Inderal and Sunitinib Malate

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.

Using SUNItinib together with propranolol can increase the risk of an irregular heart rhythm that may be serious. You may need a dose adjustment or special tests 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.

MONITOR: There is clinical evidence that sunitinib can prolong the PR interval of the electrocardiogram in some patients. Theoretically, coadministration with other agents that prolong the PR interval (e.g., beta blockers, calcium channel blockers, atazanavir, lopinavir, digoxin, lacosamide, mefloquine) may result in additive effects and increased risk of conduction disturbances and atrioventricular block. In a phase I clinical study of patients with advanced solid tumors who received sunitinib 150 mg on days 3 and 9 and 50 mg on days 4 to 8, mean placebo-adjusted changes in the PR interval were positive at all time points, with the maximum increase occurring 7 to 12 hours postdose, followed by a decline at 24 hours. Outlier analyses for the PR interval (>200 msec) showed a shift toward a higher proportion of outliers in patients treated with sunitinib. Excessive PR interval prolongation can result in AV block. On days 3 and 9, heart rate decreased progressively over the 24-hour period following sunitinib dosing, but was not affected by the positive control. During the study, an event of bradycardia occurred that was considered treatment-related, and dizziness was experienced by 7 of 48 patients. Bradycardia and AV block are recognized risk factors for torsade de pointes arrhythmia. Because sunitinib can also cause QTc prolongation, particular concerns exist with respect to its proarrhythmic potential.

MANAGEMENT: Caution is advised if sunitinib is used concomitantly with other agents that prolong the PR interval, especially in the elderly and patients with known conduction problems (e.g., marked first-degree AV block; second-degree or higher AV block; sick sinus syndrome without pacemaker) or severe cardiac disease such as myocardial ischemia or heart failure. Patients should be advised to notify their doctor if they experience dizziness, lightheadedness, fainting, or irregular heartbeat.

Inderal

Generic Name: propranolol

Brand name: Inderal LA, Inderal XL, InnoPran XL, Inderal, Hemangeol, InnoPran XL

Synonyms: n.a.

What is Inderal?

Sunitinib Malate

Generic Name: sunitinib

Brand name: Sutent

Synonyms: Sunitinib, SUNItinib

What is Sunitinib Malate?