Interactions

Drug-Drug

• Any inhibitors of the CYP1A2, CYP2D6, or CYP3A4 enzyme systems may ↑ levels, including desipramine , paroxetine , ritonavir , sertraline , ketoconazole , saquinavir , erythromycin (blood level monitoring recommended)

• Quinidine is a strong inhibitor of CYP2D6 and significantly ↑ levels of propafenone; concurrent use is not recommended

• Propafenone is also an inhibitor of CYP2D6 and may ↑ levels of desipramine , imipramine , haloperidol , and venlafaxine

• Significantly ↑ serum digoxin levels (blood level monitoring recommended, ↓ dose may be required)

• ↑ blood levels of metoprolol and propranolol (↓ dose may be required)

• Concurrent use of local anesthetics may ↑ risk of CNS adverse reactions

• ↑ effects of warfarin (↓ warfarin dose if necessary, monitor INR)

• Concurrent use with amiodarone can adversely effect conduction/repolarization and should be avoided

• May ↑ risk of CNS adverse reactions with lidocaine

• May ↑ cyclosporine trough blood levels and risk of nephrotoxicity

• Rifampin may ↓ serum levels and effectiveness

• Cimetidine may ↑ serum levels

Drug-Food
Grapefruit juice may ↑ levels

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