Rytmonorm Special Precautions

Propafenone like other antiarrhythmics may cause proarrhythmic effects, i.e. it may cause new or worsen preexisting arrhythmias (see Adverse Reactions). It is essential that each patient given propafenone hydrochloride be evaluated electrocardiographically and clinically prior to and during therapy to determine whether the response to propafenone hydrochloride supports continued treatment.
A Brugada syndrome may be unmasked or Brugada like electrocardiogram (ECG) changes may be provoked after exposure to propafenone in previously asymptomatic carriers of the syndrome. After initiating therapy with propafenone, an ECG should be performed to rule out changes suggestive of Brugada syndrome.
Propafenone hydrochloride treatment may affect both the pacing and sensing thresholds of artificial pacemakers. Pacemaker function should therefore be checked and, if necessary, reprogrammed.
There is the potential for conversion of paroxysmal atrial fibrillation to atrial flutter with accompanying 2:1 conduction block or 1:1 conduction (see Adverse Reactions).
As with other class 1c anti-arrhythmic agents, patients with significant structural heart disease may be predisposed to serious adverse events. Therefore, propafenone hydrochloride is contraindicated in these patients (see Contraindications).
Propafenone hydrochloride should be used with caution in patients with obstruction of the airways, e.g. asthma.
Effects on ability to drive and use machines: Blurred vision, dizziness, fatigue and postural hypotension may affect the patient's speed of reaction and impair the individual's ability to operate machinery and motor vehicles.