Bretylium Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 19, 2024.

Applies to bretylium: injectable solution, intravenous solution.

Cardiovascular adverse events

Cardiovascular side effects including hypotension have been commonly reported during bretylium therapy. Hypotension occurs most frequently during intravenous administration. Postural hypotension has also been reported even when administered in a supine position. Other cardiovascular side effects have included transient hypertension, induction of new arrhythmias, bradycardia, precipitation of angina, and substernal pressure sensation. Flushing has been reported.^[Ref]

Postural hypotension has occurred in most patients and was usually reversible with volume expansion or catecholamine infusion such as dopamine or epinephrine. It is recommended that patients remain supine until blood pressure changes stabilize. Some degree of supine hypotension occurred in approximately 50% of patients. The degree of hypotension did not appear to be dose-related and discontinuation was usually not required.

Bretylium administration causes an initial release of norepinephrine which may result in increased blood pressure or aggravation of arrhythmias. These effects are usually transient and do not generally require discontinuation of bretylium.^[Ref]

Gastrointestinal

Gastrointestinal side effects of nausea and vomiting have occurred with rapid intravenous infusion. Diarrhea has been reported during intravenous and intramuscular administration.^[Ref]

To minimize nausea and vomiting due to rapid intravenous infusion, it is recommended that bretylium be diluted in at least 50 cc of 5% dextrose or normal saline and infused over 10 to 15 minutes.^[Ref]

Local

Local pain at the site of intramuscular injections has occurred. Administration sites should be rotated to prevent atrophy, fibrosis, or necrosis of muscle tissue, or vascular degeneration and inflammatory changes.^[Ref]

Nervous system

Nervous system side effects of headache, sweating, and hyperthermia have occurred.^[Ref]

At least two cases of extreme hyperthermia to 108 degrees Fahrenheit have been reported. In both cases, the temperature fell rapidly after bretylium was discontinued and normalized in less than 16 hours. The mechanism for this effect is unknown.^[Ref]

Respiratory

Respiratory side effects including shortness of breath and nasal congestion have been reported rarely. A causal relationship between the side effect and the use of bretylium has not been clearly established.^[Ref]

Psychiatric

Psychiatric side effects including confusion, anxiety, psychoses, and emotional lability have been reported rarely. A causal relationship between the side effect and the use of bretylium has not been clearly established.^[Ref]

Dermatologic

Dermatologic side effects including erythematous macular rash have been reported rarely. A causal relationship between the side effect and the use of bretylium has not been clearly established.^[Ref]

See also:

Further information

Bretylium side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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