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Drug Interactions between Angiografin and Procan SR

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

procainamide diatrizoate

Applies to: Procan SR (procainamide) and Angiografin (diatrizoate)

MONITOR: The use of iodine-containing contrast media for coronary angiography in patients treated with certain antiarrhythmics such as amiodarone may result in significant prolongation of the QT interval. These contrast agents can be arrhythmogenic when injected into the coronary arteries and may have additive effects on cardiac repolarization when coadministered with antiarrhythmic agents that prolong the QT interval. In a retrospective study of patients who underwent cardiac catheterization at a German hospital, 21 patients who had been receiving long-term amiodarone therapy exhibited significantly increased QT interval 12 to 24 hours after catheterization compared to 21 age-matched controls who received cardiac catheterization without prior amiodarone or other QT prolonging treatment. In the amiodarone group, the QTc interval (i.e., QT interval corrected for heart rate) increased on average by 10% from 433 ms to 480 ms. QTc prolongation exceeding 500 ms did not occur in any of the amiodarone patients before catheterization but occurred in 6 patients after catheterization. No significant change was observed in the control group.

MANAGEMENT: Caution is advised if iodine-containing contrast media are used for coronary angiography in patients treated with class IA (e.g., disopyramide, quinidine, procainamide) or class III (e.g., amiodarone, dofetilide, ibutilide, sotalol) antiarrhythmic agents. Increased surveillance and ECG monitoring may be appropriate. Patients who receive outpatient angiographies should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of arrhythmia such as dizziness, palpitations, or syncope.

References

  1. Goernig M, Kirmeier T, Krack A, Hartog CS, Figulla HR, Leder U "Iohexol contrast medium induces QT prolongation in amiodarone patients." Br J Clin Pharmacol 58 (2004): 96-98

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Drug and food interactions

Minor

procainamide food

Applies to: Procan SR (procainamide)

Ethanol may increase the acetylation of procainamide. Subtherapeutic plasma levels of procainamide may result in some patients. Because the acetylated metabolite of procainamide also possesses antiarrhythmic properties, the clinical effects are unclear.

References

  1. Olsen H, Morland J "Ethanol-induced increase in procainamide acetylation in man." Br J Clin Pharmacol 13 (1982): 203-8

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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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.