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Can you take Bitolterol with Disopyramide?

1 drug interaction and 23 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

disopyramide bitolterol

Applies to: disopyramide and bitolterol

Using bitolterol together with disopyramide can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect.

You may be more susceptible if you have:

  • a heart condition called congenital long QT syndrome
  • other cardiac diseases
  • conduction abnormalities
  • electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)

The risk may exist even when bitolterol or similar medications are given by oral inhalation directly into the lungs, and more so if these products are overused. Do not exceed the dose and frequency of use recommended on the product label or prescribed by your doctor.

Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.

You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

disopyramide Food/Lifestyle

Applies to: disopyramide

Grapefruit juice may increase the blood levels of certain medications such as disopyramide.

You may want to limit your consumption of grapefruit and grapefruit juice during treatment with disopyramide. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication.

Contact your doctor if your condition changes or you experience increased side effects.

Orange juice is not expected to interact.

Moderate:

bitolterol Caffeine

Applies to: bitolterol

Both bitolterol and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.

Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.

Contact your doctor if your condition changes or you experience increased side effects.

It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Minor food/lifestyle interactions

Minor:

disopyramide Alcohol (Ethanol)

Applies to: disopyramide

Information for this minor interaction is available on the professional version.

Disease interactions

20 potential interactions Applies to: 18 conditions, including High Blood Pressure, Heart Failure, Seizures, Hypokalemia, and Hypotension.

Cardiogenic Shock

Major:

disopyramide

Disopyramide has a major potential interaction with Cardiogenic Shock.

The use of disopyramide is contraindicated in patients with cardiogenic shock, second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation. Therapy with disopyramide should be administered with extreme caution in patients with sick sinus syndrome (bradycardia-tachycardia), Wolff-Parkinson White syndrome, or bundle-branch block. The effect of disopyramide in these conditions has not been determined.

Diabetes Mellitus

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Diabetes Mellitus.

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with Diabetes Mellitus.

Rare cases of hypoglycemia have been reported during administration of disopyramide. Therapy with disopyramide should be administered cautiously in patients with diabetes mellitus or other conditions that alter normal glucoregulatory mechanisms such as chronic malnutrition, congestive heart failure, renal or hepatic dysfunction, or drugs (beta blockers).

Glaucoma/Intraocular Hypertension

Major:

disopyramide

Disopyramide has a major potential interaction with Glaucoma/Intraocular Hypertension.

Disopyramide has anticholinergic activity, and therapy with disopyramide should be administered with extreme caution in patients who may be adversely affected by this. Disopyramide should not be used in patients with glaucoma, myasthenia gravis, or urinary retention unless adequate overriding measures are taken.

Heart Block

Major:

disopyramide

Disopyramide has a major potential interaction with Heart Block.

The use of disopyramide is contraindicated in patients with cardiogenic shock, second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation. Therapy with disopyramide should be administered with extreme caution in patients with sick sinus syndrome (bradycardia-tachycardia), Wolff-Parkinson White syndrome, or bundle-branch block. The effect of disopyramide in these conditions has not been determined.

Heart Disease

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Heart Disease.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Heart Failure

Major:

disopyramide

Disopyramide has a major potential interaction with 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.

High Blood Pressure

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with High Blood Pressure.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Hyperkalemia

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with Hyperkalemia.

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.

Hyperthyroidism

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Hyperthyroidism.

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

Hypokalemia

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Hypokalemia.

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with Hypokalemia.

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.

Hypotension

Major:

disopyramide

Disopyramide has a major potential interaction with Hypotension.

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.

Liver Disease

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with Liver Disease.

Disopyramide is partially metabolized by the liver. The plasma half-life of disopyramide is prolonged in patients with hepatic dysfunction. Therapy with disopyramide should be administered cautiously and dosages reduced in patients with compromised hepatic function. Clinical monitoring of cardiac function (ECG) and hepatic function is recommended.

Long QT Syndrome

Major:

disopyramide

Disopyramide has a major potential interaction with Long QT Syndrome.

The use of disopyramide is contraindicated in patients with cardiogenic shock, second- or third-degree AV block in the absence of a functional artificial pacemaker, or congenital QT prolongation. Therapy with disopyramide should be administered with extreme caution in patients with sick sinus syndrome (bradycardia-tachycardia), Wolff-Parkinson White syndrome, or bundle-branch block. The effect of disopyramide in these conditions has not been determined.

Magnesium Imbalance

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with 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.

Myasthenia Gravis

Major:

disopyramide

Disopyramide has a major potential interaction with Myasthenia Gravis.

Disopyramide has anticholinergic activity, and therapy with disopyramide should be administered with extreme caution in patients who may be adversely affected by this. Disopyramide should not be used in patients with glaucoma, myasthenia gravis, or urinary retention unless adequate overriding measures are taken.

Renal Dysfunction

Moderate:

disopyramide

Disopyramide has a moderate potential interaction with Renal Dysfunction.

Disopyramide is primarily eliminated by the kidney. Approximately 50% of disopyramide is excreted in the urine as unchanged drug. The serum concentration of disopyramide is increased and the elimination half-life is prolonged in patients with renal impairment. Patients with renal impairment may be at increased risk of disopyramide-associated toxicity such as hypotension, conduction disturbances, or worsening of congestive heart failure. Therapy with disopyramide should be administered cautiously and dosage and/or frequency of administration modified in patients with compromised renal function. Clinical monitoring of cardiac function (ECG) and renal function is recommended.

Seizures

Moderate:

bitolterol

Bitolterol has a moderate potential interaction with Seizures.

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

Urinary Retention

Major:

disopyramide

Disopyramide has a major potential interaction with Urinary Retention.

Disopyramide has anticholinergic activity, and therapy with disopyramide should be administered with extreme caution in patients who may be adversely affected by this. Disopyramide should not be used in patients with glaucoma, myasthenia gravis, or urinary retention unless adequate overriding measures are taken.

More resources

bitolterol

A total of 396 drugs are known to interact with bitolterol.

disopyramide

A total of 623 drugs are known to interact with disopyramide.

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.