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Isoflurane and Prestalia

Determining the interaction of Isoflurane and Prestalia and the possibility of their joint administration.

Check result:
Isoflurane <> Prestalia
Relevance: 08.11.2022 Reviewer: Shkutko P.M., M.D., in

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:

Using isoflurane together with amLODIPine may increase the risk of cardiovascular complications such as irregular heart rhythm, cardiac conduction abnormalities, and low blood pressure resulting in collapse. Close monitoring is required during surgery and until the effects of anesthesia have worn off. 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: Calcium channel blockers may potentiate the cardiac depressant and hypotensive effects of volatile (halogenated) anesthetics, and vice versa, due to their similar pharmacologic action on the cardiovasculature. Serious consequences of this interaction may include cardiovascular collapse, ventricular impairment, and/or conduction disturbances, particularly in patients with underlying cardiac complications. The interaction may be more likely with verapamil and diltiazem due to their dromotropic and chronotropic effects. In one case report, administration of enflurane in a patient treated with atenolol and diltiazem resulted in worsening of preexisting atrioventricular and sinus node dysfunction. In another case, severe sinus bradycardia progressed to asystole when enflurane was administered in a patient treated with diltiazem. Atrioventricular block has also been reported with enflurane and verapamil. In animal studies, anesthesia with halothane, enflurane, or isoflurane has been reported to increase plasma concentrations of verapamil due to decreased total clearance.

MANAGEMENT: Discontinuation of calcium channel blockers prior to surgery is generally not recommended because of the rebound effect in patients with coronary heart disease or arterial hypertension. However, extreme care must be taken when administering halogenated anesthetics to patients under treatment with calcium channel blockers. Hemodynamic and electrocardiographic monitoring are recommended during the operation and postoperatively, and the dosage of one or both drugs adjusted as necessary.

References
  • "Product Information. Cardizem (diltiazem)." Hoechst Marion-Roussel Inc, Kansas City, MO.
  • "Product Information. Covera-HS (verapamil)." Searle, Skokie, IL.
  • Hantler CB, Wilton N, Learned DM, et al "Impaired myocardial conduction in patients receiving diltiazem therapy during enflurane anesthesia." Anesthesiology 67 (1987): 94-6
Isoflurane

Generic Name: isoflurane

Brand name: Forane, Terrell

Synonyms: n.a.

Prestalia

Generic Name: amlodipine / perindopril

Brand name: Prestalia

Synonyms: n.a.

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.

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Disease interaction