Drug Interactions between brimonidine / dorzolamide / latanoprost / timolol ophthalmic and flecainide
This report displays the potential drug interactions for the following 2 drugs:
- brimonidine/dorzolamide/latanoprost/timolol ophthalmic
- flecainide
Interactions between your drugs
flecainide timolol ophthalmic
Applies to: flecainide and brimonidine / dorzolamide / latanoprost / timolol ophthalmic
MONITOR: Beta-blockers and flecainide may have additive negative inotropic effects. Areas under the curve were increased for both drugs and negative inotropic effects occurred when flecainide and propranolol were given to normal subjects. A case of bradycardia, atrioventricular block and cardiac arrest has been reported after sotalol was added to flecainide; however, causality was not definitely determined.
MANAGEMENT: Careful monitoring of the patient's hemodynamic status is recommended during concomitant administration. The same precaution should be observed when beta blocker ophthalmic solutions are used, since they are systemically absorbed and can produce clinically significant systemic effects even at low or undetectable plasma levels. Patients should be advised to promptly report symptoms such as dizziness, slow or irregular heartbeats, syncope, or palpitations.
References
- Warren R, Vohra J, Hunt D, Hamer A (1990) "Serious interactions of sotalol with amiodarone and flecainide." Med J Aust, 152, p. 277
- Holtzman JL, Kvam DC, Berry DA, et al. (1987) "The pharmacodynamic and pharmacokinetic interaction of flecainide acetate with propranolol: effects on cardiac function and drug clearance." Eur J Clin Pharmacol, 33, p. 97-9
- Lewis GP, Holtzman JL (1984) "Interaction of flecainide with digoxin and propranolol." Am J Cardiol, 53, b52-7
- Myerburg RJ, Kessler KM, Cox MM, et al. (1989) "Reversal of proarrhythmic effects of flecainide acetate and encainide hydrochloride by propranolol." Circulation, 80, p. 1571-9
- Minish T, Herd A (2002) "Symptomatic bradycardia secondary to interaction between topical timolol maleate, verapamil, and flecainide: a case report." J Emerg Med, 22, p. 247-9
timolol ophthalmic brimonidine ophthalmic
Applies to: brimonidine / dorzolamide / latanoprost / timolol ophthalmic and brimonidine / dorzolamide / latanoprost / timolol ophthalmic
MONITOR: Topically administered alpha-2 adrenergic receptor agonists such as apraclonidine and brimonidine are systemically absorbed, with the potential for producing rare but clinically significant systemic effects such as hypotension and bradycardia. The possibility for an additive or potentiating effect on blood pressure and heart rate should be considered when used with other medications that affect these parameters, such as ophthalmic and systemic beta blockers, vasodilators, cardiac glycosides, and antihypertensive agents.
MANAGEMENT: Blood pressure and pulse rate should be monitored regularly when topical alpha-2 adrenergic receptor agonists are prescribed in combination with cardiovascular drugs. Patients should be advised to notify their physician if they experience slow pulse, irregular heartbeat, dizziness, lightheadedness, or syncope.
References
- King MH, Richards DW (1990) "Near syncope and chest tightness after administration of apraclonidine before argon laser iridotomy." Am J Ophthalmol, 110, p. 308-9
- "Product Information. Iopidine (apraclonidine ophthalmic)." Alcon Laboratories Inc
- Nordlund JR, Pasquale LR, Robin AL, Rudikoff MT, Ordman J, Chen KS, Walt J (1995) "The cardiovascular, pulmonary, and ocular hypotensive effects of 0.2% brimonidine." Arch Ophthalmol, 113, p. 77-83
- (2001) "Product Information. Alphagan (brimonidine ophthalmic)." Allergan Inc
- Walters TR (1996) "Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies." Surv Ophthalmol, 41 ( Suppl, s19-26
- Pekdemir M, Yanturali S, Karakus G (2005) "More than just an ocular solution." Emerg Med J, 22, p. 753-4
- (2013) "Product Information. Mirvaso (brimonidine topical)." Galderma Laboratories Inc
Drug and food interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
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.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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