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Rythmol
Propafenone
$153.00
150mg · 9 × 30 tablets · 3 months supply
GenericGeneric medicine· By Taro
$51.00 per month
Strength
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Annual cost
$629a year at this pack size
Prescription required
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150mg
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FDA boxed warningMortality
In the National Heart, Lung, and Blood Institute's Cardiac Arrhythmia Suppression Trial (CAST), a long-term, multicenter, randomized, double-blind trial in subjects with asymptomatic non-life-threatening ventricular arrhythmias who had a myocardial infarction more than 6 days but less than 2 years previously, an increased rate of death or reversed cardiac arrest rate (7.7%; 56/730) was seen in subjects treated with encainide or flecainide (Class IC antiarrhythmics) compared with that seen in subjects assigned to placebo (3.0%; 22/725). The average duration of treatment with encainide or flecainide in this trial was 10 months.
The applicability of the CAST results to other populations (e.g., those without recent myocardial infarction) or other antiarrhythmic drugs is uncertain, but at present, it is prudent to consider any IC antiarrhythmic to have a significant proarrhythmic risk in patients with structural heart disease. Given the lack of any evidence that these drugs improve survival, antiarrhythmic agents should generally be avoided in patients with non-life-threatening ventricular arrhythmias, even if the patients are experiencing unpleasant, but not life-threatening, symptoms or signs.
- An increased rate of death or reversed cardiac arrest rate was seen in subjects treated with encainide or flecainide (Class IC antiarrhythmics) compared with that seen in subjects assigned to placebo. At present, it is prudent to consider any IC antiarrhythmic to have a significant risk of provoking proarrhythmic events in patients with structural heart disease.
About Rythmol
Overview
Rythmol (propafenone) is a prescription antiarrhythmic medicine used to treat certain abnormal heart rhythms. It helps delay the return of episodes of atrial fibrillation/flutter or paroxysmal supraventricular tachycardia that cause disabling symptoms in people without structural heart disease. It also treats documented, life-threatening ventricular arrhythmias, with treatment started in hospital. It works mainly by reducing sodium flow into heart cells, slowing electrical signals and making the cells less easily triggered.
What it treats
- Recurrent episodes of atrial fibrillation or atrial flutter causing disabling symptoms in patients without structural heart disease, to delay recurrence. - Paroxysmal supraventricular tachycardia (PSVT) causing disabling symptoms in patients without structural heart disease, to delay recurrence. - Documented life-threatening ventricular arrhythmias, such as sustained ventricular tachycardia. Treatment must begin in hospital.
Safety information
Side effects
Common side effects include an unusual taste, nausea or vomiting, dizziness, constipation, headache and tiredness. Slowing of the heart’s electrical signals is also among the most commonly reported effects. Other reported effects include blurred vision, weakness, tremor, loss of appetite, diarrhea and problems with balance or coordination. Propafenone can cause new or worsening abnormal heart rhythms, including life-threatening rhythms and sudden death. It can also cause heart failure, a slow heartbeat or heart block. Contact a doctor promptly if you develop palpitations, fainting, chest pain or shortness of breath. ECG monitoring is needed before and during treatment. Report fever, sore throat, chills or other signs of infection promptly: these may indicate a severe reduction in white blood cells. Other serious reported effects include liver injury, including fatal hepatitis, seizures, kidney failure, unusual bleeding or bruising, and worsening myasthenia gravis. Contact a doctor promptly if you develop these problems or worsening muscle weakness. Some reactions reported after approval have an uncertain frequency and cannot be definitively linked to propafenone.
FDA boxed warning
Mortality
In the National Heart, Lung, and Blood Institute's Cardiac Arrhythmia Suppression Trial (CAST), a long-term, multicenter, randomized, double-blind trial in subjects with asymptomatic non-life-threatening ventricular arrhythmias who had a myocardial infarction more than 6 days but less than 2 years previously, an increased rate of death or reversed cardiac arrest rate (7.7%; 56/730) was seen in subjects treated with encainide or flecainide (Class IC antiarrhythmics) compared with that seen in subjects assigned to placebo (3.0%; 22/725). The average duration of treatment with encainide or flecainide in this trial was 10 months.
