

What brand names is propafenone sold under?

We track 3 propafenone-containing products in the U.S.: Propafenone Hydrochloride, Rythmol and Rythmol SR. They are the same active ingredient; they differ in form, manufacturer, price and FDA recall record.

What forms does propafenone come in?

Across the brands we track, propafenone is currently marketed as capsule, extended release and tablet, per the FDA's National Drug Code Directory. Each form is dosed differently — follow the label for the exact product you were prescribed.

Is there a generic propafenone?

Yes. Our catalog lists 1 generic propafenone product alongside the brand versions. A generic has the same active ingredient and must meet the FDA's bioequivalence standard; it usually costs less. Ask your pharmacist which one your plan covers.

Has propafenone been recalled?

The FDA's Enforcement database lists 4 recall records whose product description mentions propafenone. The most recent: Propafenone Hydrochloride Extended-Release Capsules USP (Mar 13, 2025). A recall applies to specific lots, not to the drug as a whole — check the record for the affected lot numbers.

Cite this page

APA: pharmaranks. (2026, July 24). Propafenone: uses, dosing, side effects & brands. https://pharmaranks.com/drugs/propafenone
MLA: “Propafenone: uses, dosing, side effects & brands.” pharmaranks, 24 July 2026, https://pharmaranks.com/drugs/propafenone.

We summarise public FDA and NIH sources — for a clinical claim, cite the primary source we link to as well.

Sources: FDA openFDA drug label, National Drug Code Directory, and Enforcement (recall) database. This page reproduces public FDA data and is not medical advice. Dosing is set by your prescriber.

Read the full FDA label for propafenone on DailyMed (NIH) ↗ — including its boxed warning in full.