Disopyramide Beta blockers

Other drugs that may interact with cardiac glycosides include the following Albuterol, amphotericin B, beta-blockers, calcium, disopyramide, loop diuretics, nondepolarizing muscle relaxants, potassium-sparing diuretics, succinylcholine, sympathomimetics, thiazide diuretics, thioamines, and thyroid hormones. 

Drugs that may affect disopyramide include antiarrhythmics, beta blockers, cisapride, clarithromycin, erythromycin, fluoroquinolones, hydantoins, quinidine, thioridazine, rifampin, verapamil, and ziprasidone. Drugs that may be affected by disopyramide include quinidine, anticoagulants, and digoxin. 

Drugs that may affect amiodarone include hydantoins, cholestyramine, fluoroquinolones, rifamycins, ritonavir, and cimetidine. Drugs that may be affected by amiodarone include anticoagulants, beta-blockers, calcium channel blockers, cyclosporine, dextromethorphan, digoxin, disopyramide, fentanyl, flecainide, hydantoins, lidocaine, methotrexate, procainamide, quinidine, and theophylline. Drug/Lab test interactions Amiodarone alters the results of thyroid function tests, causing an increase in serum T4 and serum reverse T3 levels and a decline in... 

Drugs that may be affected by beta blockers include flecainide, gabapentin, haloperidol, hydralazine, phenothiazines, anticoagulants, benzodiazepines, clonidine, disopyramide, epinephrine, ergot alkaloids, lidocaine, nondepolarizing muscle relaxants, prazosin, sulfonylureas, and theophylline. 

Rifampin is known to induce the hepatic microsomal enzymes that metabolize various drugs such as acetaminophen, oral anticoagulants, barbiturates, benzodiazepines, beta blockers, chloramphenicol, clofibrate, oral contraceptives, corticosteroids, cyclosporine, disopyramide, estrogens, hydantoins, mexiletine, quinidine, sulfones, sulfonylureas, theophyllines, tocainide, verapamil, digoxin, enalapril, morphine, nifedipine, ondansetron, progestins, protease inhibitors, buspirone, delavirdine, doxycycline, fluoroquinolones, losartan, macrolides, sulfonylureas, tacrolimus, thyroid hormones, TCAs, zolpidem, zidovudine, and ketoconazole. The therapeutic effects of these drugs may be decreased. 

Drug Interactions Other antihypertensive agents Carbamazepine (vasodilators, ACE inhibitors, Rifampin diuretics, and beta-blockers) Phenobarbital Digoxin Cyclosporine Disopyramide Theophylline Flecainide Inhalation anesthetics Quinidine Neuromuscular blocking agents Cimetidine Lithium ... 

DISOPYRAMIDE BETA-BLOCKERS Risk of bradycardia (occasionally severe), 1 BP, and heart failure Additive negative inotropic and chronotropic effects Monitor PR, BP and ECG at least weekly until stable watch for development of heart failure... 

VENLAFAXINE 1. ANTIARRHYTHMICS - amiodarone, disopyramide, procainamide, propafenone 2. ANTIBIOTICS — macrolides (especially azithromycin, clarithromycin, parenteral erythromycin, telithromycin), quinolones (especially moxifloxacin), quinupristin/ dalfopristin 3. ANTICANCER AND IMMUNOMODULATING DRUGS -arsenic trioxide 4. ANTIDEPRESSANTS-TCAs 5. ANTIEMETICS-dolasetron 6. ANTIFUNGALS-fluconazole, posaconazole, voriconazole 7. ANTIHISTAMINES-terfenadine, hydroxyzine, mizolastine 8. ANTIMALARIALS -artemetherwith lumefantrine, chloro-quine, hydroxychloroquine, mefloquine, quinine 9. ANTIPROTOZOALS -pentamidine isetionate 10. ANTIPSY-CHOTICS - atypicals, phenothiazines, pimozide 11. BETA-BLOCKERS -sotalol 12. BRONCHODILATORS-parenteral bronchodilators 13. CNS STIMULANTS - atomoxetine Risk of ventricular arrhythmias, particularly torsades de pointes Additive effect these drugs cause prolongation of the Q-T interval Avoid co-administration... 

Beta-blockers can also affect the clearance of high clearance drugs by altering hepatic blood flow. This occurs when propranolol is co-administered with lido-caine (400), but it appears that this interaction is due more to inhibition of enzyme activity than to a reduction in hepatic blood flow (401). Atenolol inhibits the clearance of disopyramide, but the mechanism is unknown... 

The negative inotropic effects of class I antidysrhythmic agents, such as disopyramide, procainamide, quinidine, and tocainide can be accentuated by beta-blockers this is most pronounced in patients with pre-existing myocardial disease and can result in left ventricular failure or even asystole (413). Digoxin can obviate the negative inotropic effect of beta-blockers in patients with poor left ventricular function. 

Clinically important, potentially hazardous interactions with alcohol, amiodarone, beta-blockers, cimetidine, donidine, digoxin, diltiazem, disopyramide, ephedrine, epinephrine, ergot alkaloids, guanethidine, halothane, isoprenaline, lidocaine, noradrenaline, NSAIDs, phenylephrine, quinidine, reserpine, verapamil... 

Propranolol and other beta blockers Encainide and flecainide Quinidine, procainamide, and disopyramide Tricyclic antidepressants... 

Beta blockers (mainly propranolol) Encalnide and flecalnide Quinidine, procainamide, and disopyramide Propoxyphene Tricyclic antidepressants Others Barbiturates... 

D. Important drug interactions may result in toxicity. Hypotension is more likely to occur in patients taking beta blockers, nitrates, or both, especially if they are hypovolemic after diuretic therapy. Patients taking disopyramide or other... 

Not understood. Both disopyramide and the beta blockers can depress the contractilily and conductivity of the heart muscle. 

A group of clinicians who had used single 400-mg oral doses of disopyramide successfully and with few adverse effects for reverting acute supraventricular arrhythmias, reported 5 cases of profound hypotension and collapse. Three of the patients developed severe epigastric pain. All 5 had previous myocardial disease and/or were taking myocardial depressants, either beta blockers or verapamil in small quantities [not specified]. ... 

On the basis of this report, and on reports of studies in animals and from the known risks associated with the concurrent use of beta blockers (see Disopyramide -i- Beta blockers , p.252), the UK manufacturer warns about combining disopyramide and other drugs [such as verapamil] that may have additive negative inotropic effects. However, they do point out that in some specific circumstances combinations of antiarrhythmie drugs (they specifically name digoxin, beta blockers and verapamil for the control of atrial fibrillation) may be beneficial. They note that severe hypotension caused by disopyramide has usually been associated with cardiomyopathy or uncompensated congestive heart failure. However, the US manufacturer advises that until more data is available, disopyramide should not be given within 48 hours before or 24 hours after verapamil. ... 

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