Drug interactions between Inderide and Tonocard

Results for the following 2 drugs:
Inderide (hydrochlorothiazide/propranolol)
Tonocard (tocainide)

Interactions between your selected drugs

propranolol ↔ tocainide

Applies to:Inderide (hydrochlorothiazide/propranolol) and Tonocard (tocainide)

MONITOR: The concomitant use of tocainide and beta-blockers may have additive effects on cardiac index, left ventricular function, and pulmonary wedge pressure. While significant interactions have not been reported in studies, cases of asystole have been reported in patients with preexisting electrophysiologic abnormalities after tocainide and metoprolol were coadministered. The mechanism is not known, but may be related to an additive effect on the sinus node or conduction system, especially in patients with sick sinus syndrome. Cases of confusion and paranoia have also been reported after coadministration of tocainide and propranolol.

MANAGEMENT: The concomitant use of tocainide and beta blockers should probably be avoided in patients with atrioventricular conduction abnormalities or sick sinus syndrome. This combination should be used cautiously in other patients, with careful dose titration and close clinical and electrocardiographic monitoring for efficacy and safety.

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.

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