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Details

Stereochemistry RACEMIC
Molecular Formula C21H27NO3
Molecular Weight 341.444
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of PROPAFENONE

SMILES

CCCNCC(O)COC1=C(C=CC=C1)C(=O)CCC2=CC=CC=C2

InChI

InChIKey=JWHAUXFOSRPERK-UHFFFAOYSA-N
InChI=1S/C21H27NO3/c1-2-14-22-15-18(23)16-25-21-11-7-6-10-19(21)20(24)13-12-17-8-4-3-5-9-17/h3-11,18,22-23H,2,12-16H2,1H3

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including https://www.drugbank.ca/drugs/DB01182 | http://reference.medscape.com/drug/rythmol-propafenone-342307 | https://www.drugs.com/pro/propafenone.html | https://www.ncbi.nlm.nih.gov/pubmed/26588045

Propafenone (brand name Rythmol SR or Rytmonorm) is a class 1C anti-arrhythmic medication, which treats illnesses associated with rapid heartbeats such as atrial and ventricular arrhythmias. The electrophysiological effect of propafenone manifests itself in a reduction of upstroke velocity (Phase 0) of the monophasic action potential. In Purkinje fibers, and to a lesser extent myocardial fibers, propafenone reduces the fast inward current carried by sodium ions, which is responsible for the drugs antiarrhythmic actions. Diastolic excitability threshold is increased and effective refractory period prolonged. Propafenone reduces spontaneous automaticity and depresses triggered activity. At very high concentrations in vitro, propafenone can inhibit the slow inward current carried by calcium but this calcium antagonist effect probably does not contribute to antiarrhythmic efficacy. Propafenone is metabolized primarily in the liver. Because of its short half-life, it requires dosing two or three times daily to maintain steady blood levels. The long-term safety of propafenone is unknown. Because it is structurally similar to another anti-arrhythmic medicine, flecainide, similar cautions should be exercised in its use. Flecainide and propafenone, like other antiarrhythmic drugs, have been shown to increase the occurrence of arrhythmias (5.3% for propafenone, Teva physician prescribing information), primarily in patients with underlying heart disease. However, their use in structurally normal hearts is considered safe.

Originator

Sources: Journal of the American Geriatrics Society (1961), 9, 491-7.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
RYTHMOL

Approved Use

Propafenone HCl Extended Release Capsules is indicated to prolong the time to recurrence of symptomatic atrial fibrillation (AF) in patients with episodic (most likely paroxysmal or persistent) AF who do not have structural heart disease. Usage Considerations: •The use of propafenone ER capsules in patients with permanent AF or in patients exclusively with atrial flutter or paroxysmal supraventricular tachycardia (PSVT) has not been evaluated. Do not use propafenone ER capsules to control ventricular rate during AF. •Some patients with atrial flutter treated with propafenone have developed 1:1 conduction, producing an increase in ventricular rate. Concomitant treatment with drugs that increase the functional atrioventricular (AV) nodal refractory period is recommended. • The effect of propafenone on mortality has not been determined [see BOXED WARNING

Launch Date

1989
Primary
RYTHMOL

Approved Use

Propafenone HCl Extended Release Capsules is indicated to prolong the time to recurrence of symptomatic atrial fibrillation (AF) in patients with episodic (most likely paroxysmal or persistent) AF who do not have structural heart disease. Usage Considerations: •The use of propafenone ER capsules in patients with permanent AF or in patients exclusively with atrial flutter or paroxysmal supraventricular tachycardia (PSVT) has not been evaluated. Do not use propafenone ER capsules to control ventricular rate during AF. •Some patients with atrial flutter treated with propafenone have developed 1:1 conduction, producing an increase in ventricular rate. Concomitant treatment with drugs that increase the functional atrioventricular (AV) nodal refractory period is recommended. • The effect of propafenone on mortality has not been determined [see BOXED WARNING

