Bretylium Disease Interactions

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

Bretylium is primarily eliminated by the kidney. Approximately 77% of bretylium is excreted in the urine unchanged. There are no known metabolites of bretylium. The serum concentration of bretylium is increased and the half-life prolonged in patients with renal impairment. Therapy with bretylium should be administered cautiously and the dosing interval increased in patients with compromised renal impairment. Clinical monitoring of cardiac function (ECG) and renal function is recommended. Bretylium is moderately removed during hemodialysis.