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Drug Interactions between etidocaine and Tikosyn

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

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Interactions between your drugs

Moderate

etidocaine dofetilide

Applies to: etidocaine and Tikosyn (dofetilide)

MONITOR: Amide-type local anesthetics may have additive cardiac effects (e.g., bradycardia, chest pain, heart block, arrhythmias, ECG abnormalities, cardiac arrest) with class III antiarrhythmic agents. Although specific trials studying the interaction have not been performed, a case report suggests additive depressive effects of amiodarone and lidocaine on the sinoatrial node. A 64-year-old man with sick sinus syndrome developed severe, symptomatic sinus bradycardia and sinoatrial arrest following local anesthesia with lidocaine while he was on amiodarone therapy. No other cause was identified.

MANAGEMENT: Patients treated with class III antiarrhythmic agents (e.g., amiodarone, dofetilide, ibutilide, sotalol) should be under close surveillance during administration of amide-type local anesthetics. ECG monitoring should be considered.

References

  1. Keidar S, Grenadier E, Palant A "Sinoatrial arrest due to lidocaine injection in sick sinus syndrome during amiodarone administration." Am Heart J 104 (1982): 1384-5
  2. "Product Information. Naropin (ropivacaine)." Astra-Zeneca Pharmaceuticals PROD (2001):

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Drug and food interactions

Minor

dofetilide food

Applies to: Tikosyn (dofetilide)

In vitro data suggest that grapefruit juice may inhibit the CYP450 3A4 first-pass metabolism of dofetilide. Decreased first-pass metabolism may increase dofetilide concentrations and increase the risk of QT interval prolongation and arrhythmias. The clinical significance is unknown, since dofetilide has a high oral bioavailability and a low affinity for CYP450 3A4. The manufacturer recommends caution.

References

  1. "Product Information. Tikosyn (dofetilide)." Pfizer U.S. Pharmaceuticals PROD (2001):

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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

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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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