Skip to main content

Can you take Bronkosol with Epirubicin?

1 drug interaction and 14 additional warnings found for the following 2 drugs:

Add/remove drugs

Drug interactions

Moderate drug interactions

Moderate:

isoetharine epiRUBicin

Applies to: Bronkosol (isoetharine) and epirubicin

Using isoetharine together with epiRUBicin 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, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). The risk may exist even when isoetharine 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:

isoetharine Caffeine

Applies to: Bronkosol (isoetharine)

Both isoetharine 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.

Disease interactions

13 potential interactions Applies to: 12 conditions, including High Blood Pressure, Seizures, Hypokalemia, Hyperthyroidism, and Heart Disease.

Diabetes Mellitus

Moderate:

Bronkosol

The isoetharine in Bronkosol 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.

Heart Disease

Major:

epirubicin

epiRUBicin has a major potential interaction with Heart Disease.

The use of epirubicin is contraindicated in patients with severe myocardial insufficiency, recent myocardial infarction, and severe arrhythmias. Myocardial toxicity, manifested in its most severe form by potentially fatal congestive heart failure (CHF), may occur either during therapy with epirubicin or months to years after termination of therapy. Risk factors may increase the risk of cardiac toxicity. Cardiac toxicity with epirubicin may occur at lower cumulative doses whether or not cardiac risk factors are present, so extreme caution is advised. Initial treatment with epirubicin should be preceded by a careful baseline assessment of cardiac function as measured by left ventricular ejection function (LVEF). Close cardiac monitoring during treatment is suggested.

Moderate:

Bronkosol

The isoetharine in Bronkosol 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.

High Blood Pressure

Moderate:

Bronkosol

The isoetharine in Bronkosol 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.

History - Myocardial Infarction

Major:

epirubicin

epiRUBicin has a major potential interaction with History - Myocardial Infarction.

The use of epirubicin is contraindicated in patients with severe myocardial insufficiency, recent myocardial infarction, and severe arrhythmias. Myocardial toxicity, manifested in its most severe form by potentially fatal congestive heart failure (CHF), may occur either during therapy with epirubicin or months to years after termination of therapy. Risk factors may increase the risk of cardiac toxicity. Cardiac toxicity with epirubicin may occur at lower cumulative doses whether or not cardiac risk factors are present, so extreme caution is advised. Initial treatment with epirubicin should be preceded by a careful baseline assessment of cardiac function as measured by left ventricular ejection function (LVEF). Close cardiac monitoring during treatment is suggested.

Hyperthyroidism

Moderate:

Bronkosol

The isoetharine in Bronkosol 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:

Bronkosol

The isoetharine in Bronkosol 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.

Infection

Moderate:

epirubicin

epiRUBicin has a moderate potential interaction with Infection.

Before beginning treatment with epirubicin, patients should recover from any acute toxicities, such as stomatitis, neutropenia, thrombocytopenia, and generalized infections, of prior cytotoxic treatment.

Liver Disease

Major:

epirubicin

epiRUBicin has a major potential interaction with Liver Disease.

Patients with severe hepatic dysfunction should not be treated with epirubicin. The major route of elimination of epirubicin is the hepatobiliary system. Serum total bilirubin and AST levels should be evaluated before and during treatment with epirubicin. Patients with elevated bilirubin or AST may experience slower clearance of drug with an increase in overall toxicity. Lower doses are recommended in these patients.

Neutropenia

Major:

epirubicin

epiRUBicin has a major potential interaction with Neutropenia.

Patients should not be treated with epirubicin if they have a baseline neutrophil count < 1500 cells/mm3. A dose-dependent, reversible leukopenia and/or neutropenia is the predominant manifestation of hematologic toxicity associated with epirubicin and represents the most common acute dose-limiting toxicity of this drug. Myelosuppression requires careful monitoring. Total and differential WBC, red blood cell (RBC), and platelet counts should be assessed before and during each cycle of therapy with epirubicin.

Renal Dysfunction

Moderate:

epirubicin

epiRUBicin has a moderate potential interaction with Renal Dysfunction.

Serum creatinine should be assessed before and during therapy with epirubicin. Dosage adjustment is necessary in patients with serum creatinine >5 mg/dL. Patients undergoing dialysis have not been studied.

Seizures

Moderate:

Bronkosol

The isoetharine in Bronkosol 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.

Thrombocytopenia

Moderate:

epirubicin

epiRUBicin has a moderate potential interaction with Thrombocytopenia.

Before beginning treatment with epirubicin, patients should recover from any acute toxicities, such as stomatitis, neutropenia, thrombocytopenia, and generalized infections, of prior cytotoxic treatment.

More resources

Bronkosol

A total of 393 drugs are known to interact with Bronkosol.

epirubicin

A total of 718 drugs are known to interact with epirubicin.

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.