Drug interactions
Atomoxetine + Ibutilide
Severity: Major
Atomoxetine and Ibutilide: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ibutilide has a high risk of causing torsades de pointes, and atomoxetine may add a further QT effect. The combination can increase the chance of a life-threatening ventricular arrhythmia during or after ibutilide infusion.
What this interaction means in plain words
Atomoxetine and Ibutilide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atomoxetine belongs to Central Nervous System; Ibutilide belongs to Cardiovascular.
Why it happens
Additive QT prolongation, with ibutilide as a potent class III potassium channel blocker.
What to do
Avoid giving atomoxetine around ibutilide cardioversion and hold it until after the post-infusion monitoring period. Use continuous ECG monitoring and maintain normal electrolytes.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- ATOMAID 10 mg Capsules, Hard - SmPC sections 4.3/4.5 (class statement: class IA and III antiarrhythmics; "such as neuroleptics, class IA and III antiarrhythmics, moxifloxacin, erythromycin, methadone mefloquine, tricyclic antidepressants, lithium or cisapride") — electronic medicines compendium (UK SmPC)
Other interactions of Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Other interactions of Ibutilide
- Amiodarone + Ibutilide Contraindicated
- Amisulpride + Ibutilide Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Clarithromycin + Ibutilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Dolasetron + Ibutilide Contraindicated
Frequently asked questions
Can I take Atomoxetine with Ibutilide?
MediHelp rates the interaction as major. Atomoxetine and Ibutilide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ibutilide has a high risk of causing torsades de pointes, and atomoxetine may add a further QT effect. The combination can increase the chance of a life-threatening ventricular arrhythmia during or after ibutilide infusion.
How serious is the interaction between Atomoxetine and Ibutilide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid giving atomoxetine around ibutilide cardioversion and hold it until after the post-infusion monitoring period. Use continuous ECG monitoring and maintain normal electrolytes.
What other medicines interact with Atomoxetine?
MediHelp also lists interactions of Atomoxetine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Atomoxetine page.
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