Drug Interactions between esmolol and Tambocor
This report displays the potential drug interactions for the following 2 drugs:
- esmolol
- Tambocor (flecainide)
Interactions between your drugs
esmolol flecainide
Applies to: esmolol and Tambocor (flecainide)
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
Drug and food interactions
esmolol food
Applies to: esmolol
MONITOR: Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.
MANAGEMENT: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.
References
- Sternbach H (1991) "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol, 11, p. 390-1
- Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA (1984) "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med, 101, p. 498-9
- Feder R (1991) "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry, 52, p. 139
- Ellison JM, Milofsky JE, Ely E (1990) "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry, 51, p. 385-6
- Rodriguez de la Torre B, Dreher J, Malevany I, et al. (2001) "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit, 23, p. 435-40
- Cerner Multum, Inc. "Australian Product Information."
- Pacher P, Kecskemeti V (2004) "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des, 10, p. 2463-75
- Andrews C, Pinner G (1998) "Postural hypotension induced by paroxetine." BMJ, 316, p. 595
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
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