Launch Date

1989
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
314 ng/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
189.94 ng/mL
150 mg single, oral
dose: 150 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
2900 ng × h/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
322.43 ng × h/mL
150 mg single, oral
dose: 150 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
3.61 h
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
4.1%
PROPAFENONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Other AEs: Monocyte count increased, Eosinophil count increased...
Other AEs:
Monocyte count increased (0.7%)
Eosinophil count increased (0.7%)
Platelet count decreased (0.7%)
Cardiac failure congestive (1.5%)
Coronary artery disease NOS (0.7%)
Myocardial infarction (0.7%)
Abdominal pain NOS (0.7%)
Diarrhea NOS (0.7%)
Chest pain (1.5%)
Pneumonia NOS (0.7%)
Urinary tract infection NOS (0.7%)
Prothrombin level decreased (0.7%)
Headache (0.7%)
Syncope (0.7%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Abdominal pain NOS 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Coronary artery disease NOS 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Diarrhea NOS 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Eosinophil count increased 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Headache 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Monocyte count increased 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Myocardial infarction 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Platelet count decreased 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Pneumonia NOS 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Prothrombin level decreased 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Syncope 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Urinary tract infection NOS 0.7%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Cardiac failure congestive 1.5%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Chest pain 1.5%
425 mg 2 times / day multiple, oral
Highest studied dose
Dose: 425 mg, 2 times / day
Route: oral
Route: multiple
Dose: 425 mg, 2 times / day
Sources:
unhealthy, adult
n = 135
Health Status: unhealthy
Condition: atrial fibrillation
Age Group: adult
Sex: M+F
Population Size: 135
Sources:
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



OverviewOther

Other InhibitorOther SubstrateOther Inducer







Drug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
yes
yes
yes (co-administration study)
Comment: amiodarone and tobacco (CYP1A2 inhibitor) can be expected to cause increased plasma levels of propafenone
yes
yes (co-administration study)
Comment: ketoconazole, erythromycin, saquinavir, and grapefruit juice for (CYP3A4 inhibitors) can be expected to cause increased plasma levels of propafenone; The combination of CYP3A4 inhibition and either CYP2D6 deficiency or CYP2D6 sinhibition with the simultaneous administration of propafenone may significantly increase the concentration of propafenone and thereby increase the risk of proarrhythmia and other adverse event
yes
yes (pharmacogenomic study)
Comment: Multiple studies have found that genetic variants in the CYP2D6 gene influence the plasma drug levels of propafenone
Tox targets
PubMed

