Actiq and Cordarone IV Intravenous
Determining the interaction of Actiq and Cordarone IV Intravenous and the possibility of their joint administration.
In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.
Consumer:Before taking amiodarone, tell your doctor if you also use fentaNYL. You may need dose adjustments or special tests in order to safely take both medications together. You should notify your doctor if you have symptoms of dizziness, confusion, fainting, extreme sedation, slow heart rate, slow or difficult breathing, and shortness of breath. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using your medications without first talking to your doctor first.
Professional:MONITOR CLOSELY: Coadministration with inhibitors of CYP450 3A4 such as amiodarone may increase the plasma concentrations of fentanyl, which is metabolized by the isoenzyme. Increased fentanyl concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.
MONITOR CLOSELY: Amiodarone may increase the risk of cardiovascular complications during or after general anesthesia with fentanyl. The mechanism of interaction is unknown. Severe refractory vasodilatation, hypotension, bradycardia, myocardial depression, low cardiac output, increased pacemaker dependency, heart block, and other conduction defects have been reported during surgical procedures involving fentanyl. Treatment has included inotropic support and pressor agents, but fatality has occurred despite these measures. Causality has not been clearly determined due to the presence of other medications in reported cases as well as conflicting data in some studies. One study consisting of patients undergoing coronary artery bypass grafting or valvular surgery found no adverse hemodynamic effects of short-term amiodarone during fentanyl-isoflurane anesthesia.
MANAGEMENT: Patients receiving fentanyl in combination with CYP450 3A4 inhibitors such as amiodarone should be carefully monitored, and dosage adjustments made accordingly if necessary. Patients and/or their caregivers should be advised to seek medical attention if potential signs and symptoms of toxicity occur such as dizziness, confusion, fainting, extreme sedation, bradycardia, slow or difficult breathing, and shortness of breath. Patients treated with transdermal formulations of fentanyl should be cautioned that drug interactions and drug effects may be observed for a prolonged period beyond removal of the patch, as significant amounts of fentanyl are absorbed from the skin for 17 hours or more after the patch is removed. Patients receiving fentanyl-containing anesthesia should be closely monitored for hemodynamic instability and other cardiovascular complications, and appropriate measures taken as required.
- Kerin NZ, Aragon E, Faitel K, Frumin H, Rubenfire M "Long-term efficacy and toxicity of high- and low-dose amiodarone regimens." J Clin Pharmacol 29 (1989): 418-23
- "Product Information. Duragesic Transdermal System (fentanyl)." Janssen Pharmaceutica, Titusville, NJ.
- Navalgund AA, Alifimoff JK, Jakymec AJ, Bleyaert AL "Amiodarone-induced sinus arrest successfully treated with ephedrine and isoproterenol." Anesth Analg 65 (1986): 414-6
- Gallagher JD, Lieberman RW, Meranze J, Spielman SR, Ellison N "Amiodarone-induced complications during coronary artery surgery." Anesthesiology 55 (1981): 186-8
- Liberman BA, Teasdale SJ "Anaesthesia and amiodarone." Can Anaesth Soc J 32 (1985): 629-38
- White CM, Dunn A, Tsikouris J, Waberski W, Felton K, FreemanBosco L, Giri S, Kluger J "An assessment of the safety of short-term amiodarone therapy in cardiac surgical patients with fentanyl-isoflurane anesthesia." Anesth Analg 89 (1999): 585-9
Generic Name: fentanyl
Brand name: Actiq, Abstral, Fentora, Subsys, Duragesic, Ionsys, Lazanda, Onsolis, Sublimaze
Synonyms: n.a.
Generic Name: amiodarone
Brand name: Pacerone, Cordarone, Nexterone
Synonyms: Cordarone IV (Intravenous)
In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.
- Actiq-Cordran
- Actiq-Cordran (Flurandrenolide Cream and Ointment)
- Actiq-Cordran (Flurandrenolide Lotion)
- Actiq-Cordran Lotion
- Actiq-Cordran SP
- Actiq-Cordran Tape
- Cordarone IV Intravenous-Actisite
- Cordarone IV Intravenous-Activase
- Cordarone IV Intravenous-Activated Charcoal
- Cordarone IV Intravenous-Activated Charcoal Capsules and Tablets
- Cordarone IV Intravenous-Activated Charcoal Liquid
- Cordarone IV Intravenous-Active FE