Amiodarone Intravenous and Rivastigmine transdermal
Determining the interaction of Amiodarone Intravenous and Rivastigmine transdermal 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:Rivastigmine can occasionally cause excessively slow heart rate and low blood pressure, and using it with amiodarone may increase that risk. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, or irregular heartbeat during treatment with these drugs, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Professional:MONITOR: Since acetylcholinesterase inhibitors can cause bradycardia and heart block due to vagotonic effects on the sinoatrial and atrioventricular nodes, additive effects may occur with other agents that also possess bradycardic effects such as beta-blockers, calcium channel blockers, digitalis, some protease inhibitors (atazanavir, lopinavir-ritonavir, saquinavir), amiodarone, dronedarone, moricizine, lacosamide, and mefloquine. A group of French investigators conducted a retrospective analysis of spontaneous reports in the French Pharmacovigilance Database concerning adverse drug reactions (ADRs) associated with use of the acetylcholinesterase inhibitors donepezil, galantamine, and rivastigmine. Two hundred and five cases of potential drug-drug interaction with bradycardic drugs (beta-blockers, calcium channel blockers, amiodarone, digoxin) were identified, 73 of which were associated with serious ADRs including five deaths due to syncope, bradycardia, arrhythmia, or cardiac arrest. However, no details on the individual cases such as patient characteristics or concomitant risk factors were provided, making the contribution of a potential drug interaction difficult to evaluate. The remainder of the cases were of no apparent clinical consequences. In contrast, a phase III trial of donepezil consisting of 1035 patients reported no significant increase in risk ratios for bradycardia during concomitant use of beta-blockers, nondihydropyridine calcium channel blockers, or digoxin.
MANAGEMENT: Caution is advised if acetylcholinesterase inhibitors are used concomitantly with bradycardic drugs. Patients with underlying structural heart disease, preexisting conduction system abnormalities, ischemic heart disease, or cardiomyopathies may be at increased risk for developing cardiac conduction disturbances and atrioventricular block. Patients should be advised to notify their physician if they experience dizziness, lightheadedness, fainting, or irregular heartbeat.
- "Product Information. Exelon (rivastigmine)" Novartis Pharmaceuticals, East Hanover, NJ.
- "Product Information. Cognex (tacrine)." Parke-Davis, Morris Plains, NJ.
- Tiseo PJ, Perdomo CA, Friedhoff LT "Concurrent administration of donepezil HCI and digoxin: assessment of pharmacokinetic changes." Br J Clin Pharmacol 46(Suppl 1) (1998): 40-4
- Tavassoli N, Sommet A, Lapeyre-Mestre M, Bagheri H, Montrastruc JL "Drug interactions with cholinesterase inhibitors : an analysis of the French pharmacovigilance database and a comparison of two national drug formularies (vidal, british national formulary)." Drug Saf 30 (2007): 1063-71
- "Product Information. Aricept (donepezil)." Pfizer US Pharmaceuticals, New York, NY.
- "Product Information. Razadyne (galantamine)." Johnson and Johnson Medical Inc, Arlington, TX.
Generic Name: amiodarone
Brand name: Pacerone, Cordarone, Nexterone
Synonyms: Amiodarone
Generic Name: rivastigmine
Brand name: Exelon
Synonyms: Rivastigmine
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.
- Amiodarone Intravenous-Rivelsa
- Amiodarone Intravenous-Rixubis
- Amiodarone Intravenous-Rixubis Intravenous
- Amiodarone Intravenous-Rizatriptan
- Amiodarone Intravenous-Rizatriptan Benzoate
- Amiodarone Intravenous-Rizatriptan Orally Disintegrating Tablets
- Rivastigmine transdermal-Amiodarone Intravenous, Oral
- Rivastigmine transdermal-Amiodarone Tablets
- Rivastigmine transdermal-Amitiza
- Rivastigmine transdermal-Amitriptyline
- Rivastigmine transdermal-Amitriptyline and chlordiazepoxide
- Rivastigmine transdermal-Amitriptyline and perphenazine