Sotalol injection drug interactions: Difference between revisions
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== | ==Drug Interactions== | ||
====7.1 Digoxin==== | |||
Proarrhythmic events were more common in sotalol treated patients also receiving digoxin; it is not clear whether this represents an interaction or is related to the presence of heart failure, a known risk factor for proarrhythmia, in the patients receiving digoxin. | |||
<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = SOTALOL HYDROCHLORIDE INJECTION [BIONICHE PHARMA USA LLC] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2afe7385-2441-4e22-b63e-ab8614b275df | publisher = | date = | accessdate = }}</ref> | ====7.2 Calcium Blocking Drugs==== | ||
Sotalol and calcium blocking drugs can be expected to have additive effects on atrioventricular conduction, ventricular function, and blood pressure. | |||
====7.3 Catecholamine-Depleting Agents==== | |||
Concomitant use of catecholamine-depleting drugs, such as reserpine and guanethidine, with a beta-blocker may produce an excessive reduction of resting sympathetic nervous tone. Monitor such patients for hypotension and marked bradycardia which may produce syncope. | |||
====7.4 Insulin and Oral Antidiabetic Agents==== | |||
Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. Symptoms of hypoglycemia may be masked. | |||
====7.5 Beta-2-Receptor Stimulants==== | |||
Beta-agonists such as albuterol, terbutaline and isoproterenol may have to be administered in increased dosages when used concomitantly with sotalol. | |||
====7.6 Clonidine==== | |||
Beta-blocking drugs may potentiate the rebound hypertension sometimes observed after discontinuation of clonidine. | |||
====7.7 Drugs that Prolong QT Interval and Antiarrhythmic Agents==== | |||
Sotalol has not been studied with other drugs that prolong the QT interval, such as antiarrhythmics, some phenothiazines, tricyclic antidepressants, and certain oral macrolides. Class I or Class III antiarrhythmic agents should be withheld for at least three half-lives prior to dosing with sotalol. In clinical trials, sotalol was not administered to patients previously treated with oral amiodarone for >1 month in the previous three months. Class Ia antiarrhythmic drugs, such as disopyramide, quinidine and procainamide and other Class III drugs (e.g., amiodarone) are not recommended as concomitant therapy with intravenous sotalol because of their potential to prolong refractoriness [seeWarnings and Precautions (5)]. There is only limited experience with the concomitant use of Class Ib or Ic antiarrhythmics. | |||
====7.8 Other==== | |||
No pharmacokinetic interactions were observed with hydrochlorothiazide or warfarin.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = SOTALOL HYDROCHLORIDE INJECTION [BIONICHE PHARMA USA LLC] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=2afe7385-2441-4e22-b63e-ab8614b275df | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Revision as of 06:17, 10 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Drug Interactions
7.1 Digoxin
Proarrhythmic events were more common in sotalol treated patients also receiving digoxin; it is not clear whether this represents an interaction or is related to the presence of heart failure, a known risk factor for proarrhythmia, in the patients receiving digoxin.
7.2 Calcium Blocking Drugs
Sotalol and calcium blocking drugs can be expected to have additive effects on atrioventricular conduction, ventricular function, and blood pressure.
7.3 Catecholamine-Depleting Agents
Concomitant use of catecholamine-depleting drugs, such as reserpine and guanethidine, with a beta-blocker may produce an excessive reduction of resting sympathetic nervous tone. Monitor such patients for hypotension and marked bradycardia which may produce syncope.
7.4 Insulin and Oral Antidiabetic Agents
Hyperglycemia may occur, and the dosage of insulin or antidiabetic drugs may require adjustment. Symptoms of hypoglycemia may be masked.
7.5 Beta-2-Receptor Stimulants
Beta-agonists such as albuterol, terbutaline and isoproterenol may have to be administered in increased dosages when used concomitantly with sotalol.
7.6 Clonidine
Beta-blocking drugs may potentiate the rebound hypertension sometimes observed after discontinuation of clonidine.
7.7 Drugs that Prolong QT Interval and Antiarrhythmic Agents
Sotalol has not been studied with other drugs that prolong the QT interval, such as antiarrhythmics, some phenothiazines, tricyclic antidepressants, and certain oral macrolides. Class I or Class III antiarrhythmic agents should be withheld for at least three half-lives prior to dosing with sotalol. In clinical trials, sotalol was not administered to patients previously treated with oral amiodarone for >1 month in the previous three months. Class Ia antiarrhythmic drugs, such as disopyramide, quinidine and procainamide and other Class III drugs (e.g., amiodarone) are not recommended as concomitant therapy with intravenous sotalol because of their potential to prolong refractoriness [seeWarnings and Precautions (5)]. There is only limited experience with the concomitant use of Class Ib or Ic antiarrhythmics.
7.8 Other
No pharmacokinetic interactions were observed with hydrochlorothiazide or warfarin.[1]
References
Adapted from the FDA Package Insert.