Disopyramide Side Effects

Not all side effects for disopyramide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to disopyramide: oral capsule, oral capsule extended release, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by disopyramide. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking disopyramide, check with your doctor or nurse as soon as possible:

More common
  • Dizziness, feeling of faintness
  • fainting
  • heartbeat sensations
  • shortness of breath
  • unusual tiredness
Less common
  • Chest pain
  • fast or slow heartbeat, rapid weight gain, swelling of feet or lower legs
  • lightheadedness
  • rash and/or itching
Rare
  • Enlargement of breasts in men
  • fever
  • mental depression
  • nosebleeds or bleeding gums
  • sore throat and fever
  • yellow eyes or skin
Signs and symptoms of hypoglycemia (low blood sugar)
  • Anxious feeling
  • chills
  • cold sweats
  • confusion
  • cool, pale skin
  • drowsiness
  • fast heartbeat
  • headache
  • hunger (excessive)
  • nausea
  • nervousness
  • shakiness
  • unsteady walk
  • unusual tiredness or weakness

Some of the side effects that can occur with disopyramide may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Blurred vision
  • constipation
  • dry eyes, mouth, nose, or throat
  • problems with urination
Less common
  • Bloating or stomach pain
  • diarrhea
  • headache
  • impotence
  • loss of appetite
  • muscle weakness
  • nausea
  • nervousness
  • trouble in sleeping

For Healthcare Professionals

Applies to disopyramide: compounding powder, oral capsule, oral capsule extended release

Gastrointestinal

Gastrointestinal side effects including anticholinergic side effects have been the most common cause of gastrointestinal complaints. Dry mouth (40%), constipation (11%) and nausea, pain/bloating/gas (3% to 9%) have been reported. Anorexia, diarrhea, and vomiting have occurred. Two cases of paralytic ileus have been reported. A case of oral mucosal ulceration has been associated with the (unapproved) sublingual use of disopyramide.[Ref]

Cardiovascular

Cardiovascular side effects have included arrhythmias, conduction disturbances, hypotension, and heart failure. Like other class I antiarrhythmic agents, disopyramide can be proarrhythmic and decrease cardiac contractility. The risk of proarrhythmias may be increased in patients with left ventricular dysfunction. Various ventricular tachyarrhythmias accompanied by disopyramide-induced QT interval prolongation, including ventricular tachycardia or fibrillation and torsades de pointes, have been associated with usual therapeutic doses. Evidence of QRS segment or QT widening are indications to either reduce the dose or stop the drug. Conduction disturbances, including AV block, have occurred, and are more likely in patients with preexisting conduction disorders.[Ref]

Contributing factors towards the development of torsades de pointes included female gender, hypokalemia, underlying arrhythmias, mitral valve abnormalities, or congestive heart failure.

Hypotension, pulmonary edema, and frank cardiogenic shock have been associated with both the oral and intravenous administration of disopyramide. Most affected patients had underlying congestive heart failure.[Ref]

Nervous system

A patient developed a severe sensory-motor polyneuropathy after receiving disopyramide 500 mg daily for 4 years. Symptoms did not respond to corticosteroids, but did resolve a few months after withdrawal of disopyramide.[Ref]

Nervous system side effects including anticholinergic symptoms have been reported. Other nervous system side effects have been rare, and included nervousness, insomnia, depression, and peripheral paresthesia or neuropathy.[Ref]

Genitourinary

Genitourinary side effects were related to anticholinergic properties of the drug. Urinary hesitancy (10% to 40%) has occurred. Urinary retention, frequency, and urgency has been reported in up to 9% of patients. Recommended management consisted of lowering the dose, discontinuing the drug, or if necessary, using a cholinergic drug to counteract this effect. Sexual impotence has been reported.[Ref]

Hepatic

Hepatic side effects including reversible, dose-independent intrahepatic cholestasis, hepatocellular damage, and nonspecific hepatic inflammatory changes have been reported in rare cases where venous congestion secondary to heart failure was reasonably excluded. Manifestations of liver dysfunction usually appeared during the first week of treatment (malaise, dark urine) and resolved promptly upon discontinuation of the drug. In one review, 20 cases were reported during a 14-year period.[Ref]

Endocrine

Endocrine side effect have included hypoglycemia due to stimulation of insulin secretion and rare cases of hypokalemia and dyslipidemia. Hypoglycemia can occur in nondiabetic patients at therapeutic plasma disopyramide levels.[Ref]

Elevated insulin levels have been measured during disopyramide-associated hypoglycemic episodes. Data have revealed that disopyramide blocks pancreatic ATP-sensitive potassium channels, enhancing insulin release. Other factors such as increased peripheral utilization of glucose or decreased glycogenolysis have not been fully evaluated.[Ref]

Immunologic

Immunologic side effects, such as the production of antinuclear antibodies and other immunologically-mediated changes associated with other class 1 antiarrhythmic agents, do not appear to occur during disopyramide therapy.[Ref]

Dermatologic

Dermatologic reactions have been reported rarely, usually presenting as a rash or pruritus.[Ref]

Ocular

Ocular side effects of blurred vision (3% to 9%) have been associated with the anticholinergic effects of disopyramide.[Ref]

General

General body symptoms of fatigue, muscle weakness, malaise, and aches/pains have been reported in 3% to 9% of patients administered disopyramide. Rarely, fever has occurred.[Ref]

Psychiatric

Psychiatric side effects including reversible psychiatric symptoms of psychosis have been reported rarely.[Ref]

Hematologic

Hematologic adverse effects of thrombocytopenia, and reversible agranulocytosis have occurred rarely.[Ref]

Other

Gynecomastia has been reported.[Ref]

Respiratory

Respiratory difficulty has been reported rarely.[Ref]

References

1. Witkowsky AK, Reddy R, Bardy GH "Oral mucosal ulceration from disopyramide." Ann Pharmacother 29 (1995): 1299

2. Ekelund LG, Nilsson E, Walldius G "Efficacy of and adverse effects of disopyramide." Eur J Clin pharmacol 29 (1986): 673-7

3. Fulton B, Wagstaff AJ, Sorkin EM "Doxazosin: an update of its clinical pharmacology and therapeutic applications in hypertension and benign prostatic hyperplasia." Drugs 2 (1995): 295-320

4. Ahmad S "Disopyramide-related paralytic ileus: case report." J Am Geriatr Soc 39 (1991): 317-8

5. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.