The applicability of the CAST results to other populations (e.g., those without recent myocardial infarction) or other antiarrhythmic drugs is uncertain, but at present, it is prudent to consider any IC antiarrhythmic to have a significant proarrhythmic risk in patients with structural heart disease. Given the lack of any evidence that these drugs improve survival, antiarrhythmic agents should generally be avoided in patients with non-life-threatening ventricular arrhythmias, even if the patients are experiencing unpleasant, but not life-threatening, symptoms or signs.
- An increased rate of death or reversed cardiac arrest rate was seen in subjects treated with encainide or flecainide (Class IC antiarrhythmics) compared with that seen in subjects assigned to placebo. At present, it is prudent to consider any IC antiarrhythmic to have a significant risk of provoking proarrhythmic events in patients with structural heart disease.
A boxed warning is the strongest warning the US Food and Drug Administration requires on a medicine label. Text is taken from the official label, with internal section references removed.
When to call your doctor
If symptoms are severe or getting worse quickly, seek emergency care rather than waiting.
Before taking this medicine
Do not take propafenone if you have heart failure; cardiogenic shock (when the heart cannot pump enough blood); a slow heartbeat; very low blood pressure; known Brugada syndrome; a marked imbalance in blood electrolytes; conditions that cause narrowing or spasms of the airways; or severe obstructive lung disease. It must not be used for certain problems with the heart’s electrical signals, including sick sinus syndrome or heart block, unless an artificial pacemaker is present. Propafenone can cause new or worsening heart rhythm problems, including life-threatening rhythms and sudden death. ECG checks are needed before and during treatment. It may also reveal previously unrecognised Brugada syndrome, cause heart failure or slow electrical conduction through the heart. Extra monitoring is needed if you have liver or kidney problems, or an implanted pacemaker or defibrillator, as propafenone may affect how these devices work. It may worsen myasthenia gravis. Avoid use with other medicines that prolong the QT interval, including certain medicines for abnormal heart rhythms. Propafenone must not be used together with both a CYP2D6 inhibitor and a CYP3A4 inhibitor, as this can raise propafenone levels and increase the risk of heart rhythm problems. Grapefruit juice can also increase propafenone levels. Have your prescriber review other medicines and potential interactions. Report fever, sore throat, chills or other signs of infection promptly, as propafenone can cause a severe fall in certain white blood cells. Abnormal antinuclear antibody (ANA) blood test results require medical assessment; drug-induced lupus has also been reported.
Interactions
Grapefruit juice and certain medicines can increase propafenone levels and the risk of side effects, including new or worsening abnormal heart rhythms. Examples include paroxetine, fluoxetine, sertraline, desipramine, ritonavir, saquinavir, ketoconazole, erythromycin and cimetidine. Combining propafenone with medicines that block both the CYP2D6 and CYP3A4 enzymes should be avoided. Other notable interactions to discuss with your doctor include: - Amiodarone and quinidine: use with propafenone is not recommended or should be avoided because of effects on the heart’s electrical activity or increased propafenone levels. - Digoxin and warfarin: propafenone can increase their levels. Your doctor may need to monitor digoxin blood levels or INR and adjust treatment. - Propranolol and metoprolol: propafenone can increase their blood levels. - Rifampin: can lower propafenone levels. - Orlistat: may reduce propafenone absorption. Stopping orlistat suddenly has been linked to seizures, heart block and acute circulatory failure. Discuss any plan to stop it with your doctor. - Lidocaine: use together may increase lidocaine’s side effects on the brain and nervous system.
Using Rythmol
Dosing
Dosing is set by your prescriber. Each health care professional may prescribe medication differently according to a patient's medical history and condition, so follow the directions on your prescription label and speak to your doctor or pharmacist before changing anything.
Storage
Store below 25°C in a dry place, in the original pack, away from direct light and moisture. Do not keep it in a bathroom. Keep all medicines out of the sight and reach of children.
Clinical information on this page is summarised from the US FDA label PROPAFENONE HYDROCHLORIDE TABLET, FILM COATED [STRIDES PHARMA SCIENCE LIMITED] (DailyMed, retrieved 19 September 2026).
Patient information and references
Official and supporting information to read alongside advice from your prescriber or pharmacist.
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