Drug interactions between Inderide and Norpace
| Results for the following 2 drugs: |
|---|
| Inderide (hydrochlorothiazide/propranolol) |
| Norpace (disopyramide) |
Interactions between your selected drugs
propranolol ↔ disopyramide
Applies to:Inderide (hydrochlorothiazide/propranolol) and Norpace (disopyramide)
GENERALLY AVOID: Due to its potent negative inotropic and chronotropic effects, disopyramide has been associated with severe hypotension, syncope, severe bradycardia, asystole, and heart failure when used with beta-blockers. Fatalities have been reported. In addition, QT interval prolongation and excessive QRS complex widening may occur with concurrent administration of disopyramide and beta-blockers in the treatment of arrhythmias. Some beta-blockers have also been reported to decrease the clearance of disopyramide. No significant drug interaction was reported when disopyramide was coadministered with oral propranolol in healthy subjects.
MONITOR CLOSELY: The use of disopyramide has been associated with rare cases of significant hypoglycemia. Since beta-blockers may inhibit some of the normal physiologic response to hypoglycemia, glucoregulatory mechanisms (in the absence of food) may be compromised. Specifically, inhibition of catecholamine-mediated glycogenolysis and glucose mobilization in association with beta-blockade can potentiate the hypoglycemia and delay recovery of normal blood glucose levels. In addition, symptoms of hypoglycemia such as tremors and tachycardia may be absent, making it more difficult for patients to recognize an oncoming episode. These effects may be more likely with noncardioselective beta-blockers (e.g., propranolol, pindolol, timolol) but may occasionally also occur with relatively beta-1 selective agents (e.g., atenolol, metoprolol), particularly at higher dosages.
MANAGEMENT: The use of disopyramide in combination with beta-blockers should generally be avoided unless the benefits are anticipated to outweigh the risks. Close monitoring of cardiac output, blood pressure, heart rate, and/or ECG is recommended if these drugs must be used together. Patients should be advised to seek medical attention if they experience dizziness, lightheadedness, syncope, palpitations, slow or fast pulse, or irregular heartbeats.
disopyramide ↔ hydrochlorothiazide
Applies to:Norpace (disopyramide) and Inderide (hydrochlorothiazide/propranolol)
GENERALLY AVOID: Disopyramide can cause dose-related prolongation of the QT interval. Theoretically, coadministration with agents that can produce hypokalemia and/or hypomagnesemia (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins, stimulant laxatives) may result in elevated risk of ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, because of additive arrhythmogenic potential.
MANAGEMENT: Coadministration of disopyramide with medications that can cause potassium and/or magnesium disturbances should generally be avoided. Serum electrolytes should be evaluated and any abnormalities corrected prior to initiating therapy with disopyramide. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsades de pointes such as dizziness, palpitations, or syncope.
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.
