Atrial fibrillation: adverse effects of "pill-in-the-pocket" treatment and propafenone-carvedilol interaction.
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.
Boriani
Giuseppe
G
Biffi
Mauro
M
Diemberger
Igor
I
Domenichini
Giulia
G
Marziali
Alessandro
A
Martignani
Cristian
C
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*
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D011405:Propafenone