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Bretylium Disease Interactions

There are 2 disease interactions with bretylium.

Major

Antiarrhythmics (applies to bretylium) cardiovascular dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Congestive Heart Failure, Hypotension

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

References

  1. Halkin H, Meffin P, Melmon KL, Rowland M (1975) "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther, 17, p. 669-76
  2. Crouthamel WG (1975) "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J, 90, p. 335-9
  3. Ravid S, Podrid PJ, Lampert S, Lown B (1989) "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol, 14, p. 1326-30
  4. Swiryn S, Kim SS (1983) "Quinidine-induced syncope." Arch Intern Med, 143, p. 314-6
  5. Gottlieb SS, Packer M (1989) "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J, 118, p. 611-2
  6. Ochs HR, Grube E, Greenblatt DJ, Arendt R (1981) "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol, 19, p. 173-6
  7. Prescott LF, Adjepon-Yamoah KK, Talbot RG (1976) "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J, 1, p. 939-41
  8. (2002) "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories
  9. (2002) "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals
  10. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
  11. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  12. (2001) "Product Information. Adenocard (adenosine)." Fujisawa
  13. (2001) "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim
  14. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M (1973) "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med, 78, p. 499-508
  15. Singh SN, Fletcher RD, Fisher SG, et al. (1995) "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med, 333, p. 77-82
  16. (2022) "Product Information. Cordarone (amiodarone)." Apothecon Inc
  17. (2001) "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn
View all 17 references
Moderate

Bretylium (applies to bretylium) renal dysfunction

Moderate Potential Hazard, High plausibility.

Bretylium is primarily eliminated by the kidney. Approximately 77% of bretylium is excreted in the urine unchanged. There are no known metabolites of bretylium. The serum concentration of bretylium is increased and the half-life prolonged in patients with renal impairment. Therapy with bretylium should be administered cautiously and the dosing interval increased in patients with compromised renal impairment. Clinical monitoring of cardiac function (ECG) and renal function is recommended. Bretylium is moderately removed during hemodialysis.

References

  1. Adir J, Narang PK, Josselson H, Sadler JH (1979) "Pharmacokinetics of bretylium in renal insufficiency." N Engl J Med, 300, p. 1390-1
  2. Josselson J, Narang PK, Adir J, Yacobi A, Sadler JH (1983) "Bretylium kinetics in renal insufficiency." Clin Pharmacol Ther, 33, p. 144-50
  3. Adir J, Narang PK, Josselson J (1985) "Nomogram for bretylium dosing in renal impairment." Ther Drug Monit, 7, p. 265-8
  4. Adir J, Narang PK, Josselson J, Sadler JH (1979) "Pharmacokinetics of bretylium in renal insufficiency." N Engl J Med, 300, p. 1390-1
  5. (2002) "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals
View all 5 references

Bretylium drug interactions

There are 22 drug interactions with bretylium.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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