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Related Experiment Videos

Propafenone-theophylline interaction

S A Spinler1, A Gammaitoni, S L Charland

  • 1Department of Clinical Pharmacy, Philadelphia College of Pharmacy and Science, PA 19104-4495.

Pharmacotherapy
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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Propafenone can dangerously increase theophylline levels in patients with ventricular tachycardia (VT). This drug interaction, caused by competing metabolism, necessitates close monitoring of theophylline concentrations and electrocardiograms.

Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Drug Metabolism

Background:

  • Ventricular tachycardia (VT) is a serious arrhythmia often requiring complex management.
  • Surgical ablation and coronary artery bypass graft surgery were indicated for a patient with refractory VT.
  • Theophylline is a medication used for various respiratory conditions and sometimes arrhythmias.

Observation:

  • A patient receiving sustained-release theophylline experienced elevated serum theophylline concentrations after initiating propafenone therapy.
  • Theophylline clearance significantly decreased (25% to 69%) despite dose adjustments.
  • Theophylline was discontinued due to rising levels, though propafenone levels were not assessed.

Findings:

  • Propafenone and theophylline share hepatic metabolism via the cytochrome P-450 enzyme system.

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  • Competitive metabolism between propafenone and theophylline likely led to theophylline enzyme inhibition and reduced clearance.
  • This interaction resulted in potentially toxic theophylline levels.

    • Implications:

    • Healthcare providers must be vigilant for this drug interaction when coadministering propafenone and theophylline.
    • Close monitoring of theophylline serum concentrations and electrocardiograms is crucial.
    • Awareness of this interaction can prevent adverse events and guide therapeutic adjustments.