title: Atrial fibrillation: adverse effects of "pill-in-the-pocket" treatment and propafenone-carvedilol interaction.
abstract: Propafenone and carvedilol share a common hepatic metabolism involving the oxidative pathway (CYP2D6). Therefore, oral loading with propafenone (as "pill-in-the-pocket" treatment of recent-onset atrial fibrillation) in a patient on concurrent carvedilol treatment may lead to a pharmacokinetic interaction, with high plasma levels of propafenone and potential drug-related adverse effects. In clinical practice, in order to improve the safety of "pill-in-the-pocket" treatment, use of propafenone loading should, in our view, be discouraged in patients on concurrent treatment with carvedilol.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.forename: Mauro
authors.initials: M
authors.lastname: Biffi
authors.forename: Igor
authors.initials: I
authors.lastname: Diemberger
authors.forename: Giulia
authors.initials: G
authors.lastname: Domenichini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marziali
authors.forename: Cristian
authors.initials: C
authors.lastname: Martignani
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002227:Carbazoles / Q000008:administration & dosage / Q000009:adverse effects*; D000077261:Carvedilol; D004347:Drug Interactions; D006801:Humans; D011405:Propafenone / Q000008:administration & dosage / Q000009:adverse effects*; D011412:Propanolamines / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D011405:Propafenone