Drug interactions
Bretylium + Digoxin
Severity: Major
Bretylium and Digoxin: major interaction.
Last updated
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
Bretylium initially releases norepinephrine from sympathetic nerve endings, which can provoke or worsen digitalis-induced arrhythmias. Its use in a digitalized patient may aggravate toxicity.
What this interaction means in plain words
Bretylium and Digoxin 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.
Why it happens
Bretylium-induced norepinephrine release increases myocardial automaticity and sensitizes the heart to the proarrhythmic effects of digoxin.
What to do
Avoid starting both together and do not use bretylium if digoxin toxicity may be causing the arrhythmia. If needed, use continuous ECG monitoring and check digoxin level and 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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Other interactions of Digoxin
- Digoxin + Lily of the valley Contraindicated
- Digoxin + Squill Contraindicated
- Adagrasib + Digoxin Major
- Amiodarone + Digoxin Major
- Amlodipine-hydrochlorothiazide-valsartan + Digoxin Major
- Amphotericin b deoxycholate + Digoxin Major
Frequently asked questions
Can I take Bretylium with Digoxin?
MediHelp rates the interaction as major. Bretylium and Digoxin 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. Bretylium initially releases norepinephrine from sympathetic nerve endings, which can provoke or worsen digitalis-induced arrhythmias. Its use in a digitalized patient may aggravate toxicity.
How serious is the interaction between Bretylium and Digoxin?
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 starting both together and do not use bretylium if digoxin toxicity may be causing the arrhythmia. If needed, use continuous ECG monitoring and check digoxin level and electrolytes.
What other medicines interact with Digoxin?
MediHelp also lists interactions of Digoxin with, for example, Lily of the valley, Squill, Adagrasib. The full list is on the Digoxin page.
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