藥物交互作用
Amiodarone + Torsemide
嚴重程度: 嚴重
Amiodarone and Torsemide: major interaction.
最後更新 來源: US FDA label
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摘要
Torsemide can cause hypokalemia and hypomagnesemia, which increase the risk of QT prolongation and torsades de pointes in patients taking amiodarone. Amiodarone prolongs repolarization, so electrolyte loss lowers the threshold for arrhythmia. The risk is highest with high diuretic doses, renal dysfunction, bradycardia, structural heart disease, female sex and other QT-prolonging drugs.
用白話說明這項交互作用的意義
Amiodarone and Torsemide 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.
Amiodarone belongs to Cardiovascular; Torsemide belongs to Cardiovascular.
為什麼會發生
Additive pharmacodynamic effect: loop diuretic-induced potassium and magnesium depletion potentiates the QT-prolonging effect of amiodarone.
處置方式
Check serum potassium and magnesium before starting and periodically during co-therapy, especially after dose changes or intercurrent illness with vomiting or diarrhea. Replete deficits promptly and keep potassium in the high-normal range (about 4.0 mmol/L or above) and magnesium in the normal range.
可向藥師詢問的問題
- 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?
參考資料
Amiodarone 的其他交互作用
Torsemide 的其他交互作用
常見問題
Can I take Amiodarone with Torsemide?
MediHelp rates the interaction as major. Amiodarone and Torsemide 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. Torsemide can cause hypokalemia and hypomagnesemia, which increase the risk of QT prolongation and torsades de pointes in patients taking amiodarone. Amiodarone prolongs repolarization, so electrolyte loss lowers the threshold for arrhythmia. The risk is highest with high diuretic doses, renal dysfunction, bradycardia, structural heart disease, female sex and other QT-prolonging drugs.
How serious is the interaction between Amiodarone and Torsemide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and magnesium before starting and periodically during co-therapy, especially after dose changes or intercurrent illness with vomiting or diarrhea. Replete deficits promptly and keep potassium in the high-normal range (about 4.0 mmol/L or above) and magnesium in the normal range.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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