Drug interactions between Inderide and Multaq
| Results for the following 2 drugs: |
|---|
| Inderide (hydrochlorothiazide/propranolol) |
| Multaq (dronedarone) |
Interactions between your selected drugs
hydrochlorothiazide ↔ dronedarone
Applies to:Inderide (hydrochlorothiazide/propranolol) and Multaq (dronedarone)
MONITOR CLOSELY: Dronedarone may cause dose-related prolongation of the QT interval. Since hypokalemia and hypomagnesemia are known risk factors for arrhythmia associated with QT prolongation, coadministration of dronedarone with agents that can cause significant potassium and/or magnesium loss (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins) may increase the risk of ventricular arrhythmias such as torsade de pointes and sudden death.
MANAGEMENT: Caution is advised if dronedarone must be used concomitantly with medications that can cause significant potassium and/or magnesium loss. Serum electrolytes should be evaluated at baseline and at regular intervals throughout the duration of therapy. Any abnormalities should be corrected prior to initiating therapy, and levels should be maintained within the normal range during treatment. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope. Dronedarone should be discontinued if QTc Bazett interval increases to 500 ms or greater.
propranolol ↔ dronedarone
Applies to:Inderide (hydrochlorothiazide/propranolol) and Multaq (dronedarone)
MONITOR: Coadministration with dronedarone may increase the plasma concentrations of some beta-blockers. The mechanism is dronedarone inhibition of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of beta-blockers like metoprolol and propranolol. According to the product labeling, dronedarone increased metoprolol systemic exposure (AUC) by 1.6-fold and propranolol AUC by 1.3-fold. Pharmacodynamically, beta-blockers can potentiate the depressant effects of dronedarone on the sinus and AV nodes. In clinical trials, bradycardia was more frequently observed when dronedarone was given in combination with beta-blockers.
MANAGEMENT: Caution is advised if dronedarone is coadministered with a beta-blocker, including ophthalmic formulations. The dosage of the beta-blocker should start low and increased only after ECG verification of good tolerability. Patients should be advised to promptly report potential symptoms of toxicity such as excessive fatigue, fainting, difficulty breathing, chest pain or tightness, bradycardia, or arrhythmia.
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.
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