Amiodarone with Foscarnet Interaction Details

Brand Names Associated with Amiodarone

  • Amiodarone
  • Cordarone®
  • Pacerone®

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Last updated Feb 27, 2024

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Interaction Effect

An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)

Interaction Summary

Foscarnet can prolong the QT interval in some patients, which may result in ventricular tachycardia, ventricular fibrillation, and torsades de pointes. Because Class III antiarrhythmics may also prolong the QT interval and increase the risk of arrhythmias, the concurrent administration of foscarnet and a Class III antiarrhythmic is not recommended[1][2].

Severity

Major

Onset

Unspecified

Evidence

Theoretical

How To Manage Interaction

The concurrent administration of foscarnet and Class III antiarrhythmics is not recommended.

Mechanism Of Interaction

Additive cardiac effects

Literature Reports

A) Because ibutilide prolongs the QT interval, this agent should not be given concomitantly with other drugs that also prolong the QT interval [3].

B) A 72-year-old woman developed torsade de pointes while on oral acecainide therapy. The torsade de pointes resolved when acecainide was discontinued [4].

C) In 1 patient, torsade de pointes was reported on 2 occasions soon after initiation of oral amiodarone therapy at relatively low doses. The first event occurred 36 hours after the patient received a total loading dose of 1600 milligrams and amiodarone was discontinued. Twenty days later amiodarone was restarted at 200 milligrams/day and torsade de pointes occurred on the third day of treatment. Amiodarone was discontinued [5].

D) Azimilide produces dose-dependent prolongation of QT and QTc intervals in the absence of clinically significant effects on heart rate and PR and QRS intervals. These effects occurred whether azimilide was administered as a single IV dose, as a single oral dose, or in multiple oral dose regimens [6][7].

References

    1 ) Product Information: Betapace(R), sotalol HCl. Berlex Laboratories, Wayne, NJ, 2001.

    2 ) Product Information: Foscavir(R), foscarnet. AstraZeneca, Inc., Alexandria, VA, 1998.

    3 ) Product Information: Corvert(R), ibutilide fumarate injection. Pharmacia & Upjohn Co., Kalamazoo, Michigan, 2000.

    4 ) Chow MJ, Piergies AA, Bowsher DJ, et al: Torsade de pointes induced by N-acetylprocainamide. J Am Coll Cardiol 1984; 4:621-624.

    5 ) Faggiano P, Gardini A, D'Aloia A, et al: Torsade de pointes occurring early during oral amiodarone treatment. Int J Cardiol 1996; 55(2):205-208.

    6 ) Corey AE, Agnew JR, Valentine SN, et al: Azimilide pharmacokinetics following intravenous and oral administration of a solution and capsule formulation. J Clin Pharmacol 1999; 39(12):1272-1276.

    7 ) Karam R, Marcello S, Brooks RR, et al: Azilimide dihydrochloride, a novel antiarrhythmic agent. Am J Cardiol 1998; 81(6A):40D-46D.

Amiodarone Overview

  • Amiodarone is used to treat and prevent certain types of serious, life-threatening ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could not be tolerated. Amiodarone is in a class of medications called antiarrhythmics. It works by relaxing overactive heart muscles.

See More information Regarding Amiodarone

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.