6. Desai JM, Scheinman MM, Hirschfeld D, et al "Cardiovascular collapse associated with disopyramide therapy." Chest 79 (1981): 545-51

7. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8

8. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146

9. Brogden RN, Todd PA "Disopyramide: a reappraisal of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiac arrhythmias." Drugs 34 (1987): 151-87

10. Bauman JL, Gallasategui J, Strasberg B, et al "Long-term therapy with disopyramide phosphate: side effects and effectiveness." Am Heart J 111 (1986): 654-60

11. Simpson RJ, Foster JR, Benge C, et al "Safety of multiple bolus loading of intravenous disopyramide." Am Heart J 106 (1983): 505-8

12. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4

13. Lo KS, Gantz KB, Stetson PL, et al "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4

14. Bauman DJ "Myocardial depression with disopyramide." Ann Intern Med 94 (1981): 411-2

15. Timins BI, Gutman JA, Haft JI "Disopyramide-induced heart block." Chest 79 (1981): 477-9

16. Sinatra ST, Landry AB, Galle JS, Amato J "Cariogenic shock associated with disopyramide phosphate." JAMA 243 (1980): 1132

17. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7

18. Masuhara K, Ohno T, Hamaguchi K, Katoh K, Kashiwada K, Takahashi S, Tanaka Y, Someya K, Ogata H "Relationship between the therapeutic effects or side-effects and the serum disopyramide or mono-n-dealkylated disopyramide concentration after repeated oral administration of disopyramide to arrhythmic patients." Int J Clin Pharmacol Res 15 (1995): 103-13

19. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1

20. Porterfield JG, Antman EM, Lown B "Respiratory difficulty after use of disopyramide." N Engl J Med 303 (1980): 584

21. Podrid PJ, Schoeneberger A, Lown B "Congestive heart failure caused by oral disopyramide." N Engl J Med 302 (1980): 614-7

22. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7

23. Timins BI "Disopyramide and bundle-branch block." Ann Intern Med 96 (1982): 684

24. Tonkin AM, Joel SE, Reynolds JL "Unusual hepatocellular and cardiovascular complications of disopyramide." Chest 77 (1980): 125

25. Teichman SL, Ferrick A, Kim SG, et al "Disopyramide-pyridostigmine interaction: selective reversal of anticholinergic symptoms with preservation of antiarrhythmic effect." J AM Coll Cardiol 10 (1987): 633-41

26. Briani C, Zara G, Negrin P "Disopyramide-induced neuropathy." Neurology 58 (2002): 663

27. Teichman SL, Fisher JD, Matos JA, Kim SG "Disopyramide-pyridostigmine: report of a beneficial drug interaction." J Cardiovasc Pharmacol 7 (1985): 108-13

28. Ahmad S "Disopyramide and impotence." South Med J 73 (1980): 958

29. Danziger LH, Horn JR "Disopyramide-induced urinary retention." Arch Intern Med 143 (1983): 1683-6

30. Bakris GL, Cross PD, Hammarsten JE "Disopyramide-associated liver dysfunction." Mayo Clin proc 58 (1983): 265-7

31. Doody PT "Disopyramide hepatotoxicity and disseminated intravascular coagulation." South Med J 75 (1982): 496-8

32. Craxi A, Gatto G, Maringhini A, et al "Disopyramide and cholestasis." Ann Intern Med 93 (1980): 150-1

33. Antonelli D, Koltun B, Barzilay J "Acute hepatotoxic effect of disopyramide." Chest 86 (1984): 274

34. Semel JD, Wortham E, Karl DM "Fasting hypoglycemia associated with disopyramide." Am Heart J 106 (1983): 1160-1

35. Goldberg IJ, Brown LK, Rayfield EJ "Disopyramide (norpace)-induced hypoglycemia." Am J Med 69 (1980): 463-6

36. Rubin M, Zakheim B, Pitchumoni C "Disopyramide-induced profound hypoglycemia." N Y State J Med July,Aug,S (1983): 1057-8

37. Nappi JM, Dhanani S, Lovejoy JR, VanderArk C "Severe hypoglycemia associated with disopyramide." West J Med 138 (1983): 95-7

38. Croxson MS, Shaw DW, Henley PG, Gabriel HDLL "Disopyramide-induced hypoglycaemia and increased serum insulin." N Z Med J July (1987): 407-8

39. Quevedo SF, Krauss DS, Chazan JA, et al "Fasting hypoglycemia secondary to disopyramide therapy." JAMA 245 (1981): 2424

40. Hayashi S, Horie M, Tsuura Y, Ishida H, Okada Y, Seino Y, Sasayama S "Disopyramide blocks pancreatic ATP-sensitive K+ channels and enhances insulin release." Am J Physiol 265 (1993): c337-42

41. Wanner WR, Irvin WS "Disopyramide and antinuclear antibodies." Am Heart J 101 (1981): 687-9

Disclaimer: Every effort has been made to ensure that the information provided 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. This material does not endorse drugs, diagnose patients, or recommend therapy. This 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 combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information 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 substances you are taking, check with your doctor, nurse, or pharmacist.

Hide
(web3)