Drug interactions between Anzemet and Inderide
| Results for the following 2 drugs: |
|---|
| Anzemet (dolasetron) |
| Inderide (hydrochlorothiazide/propranolol) |
Interactions between your selected drugs
propranolol ↔ dolasetron
Applies to:Inderide (hydrochlorothiazide/propranolol) and Anzemet (dolasetron)
MONITOR CLOSELY: Dolasetron has been shown to cause dose-dependent prolongation of the PR and QRS intervals. There have been reports of second- and third-degree atrioventricular block, cardiac arrest, and serious ventricular arrhythmias including fatalities in both adult and pediatric patients. Theoretically, coadministration with other agents that prolong the PR interval (e.g., beta blockers; calcium channel blockers; some protease inhibitors such as atazanavir, lopinavir and saquinavir; digitalis; lacosamide; mefloquine; moricizine) or QRS interval (e.g., flecainide; moricizine; quinidine) may result in additive effects and increased risk of bradycardia and heart block. Other risk factors include underlying structural heart disease, preexisting conduction abnormalities, advanced age, sick sinus syndrome, atrial fibrillation with slow ventricular response, and myocardial ischemia. In a study of 80 healthy adult subjects, maximum mean difference in PR interval from placebo after baseline-correction was 9.8 ms and 33.1 ms for the 100 mg and supratherapeutic 300 mg dose of dolasetron, respectively. The maximum mean difference in QRS interval from placebo after baseline-correction was 3.5 ms for the 100 mg dose and 13 ms for the supratherapeutic 300 mg dose of dolasetron. Over 25% of the subjects treated with the 300 mg dose had an absolute PR over 200 ms and absolute QRS over 110 ms after treatment. A change from baseline of 25% or greater was noted in several of these subjects.
MANAGEMENT: Caution is advised if dolasetron is used concomitantly with other agents that prolong the PR or QRS interval, especially in the elderly and patients with known risk factors. An ECG should be obtained in these patients before initiating dolasetron and periodically during treatment. Patients should be advised to notify their physician if they experience dizziness, lightheadedness, fainting, or irregular heartbeat. Dolasetron should be avoided in patients with complete heart block or at risk for complete heart block, unless they have an implanted pacemaker.
hydrochlorothiazide ↔ dolasetron
Applies to:Inderide (hydrochlorothiazide/propranolol) and Anzemet (dolasetron)
MONITOR CLOSELY: The risk of arrhythmia may be increased in patients taking dolasetron and diuretics. Dolasetron induced ECG changes (PR and QTc prolongation; QRS widening) have been observed in healthy volunteers and in controlled clinical trials. Diuretics may further predispose the patient to arrhythmia by inducing electrolyte abnormalities.
MANAGEMENT: Close clinical and laboratory monitoring for cardiac rhythm and electrolyte disturbances is recommended if this combination is used.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| 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. |
Do not stop taking any medications without consulting your healthcare provider.
Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. Multum's drug information does not endorse drugs, diagnose patients, or recommend therapy. Multum's drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2012 Multum Information Services, Inc. The information in contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.
