Two medicines, side by side
Flecainide vs propafenone
Flecainide has no indication this site maps; propafenone for atrial fibrillation. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of flecainide since 1985 and of propafenone since 1989. Pharmacies paid $0.171 per flecainide acetate 100 mg tablet and $0.115 per propafenone HCl 150 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Only the propafenone label carries a boxed warning.
Check it at the source: the flecainide FDA label on DailyMed (effective June 11, 2026); the propafenone FDA label on DailyMed (effective September 1, 2025).
Highlights of the flecainide record
Flecainide (Tambocor) · label of June 11, 2026
Used for
From the label: indicationsIn patients without structural heart disease, flecainide is indicated for the prevention of - paroxysmal supraventricular tachycardias (PSVT), including atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia and other supraventricular tachycardias of unspecified mechanism associated with disabling symptoms - paroxysmal atrial fibrillation/flutter (PAF) associated with disabling symptoms. […]
On the market
- Earliest approval on file
- October 31, 1985
- Generic labelers
- 15 labelers
- Pharmacy cost
- $0.171 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Highlights of the propafenone record
Propafenone (Rythmol) · label of September 1, 2025
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).
Used for
From the label: indicationsPropafenone hydrochloride tablets are indicated to: prolong the time to recurrence of paroxysmal atrial fibrillation/flutter (PAF) associated with disabling symptoms in patients without structural heart disease. prolong the time to recurrence of paroxysmal supraventricular tachycardia (PSVT) associated with disabling symptoms in patients without structural heart disease. treat documented ventricular arrhythmias, such as sustained ventricular tachycardia that, in the judgment of the physician, are life-threatening. […]
On the market
- Earliest approval on file
- November 27, 1989
- Generic labelers
- 14 labelers
- Pharmacy cost
- $0.115 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Flecainide label of June 11, 2026, Propafenone label of September 1, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do flecainide and propafenone differ on the record?
Only the propafenone label carries a boxed warning.
Both are in FDA's class antiarrhythmics.
Half-life, in each label's words: Flecainide, “The apparent plasma half-life averages about 20 hours and is quite variable (range, 12 to 27 hours) after multiple oral …”; Propafenone, “The average distribution half-life corresponding to the first phase was about 5 minutes.”
Generics: flecainide since 2001; propafenone since 2000 (Drugs@FDA).
| Flecainide | Propafenone | |
|---|---|---|
| Labeled for | n/a | Atrial fibrillation |
| Pharmacologic class | Antiarrhythmic | Antiarrhythmic |
| How it works (label) | n/a | Propafenone is a Class 1C antiarrhythmic drug with local anesthetic effects, and a direct stabilizing action on myocardial membranes. |
| Half-life (label) | The apparent plasma half-life averages about 20 hours and is quite variable (range, 12 to 27 hours) after multiple oral doses in patients with premature ventricular contractions (PVCs). | The average distribution half-life corresponding to the first phase was about 5 minutes. |
| Earliest approval on file (Drugs@FDA) | October 31, 1985 | November 27, 1989 |
| First generic approved | July 31, 2001 | October 24, 2000 |
| Generic labelers (NDC) | 15 labelers | 14 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.171 per tablet (Flecainide acetate 100 mg tablet) | $0.115 per tablet (Propafenone HCl 150 mg tablet) |
| 12-month price change | -4% | +2% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 2 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,246 | 4,209 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Propafenone label, boxed warningAn 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.
Source: FDA drug labels via openFDA
What next?
- Alternatives to flecainide
- every medicine labeled for the same conditions