Drug interactions
Donepezil + Ibutilide
Severity: Major
Donepezil 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 is a class III antiarrhythmic with a high risk of torsades de pointes. Donepezil adds QT liability and can cause bradycardia, so co-use increases the chance of life-threatening arrhythmia.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Ibutilide belongs to Cardiovascular.
Why it happens
Additive prolongation of repolarization; ibutilide blocks IKr.
What to do
Avoid the combination where possible, or hold donepezil around cardioversion. If ibutilide is given, use continuous ECG monitoring with correction of 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
- Apozyl 10 mg Orodispersible Tablets - SmPC sections 4.3/4.5 (class statement: Class III antiarrhythmics; "Class III antiarrhythmics (e.g. amiodarone, sotalol)") — electronic medicines compendium (UK SmPC)
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
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 Donepezil with Ibutilide?
MediHelp rates the interaction as major. Donepezil 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 is a class III antiarrhythmic with a high risk of torsades de pointes. Donepezil adds QT liability and can cause bradycardia, so co-use increases the chance of life-threatening arrhythmia.
How serious is the interaction between Donepezil 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 the combination where possible, or hold donepezil around cardioversion. If ibutilide is given, use continuous ECG monitoring with correction of potassium and magnesium.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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