Propafenone and Venlafaxine interaction
Propafenone and Venlafaxine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Propafenone (propafenone hydrochloride) label · effective 2026-01-29
• Avoid use with other antiarrhythmic agents or drugs that prolong the QT interval.
It may also worsen premature ventricular contractions or supraventricular arrhythmias, and it may prolong the QT interval.
Use with Drugs that Prolong the QT Interval and Antiarrhythmic Agents The use of propafenone hydrochloride extended-release capsules in conjunction with other drugs that prolong the QT interval has not been extensively studied.
Such drugs may include many antiarrhythmics, some phenothiazines, tricyclic antidepressants, and oral macrolides.
From the Venlafaxine (Venlafaxine Hydrochloride) label · effective 2025-01-31
Therefore, the potential exists for a drug interaction between drugs that inhibit CYP2D6-mediated metabolism of venlafaxine, reducing the metabolism of venlafaxine to ODV, resulting in increased plasma concentrations of venlafaxine and decreased concentrations of the active metabolite.
Drugs that Inhibit Cytochrome P450 Isoenzymes CYP2D6 Inhibitors: In vitro and in vivo studies indicate that venlafaxine is metabolized to its active metabolite, ODV, by CYP2D6, the isoenzyme that is responsible for the genetic polymorphism seen in the metabolism of many antidepressants.
CYP2D6 inhibitors such as quinidine would be expected to do this, but the effect would be similar to what is seen in patients who are genetically CYP2D6 poor metabolizers [see Clinical Pharmacology ( 12.3 )] .
Drugs Metabolized by Cytochrome P450 Isoenzymes CYP2D6 In vitro studies indicate that venlafaxine is a relatively weak inhibitor of CYP2D6.
Therefore, no dosage adjustment is required when venlafaxine is coadministered with a CYP2D6 inhibitor.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.