How to safely discontinue Propafenone?

Question

Hello doctor,

I am currently taking Rytmonorm 75 milligrams twice daily (I split a 150 milligram tablet in half) and Saneloc 25 milligrams in the evenings with food.

I was prescribed these medications because of PVCs that were likely caused by reflux and gastritis. Since I have now managed my stomach issues, I feel I may no longer need these medications.

My questions:

How should I safely discontinue these medications?
Could you please suggest a tapering schedule?
My evening heart rate often drops to 50 to 60 beats per minute before sleep. Is this considered normal, or should I be concerned?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

You are taking 150 milligrams of Propafenone every day, split into two doses (75 milligrams morning, 75 milligrams evening). This is a low dose, but never stop it suddenly as your heart rhythm can bounce back and cause fast or dangerous beats. Always follow your doctor’s plan.

Here is a simple, safe way doctors often taper this medicine (only do this with your doctor’s approval):

Week 1: Take 75 milligrams in the morning only (skip evening dose).
Week 2: Take 75 milligrams every other morning (for example: Monday, Wednesday, Friday).
Week 3: Stop the medicine completely.

I suggest you follow these instructions:

Do this slowly over two to three weeks so your heart adjusts.
Check your pulse daily. If it feels too fast, slow, or irregular, call your doctor right away.
Have a heart tracing (electrocardiogram) done when you lower the dose.
Keep taking other heart medicines (like beta-blockers, Metoprolol) for two weeks more and then taper down.
Eat food with each pill to avoid stomach upset.
Avoid grapefruit juice.
If you experience dizziness, fainting, chest pain, or strong palpitations, go to the emergency room immediately. Tell your doctor today that you want to stop, so they can make a safe plan just for you. Never change doses alone.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

A drop in your evening heart rate of 50 to 60 bpm before sleep is considered normal.

I hope this helps.

Kindly follow up if you have more doubts.

Thank you.