Drug interactions
Disopyramide + Paroxetine
Severity: Major
Disopyramide and Paroxetine: 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
Both drugs can prolong the QT interval, so combining them may raise the risk of torsades de pointes and other ventricular arrhythmias. Paroxetine's CYP2D6 inhibition may also modestly affect disopyramide exposure. The risk is greater with electrolyte disturbances or structural heart disease.
What this interaction means in plain words
Disopyramide and Paroxetine 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.
Disopyramide belongs to Cardiovascular; Paroxetine belongs to Central Nervous System.
Why it happens
Additive QT prolongation through pharmacodynamic effects, with possible CYP2D6 inhibition by paroxetine.
What to do
Prefer an alternative antidepressant with less QT effect, such as sertraline, if disopyramide is required. If combined, obtain a baseline and follow-up ECG and correct potassium and magnesium.
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
- Paroxetine 10 mg Tablets - SmPC sections 4.3/4.5 (class statement: drugs which prolong the QTc interval; "The risk of QTc prolongation and/or ventricular arrhythmias (e.g. TdP) may be increased with concomitant use of other drugs which prolong the QTc interval (e.g.") — electronic medicines compendium (UK SmPC)
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Other interactions of Disopyramide
- Amisulpride + Disopyramide Contraindicated
- Desipramine + Disopyramide Contraindicated
- Disopyramide + Dronedarone Contraindicated
- Disopyramide + Itraconazole Contraindicated
- Disopyramide + Ketoconazole Contraindicated
- Disopyramide + Maprotiline Contraindicated
Frequently asked questions
Can I take Disopyramide with Paroxetine?
MediHelp rates the interaction as major. Disopyramide and Paroxetine 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. Both drugs can prolong the QT interval, so combining them may raise the risk of torsades de pointes and other ventricular arrhythmias. Paroxetine's CYP2D6 inhibition may also modestly affect disopyramide exposure. The risk is greater with electrolyte disturbances or structural heart disease.
How serious is the interaction between Disopyramide and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antidepressant with less QT effect, such as sertraline, if disopyramide is required. If combined, obtain a baseline and follow-up ECG and correct potassium and magnesium.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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