Flecainide and amiodarone interaction

Shea, Patrick J.; Lal, Roop; Kim, Sung Soon; Schechtman, Kenneth B.; Ruffy, Rodolphe

doi:10.1016/s0735-1097(86)80234-0

Cited by 57 publications

(10 citation statements)

References 5 publications

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“…In addition to the additive electrophysiologic effects, an increase in plasma level and altered pharmacokinetics of the combined agents may be of importance. Amiodarone increases the plasma level of concurrently administered aprindine [216], flecainide [204], procainamide [189], and quinidine [230]. In the latter case, proarrhytymia occurred [138,230].…”

Section: Characteristics Of Proarrhythmia After Drug-lnduced Qt Prolomentioning

confidence: 99%

QT-Interval prolonging drugs: Mechanisms and clinical relevance of their arrhythmogenic hazards

Zehender

Hohnloser

Just

1991

Cardiovasc Drug Ther

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The antiarrhythmic principle of drug-induced QT-interval prolongation is well known. However, with the widespread use of the presently known and new Class III antiarrhythmic agents under investigation, and the growing number of agents not primarily designed as antiarrhythmic drugs that potentially cause QT prolongation, we have also become aware of the proarrhythmic hazards associated with many of these agents. The proarrhythmic risk differs markedly from one agent to another and interferes with many individual clinical variables (e.g., hypokalemia, sinus bradycardia). This paper summarizes the present data on the proarrhythmic risk of drug-induced QT prolongation, including the value and problems of the rate-corrected QT interval, the mechanisms involved in the genesis of proarrhythmia, and the clinical cofactors that facilitate the occurrence of proarrhythmic events. In addition, an extensive database provides information on the known proarrhythmic risk of all currently used QT-prolonging agents.

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Section: Characteristics Of Proarrhythmia After Drug-lnduced Qt Prolomentioning

confidence: 99%

QT-Interval prolonging drugs: Mechanisms and clinical relevance of their arrhythmogenic hazards

Zehender

Hohnloser

Just

1991

Cardiovasc Drug Ther

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“…For this reason the combination of amiodarone with other potent antiarrhythmic agents may have antagonistic as well as synergistic effects (Borgreffe et al 1986;Marcus 1983;Saal et al 1984;Shea et al 1986). …”

Section: Combination Of Amiodarone With Other Agentsmentioning

confidence: 99%

Risk-Benefit Assessment of Amiodarone in the Treatment of Cardiac Arrhythmias

Counihan

McKenna

1990

Drug Safety

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Cardiac arrhythmias are a cause of significant morbidity and mortality in patients with cardiac disease, and thus represent a major management problem. The recognition that antiarrhythmic drugs have the potential to aggravate as well as to attenuate arrhythmias has prompted clinicians to reconsider treatment strategies and weight the benefits of treatment against the risks. In this context, amiodarone has emerged as an effective antiarrhythmic agent and when used at the lowest effective dose has an acceptable side effect profile. This review focuses on the current clinical usage of amiodarone in a broad variety of cardiac arrhythmias, and addresses the risk-benefits arising from its use. It further discusses the current position of amiodarone in the management of sudden cardiac death.

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“…In the present case, amiodarone was prescribed by an outside physician, and its prescription was probably an oversight. In one study, the mean percent increase in the dose-adjusted plasma flecainide levels after initiation of amiodarone was 60% 4 . The authors hypothesized that more than one mechanism of interaction may be operative including decreased rate of enzymatic biotransformation from altered hepatic function, a decrease in renal elimination, and/or a change in drug distribution 4 …”

Section: Discussionmentioning

confidence: 99%