PubMed

TitleDatePubMed
An organic psychosis due to a venlafaxine-propafenone interaction.
2001
Algorithmic complexity. A new approach of non-linear algorithms for the analysis of atrial signals from multipolar basket catheter.
2001
Blocking effects of the antiarrhythmic drug propafenone on the HERG potassium channel.
2001 Apr
[Comparison of efficacy, safety and cost-effectiveness of intravenous versus oral propafenone in paroxysmal atrial fibrillation].
2001 Aug
Visual compatibility of sodium nitroprusside with other injectable medications given to pediatric patients.
2001 Aug 1
Chiral metabolism of propafenone in rat hepatic microsomes treated with two inducers.
2001 Dec
Efficacy of sequential antiarrhythmic treatment in sinus rhythm maintenance after successful electrocardioversion in patients with chronic non-valvular atrial fibrillation.
2001 Jan-Feb
Can short-term verapamil therapy reduce the recurrence of atrial fibrillation after successful low energy intracardiac cardioversion?
2001 Jul
Efficacy and safety of dofetilide in the prevention of symptomatic episodes of paroxysmal supraventricular tachycardia: a 6-month double-blind comparison with propafenone and placebo.
2001 Jul
Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation.
2001 Sep 15
Risk of mortality in a cohort of patients newly diagnosed with chronic atrial fibrillation.
2002
Oral loading with propafenone for conversion of recent-onset atrial fibrillation: a review on in-hospital treatment.
2002
Adverse drug events in hospitalized patients treated with cardiovascular drugs and anticoagulants.
2002 Apr-May
How to enhance acute outcome of electrical cardioversion by drug therapy: importance of immediate reinitiation of atrial fibrillation.
2002 Aug
[Disclosure of "Brugada's syndrome" with intravenous propafenone].
2002 Jan-Mar
[Proarrhythmic effects of propafenone in a woman with hepatopathy: is it always a simple drug in clinical practice?].
2002 Jul
[The treatment of postoperative junctional ectopic tachycardia].
2002 Jun
An evaluation of the strategy of maintenance of sinus rhythm by antiarrhythmic drug therapy after ablation and pacing therapy in patients with paroxysmal atrial fibrillation.
2002 Jun
Intermittent Brugada syndrome misdiagnosed as acute myocardial infarction and unmasked with propafenone.
2002 Jun
Effect of propafenone on the contractile activity of Latissimus dorsi muscle isolated in an organ chamber: experimental study in rats.
2002 Mar
[Structure and activity relationship of propafenone and alkylesters of 2-and 4-[(3-propylamino-2-hydroxy)-propoxy]-phenylcarbamic acid].
2002 May
Similarity based SAR (SIBAR) as tool for early ADME profiling.
2002 Nov
Beta-adrenergic stimulation modulates the sodium current block by propafenone in rat ventricular myocardium.
2002 Oct
New insights into the mechanisms and management of atrial fibrillation.
2002 Oct 29
Maintaining stability of sinus rhythm in atrial fibrillation: antiarrhythmic drugs versus ablation.
2002 Sep
Exercise-induced bidirectional ventricular tachycardia with alternating right and left bundle branch block-type patterns--a case report.
2002 Sep-Oct
Lopinavir/ritonavir: a review of its use in the management of HIV infection.
2003
High-throughput screening to estimate single or multiple enzymes involved in drug metabolism: microtitre plate assay using a combination of recombinant CYP2D6 and human liver microsomes.
2003 Aug
Class I or class III agents for atrial fibrillation: are asking the right question?
2003 Jul
A novel two-pore domain K+ channel, TRESK, is localized in the spinal cord.
2003 Jul 25
Amiodarone for pharmacological cardioversion of recent-onset atrial fibrillation.
2003 Jun
[Drug therapy of atrial fibrillation].
2003 Jun 15
Effects of a series of dihydroanthracene derivatives on drug efflux in multidrug resistant cancer cells.
2003 Mar
Molecular site of action of the antiarrhythmic drug propafenone at the voltage-operated potassium channel Kv2.1.
2003 Mar
Pharmacologic and nonpharmacologic options to maintain sinus rhythm: guideline-based and new approaches.
2003 Mar 20
Patents

Sample Use Guides

Initiate therapy with 150 mg given every 8 hours. As needed, uptitrate in 3-4 days to 225-300 mg every 8 hours
Route of Administration: Oral
Hela cells were used for activity evaluation. Proliferation percentage was determined by the SRB assay. Cells were incubated with the Propafenone at the concentrations of 0.005-0.2 g/L for 48 h, and the cell proliferation/viability was determined using the survival percentage with the cells treated only with dimethyl sulfoxide (DMSO) at 0.1% as a reference
Name Type Language
PROPAFENONE
INCI   INN   MI   VANDF   WHO-DD  
INN   INCI  
Official Name English
PROPAFENONE [MI]
Common Name English
PROPAFENON HEXAL
Brand Name English
PROPAFENONE [INCI]
Common Name English
PROPAFENONE [VANDF]
Common Name English
Propafenone [WHO-DD]
Common Name English
propafenone [INN]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C93038
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
LIVERTOX NBK548005
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
NDF-RT N0000175426
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
NCI_THESAURUS C47793
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
WHO-VATC QC01BC03
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
WHO-ATC C01BC03
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
Code System Code Type Description
EPA CompTox
DTXSID9045184
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
DRUG BANK
DB01182
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
IUPHAR
2561
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
DRUG CENTRAL
2291
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
ECHA (EC/EINECS)
258-955-6
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
WIKIPEDIA
PROPAFENONE
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
ChEMBL
CHEMBL631
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
FDA UNII
68IQX3T69U
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
LACTMED
Propafenone
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
PUBCHEM
4932
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
RXCUI
8754
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PRIMARY RxNorm
CAS
54063-53-5
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
SMS_ID
100000081149
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
CHEBI
63619
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
HSDB
7929
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
INN
3312
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
MERCK INDEX
m9178
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY Merck Index
MESH
D011405
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
NCI_THESAURUS
C61909
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
DAILYMED
68IQX3T69U
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY
EVMPD
SUB10094MIG
Created by admin on Fri Dec 15 15:30:38 GMT 2023 , Edited by admin on Fri Dec 15 15:30:38 GMT 2023
PRIMARY