Disopyramide

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Generic Name of Disopyramide - Learn More

Disopyramide

Disopyramide Precaution - What You Need to Know

- Heart Failure: Disopyramide can worsen heart failure due to its negative inotropic effect, which reduces the heart's contractility. Use with caution in patients with heart failure or left ventricular dysfunction.
- Proarrhythmic Effects: Disopyramide can increase the risk of arrhythmias, including ventricular tachycardia and ventricular fibrillation, especially in patients with structural heart disease. Monitor patients closely for signs of new or worsening arrhythmias.
- Anticholinergic Effects: Disopyramide has anticholinergic properties, which can lead to side effects such as dry mouth, blurred vision, constipation, and urinary retention. Use with caution in patients with glaucoma, myasthenia gravis, or prostate enlargement.
- QT Prolongation: Disopyramide can prolong the QT interval, increasing the risk of torsade de pointes, a serious type of arrhythmia. Avoid use in patients with long QT syndrome or those taking other QT-prolonging medications.
- Hypotension: Disopyramide can cause low blood pressure, especially when administered intravenously. Monitor blood pressure closely during treatment.
- Liver and Kidney Function: Use with caution in patients with liver or kidney impairment, as disopyramide is metabolized by the liver and excreted by the kidneys. Dosage adjustments may be necessary.
- Drug Interactions: Disopyramide can interact with other medications, including those that affect liver enzymes or prolong the QT interval. Always inform your healthcare provider about all medications you are taking.
- Elderly Patients: Elderly patients may be more sensitive to the side effects of disopyramide, particularly its anticholinergic effects. Use with caution and consider lower doses in this population.

Disopyramide Indication - Uses and Benefits

- Ventricular Tachycardia: Disopyramide is primarily used to treat life-threatening ventricular arrhythmias, including ventricular tachycardia and ventricular fibrillation. It is a Class 1A antiarrhythmic agent that stabilizes heart rhythm by slowing down electrical signals in the heart.
- Atrial Fibrillation: Although not approved for this indication in the United States, disopyramide can be used to convert and maintain normal sinus rhythm in patients with atrial fibrillation, particularly those with vagally mediated atrial fibrillation.
- Hypertrophic Cardiomyopathy: Disopyramide can be used off-label to decrease the left ventricular outflow tract gradient in patients with hypertrophic obstructive cardiomyopathy, improving symptoms.
- Diagnostic Uses: Disopyramide may be used in diagnostic settings to assess the risk of arrhythmias or to evaluate the effectiveness of implantable cardioverter-defibrillators (ICDs).

Disopyramide Contraindications - Important Warnings

- Hypersensitivity: Do not use disopyramide if you have a known hypersensitivity or allergy to the drug or any of its components.
- Severe Heart Failure: Avoid use in patients with severe heart failure due to the risk of worsening symptoms.
- Cardiogenic Shock: Avoid use in patients with cardiogenic shock due to the risk of further reducing cardiac output.
- Second- or Third-Degree AV Block: Avoid use in patients with second- or third-degree AV block unless a pacemaker is present, as disopyramide can worsen conduction blocks.
- Glaucoma and Urinary Retention: Use with caution in patients with glaucoma or urinary retention due to its anticholinergic effects. Adequate precautions should be taken to manage these conditions.
- Long QT Syndrome: Avoid use in patients with congenital or acquired long QT syndrome due to the risk of torsade de pointes.

Disopyramide Side Effects - What to Expect

- Common Side Effects: These include dry mouth, constipation, blurred vision, and urinary retention due to the drug's anticholinergic effects. These are usually mild and may go away as your body adjusts to the medication.
- Cardiovascular Side Effects: Disopyramide can cause hypotension, heart failure, and new or worsening arrhythmias, including ventricular tachycardia and ventricular fibrillation.
- Anticholinergic Side Effects: More severe anticholinergic effects can include confusion, hallucinations, and delirium, particularly in elderly patients.
- Hepatotoxicity: Although rare, disopyramide can cause liver injury, indicated by elevated liver enzymes. Monitor liver function tests regularly during treatment.
- Hematological Side Effects: Disopyramide can cause blood dyscrasias, including agranulocytosis and aplastic anemia, although these are rare.

