Skip to Content

Quin-Release (quinidine) Disease Interactions

There are 7 disease interactions with Quin-Release (quinidine):

Major

Antiarrhythmics (applies to Quin-Release) cardiovascular dysfunction

Major Potential Hazard, Moderate plausibility. Applicable conditions: Hypotension, Congestive Heart Failure

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.

References

  1. Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
  2. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
  3. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  5. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
  6. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  7. Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
  8. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  9. Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
  10. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  11. Singh SN, Fletcher RD, Fisher SG, et al. "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med 333 (1995): 77-82
  12. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
  14. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  15. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  16. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  17. Prescott LF, Adjepon-Yamoah KK, Talbot RG "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J 1 (1976): 939-41
View all 17 references
Major

Antiarrhythmics (applies to Quin-Release) proarrhythmic effects

Major Potential Hazard, High plausibility. Applicable conditions: Arrhythmias, Abnormal Electrocardiogram

Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.

References

  1. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
  2. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  3. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals, Wilmington, DE.
  4. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
  5. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
  6. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  8. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
  9. Lo KS, Gantz KB, Stetson PL, et al "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
  10. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  11. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
  12. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
  13. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
  14. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
  15. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
  16. Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
  17. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7
  18. Hii JT, Wyse DG, Gillis AM, et al "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
  19. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
  20. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  21. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
  22. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
  23. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
  24. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
  25. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
  26. Damle R, Levine J, Matos J, et al "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
  27. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  28. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  29. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
  30. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  31. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
  32. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
  33. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
  34. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
  35. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  36. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  37. Au PK, Bhandari AK, Bream R, et al "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
  38. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
  39. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
  40. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  41. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
  42. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
  43. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
  44. Strasberg B, Sclarovsky S, Erdberg A, et al "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
  45. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
  46. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
  47. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
  48. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
  49. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
  50. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
  51. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  52. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  53. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
  54. 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
  55. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
  56. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  57. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
  58. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
  59. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
  60. Bauman JL, Bauernfeind RA, Hoff JV, et al "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
  61. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
  62. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
View all 62 references
Major

Quinidine (applies to Quin-Release) anticholinergic activity

Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Myasthenia Gravis, Urinary Retention

The use of quinidine is contraindicated in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as myasthenia gravis, glaucoma, and urinary retention or obstruction.

References

  1. Fisher CM "Visual disturbances associated with quinidine and quinine." Neurology 31 (1981): 1569-71
  2. Stoffer SS, Chandler JH "Quinidine-induced exacerbation of myasthenia gravis in patient with Graves' disease ." Arch Intern Med 140 (1980): 283-4
  3. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
View all 4 references
Major

Quinidine (applies to Quin-Release) sinus-AV node dysfunction

Major Potential Hazard, High plausibility. Applicable conditions: Heart Block

The use of quinidine is contraindicated for use in patients without a functioning artificial pacemaker whose cardiac rhythm is dependent upon a junctional or idioventricular pacemaker, including patients with complete AV block. Therapy with quinidine should be administered with caution in patients with severe sinus-node dysfunction such as sick sinus syndrome, bradycardia-tachycardia syndrome, or second- or third-degree heart block.

References

  1. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
Moderate

Antiarrhythmics (applies to Quin-Release) electrolyte imbalance

Moderate Potential Hazard, High plausibility. Applicable conditions: Hyperkalemia, Hypokalemia, Magnesium Imbalance

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

References

  1. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  3. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  4. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  5. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  7. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  8. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  10. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  11. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  12. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 13 references
Moderate

Quinidine (applies to Quin-Release) liver dysfunction

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

Quinidine is primarily metabolized by the liver to active and inactive forms. Hepatic dysfunction causes a slowed metabolism and elimination of the drug which can lead to quinidine toxicity if dosage is not appropriately reduced. Clinical monitoring of hepatic function is recommended.

References

  1. Affrime M, Reidenberg MM "The protein binding of some drugs in plasma from patients with alcoholic liver disease." Eur J Clin Pharmacol 8 (1975): 267-9
  2. Handler SD, Hirsch NR, Haas K, Davidson FZ "Quinidine hepatitis." Arch Intern Med 135 (1975): 871-2
  3. Debruyne D, Gram LF, Grollier G, et al "Quinidine disposition in relation to antipyrine elimination and debrisoquine phenotype in alcoholic patients with and without cirrhosis." Int J Clin Pharmacol Res 9 (1989): 319-25
  4. Knobler H, Levij IS, Gavish D, Chajek-Shaul T "Quinidine-induced hepatitis: a common and reversible hypersensitivity reaction." Arch Intern Med 146 (1986): 526-8
  5. Deisseroth A, Morganroth J, Winokur S "Quinidine-induced liver disease." Ann Intern Med 77 (1972): 595-7
  6. Bramlet DA, Posalaky Z, Olson R "Granulomatous hepatitis as a manifestation of quinidine hypersensitivity." Arch Intern Med 140 (1980): 395-7
  7. Hogan DB, Morin J, Crilly RG "Unusual hepatotoxic reaction to quinidine ." Can Med Assoc J 130 (1984): 973
  8. Chajek T, Lehrer B, Geltner D, Levij IS "Quinidine-induced granulomatous hepatitis." Ann Intern Med 81 (1974): 774-6
  9. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. Herman JE, Bassan HM "Liver injury due to quinidine." JAMA 234 (1975): 310-11
View all 10 references
Moderate

Quinidine (applies to Quin-Release) renal dysfunction

Moderate Potential Hazard, High plausibility.

Renal dysfunction causes a slowed elimination of quinidine which can lead to quinidine toxicity if dosage is not appropriately reduced. Therapy with quinidine should be administered cautiously and dosages reduced in patients with compromised renal function. Quinidine is not appreciably removed by hemodialysis.

References

  1. Chin TW, Pancorbo S, Comty C "Quinidine pharmacokinetics in continuous abulatory peritoneal dialysis." Clin Exp Dial Apheresis 5 (1981): 391-7
  2. Woie L, Oyri A "Quinidine intoxication treated with hemodialysis." Acta Med Scand 195 (1974): 237-9
  3. Perez-Mateo M, Erill S "Protein binding of salicylate and quinidine in plasma from patients with renal failure, chronic liver disease and chronic respiratory insufficiency." Eur J Clin Pharmacol 11 (1977): 225-31
  4. Bellet S, Roman LR, Boza A "Relation between serum quinidine levels and renal function." Am J Cardiol 27 (1971): 368-71
  5. Kessler KM, Lowenthal DT, Warner H, et al "Quinidine elimination in patients with congestive heart failure or poor renal function." N Engl J Med 290 (1974): 706-9
  6. Quin J, Adamski M, Howlin K, et al "Quinidine-induced allergic granulomatous angiitis: an unusual cause of acute renal failure." Med J Aust 148 (1988): 145-6
  7. Levy R, Sellers A, Mandel WJ, et al "Quinidine pharmacokinetics in anephric and normal subjects (abstract)." Clin Res 24 (1976): a85
  8. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  9. Kessler KM, Perez GO "Decreased quinidine plasma protein binding during hemodialysis." Clin Pharmacol Ther 30 (1981): 121-6
  10. Reimold EW, Reynolds WJ, Fixler DE, McElroy L "Use of hemodialysis in the treatment of quinidine poisoning." Pediatrics 52 (1973): 95-9
View all 10 references

Quin-Release (quinidine) drug interactions

There are 529 drug interactions with Quin-Release (quinidine)

Quin-Release (quinidine) alcohol/food interactions

There is 1 alcohol/food interaction with Quin-Release (quinidine)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.