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Drug Interactions between Coreg and Tonocard

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

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Interactions between your drugs

Moderate

tocainide carvedilol

Applies to: Tonocard (tocainide) and Coreg (carvedilol)

MONITOR: The concomitant use of tocainide and beta-blockers may have additive effects on cardiac index, left ventricular function, and pulmonary wedge pressure. While significant interactions have not been reported in studies, cases of asystole have been reported in patients with preexisting electrophysiologic abnormalities after tocainide and metoprolol were coadministered. The mechanism is not known, but may be related to an additive effect on the sinus node or conduction system, especially in patients with sick sinus syndrome. Cases of confusion and paranoia have also been reported after coadministration of tocainide and propranolol.

MANAGEMENT: The concomitant use of tocainide and beta blockers should probably be avoided in patients with atrioventricular conduction abnormalities or sick sinus syndrome. This combination should be used cautiously in other patients, with careful dose titration and close clinical and electrocardiographic monitoring for efficacy and safety.

References

  1. Rubino M, Jackson E "Severe paranoia with concomitant tocainide and propranolol therapy." Clin Pharm 1 (1982): 177-9
  2. Roden DM, Woosley RL "Tocainide." N Engl J Med 315 (1986): 41-5
  3. Ikram H "Hemodynamic and electrophysiologic interactions between antiarrhythmic drugs and beta blockers, with special reference to tocainide." Am Heart J 100 (1980): 1076-80

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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.

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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.

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