Disopyramide Pregnancy Category ID - Safety Information

3

Disopyramide Mode of Action - How It Works

- Sodium Channel Blockade: Disopyramide works by blocking sodium channels in the heart, which slows down the electrical signals that cause the heart to beat. This helps to stabilize the heart rhythm and prevent arrhythmias.
- Prolongation of Refractory Period: Disopyramide prolongs the refractory period of the atrium and ventricles, which helps to prevent premature contractions and tachyarrhythmias.
- Anticholinergic Activity: Disopyramide has anticholinergic effects, which can help to reduce vagally mediated arrhythmias, such as those that occur during sleep or in athletes.
- Negative Inotropic Effect: Disopyramide has a negative inotropic effect, which means it reduces the contractility of the heart muscle. This can help to decrease the workload on the heart but can also worsen heart failure in some patients.
- Effect on Action Potential: Disopyramide decreases the upstroke velocity of the action potential and increases its duration, which helps to stabilize the heart rhythm.

Disopyramide Drug Interactions - What to Avoid

- QT-Prolonging Drugs: Avoid concomitant use with other drugs that prolong the QT interval, such as certain antiarrhythmics, antipsychotics, and antibiotics, due to the increased risk of torsade de pointes.
- CYP3A4 Inhibitors: Disopyramide is metabolized by CYP3A4, and drugs that inhibit this enzyme, such as macrolide antibiotics and azole antifungals, can increase disopyramide levels, leading to toxicity.
- Anticholinergic Drugs: Concomitant use with other anticholinergic drugs can exacerbate anticholinergic side effects, such as dry mouth, constipation, and urinary retention.
- Beta-Blockers and Calcium Channel Blockers: Concomitant use with beta-blockers or calcium channel blockers can increase the risk of bradycardia and heart block.
- Digoxin: Concomitant use with digoxin can increase the risk of heart block and other conduction disturbances.

Disopyramide Adult Dose - Recommended Dosage

- Oral Dosage: The typical adult dose for treating arrhythmias is 400 to 800 mg daily, divided into 2 to 4 doses. The extended-release capsule is usually taken every 12 hours.
- Intravenous Dosage: For acute arrhythmias, disopyramide can be administered intravenously at a dose of 1.5 to 2 mg/kg, followed by a maintenance infusion of 0.4 mg/kg/hr. The infusion rate may be adjusted based on response and tolerability.
- Dosage Adjustments: Dosage adjustments may be necessary based on individual response to treatment, liver and kidney function, and concomitant medications. Always follow your doctor's instructions for dosing.

Disopyramide Child Dose - Dosage for Children

- Age Restrictions: The safety and effectiveness of disopyramide in children have not been established. Use in children should be under the close supervision of a healthcare provider.
- Dosage: If used in children, the dosage is typically based on body weight and must be determined by a healthcare provider. Close monitoring is essential to adjust the dose based on individual response and tolerability.
- Medical Supervision: Any use of disopyramide in children should be closely monitored. Dosage adjustments may be necessary based on individual response and tolerance.

Disopyramide Renal Dose - Dosage for Kidney Conditions

- Renal Impairment: Dosage adjustments may be necessary in patients with renal impairment, as disopyramide is partially excreted by the kidneys. Monitor patients closely for side effects, and adjust the dose based on individual response and tolerability.
- Monitoring: Patients with renal impairment should have regular monitoring of kidney function and electrolyte levels during treatment with disopyramide. Dosage adjustments may be made based on these results.
- Consultation: Always consult your healthcare provider for personalized advice on disopyramide dosing if you have renal impairment. They may consider other factors, such as liver function and concomitant medications, when determining the appropriate dose.