ISOPROTERENOL Drug Interactions: What You Need to Know

INTERACTIONS Table 1.

Clinically Relevant

Interactions with Isoproterenol Epinephrine Clinical Impact Both drugs are direct cardiac stimulants, and their combined effects may induce serious arrhythmias upon simultaneous administration.

Intervention

Isoproterenol hydrochloride injection and epinephrine should not be administered simultaneously. Drugs that may potentiate clinical response of Isoproterenol Clinical Impact The effects of isoproterenol may be potentiated by tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium, and certain antihistamines, notably chlorpheniramine, tripelennamine, and diphenhydramine.

Intervention

Monitor hemodynamic parameters in patients who concurrently are taking tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium and certain antihistamines. Adjust doses appropriately. Drugs that may reduce clinical response of Isoproterenol Clinical Impact The cardiostimulating and bronchodilating effects of isoproterenol are antagonized by beta-adrenergic blocking drugs, such as propranolol.

Intervention

Monitor for hemodynamic response and relief of bronchospasm and adjust dose appropriately. Do not administer isoproterenol hydrochloride injection and epinephrine simultaneously due to combined effects may induce serious arrhythmias. ( 7 ) Concomitant use of tricyclic antidepressants, monoamine oxidase inhibitors, levothyroxine sodium and certain antihistamines; hemodynamic parameters may potentiate a clinical response of isoproterenol. ( 7 ) Beta-adrenergic blocking drugs may reduce cardiostimulating and bronchodilating effects of isoproterenol. ( 7 )

See

17 for PATIENT COUNSELING INFORMATION.

Isoproterenol hydrochloride injection is contraindicated in patients with:

• tachycardia
• ventricular arrhythmias
• angina pectoris Isoproterenol hydrochloride injection is contraindicated in patients with:
• Tachycardia ( 4 )
• Ventricular arrhythmias ( 4 )
• Angina pectoris ( 4 )

AND PRECAUTIONS

• Cardiac arrhythmias and ischemia may be induced by isoproterenol hydrochloride injection ( 5.1 )
• Sulfite: Isoproterenol hydrochloride injection contains metabisulfite, which may cause allergic reaction ( 5.2 ) 5.1.

Cardiac

Arrhythmias and Ischemia Isoproterenol may induce cardiac arrhythmias and myocardial ischemia in patients, especially patients with coronary artery disease, or cardiomyopathy.

5.2 Allergic Reactions associated with Sulfite Isoproterenol hydrochloride injection contains sodium metabisulfite, which may cause mild to severe allergic reactions including anaphylaxis or asthmatic episodes, particularly in patients with a history of allergies. However, the presence of metabisulfite in this product should not preclude its use for treatment in emergency situations, even if the patient is sulfite-sensitive, as the alternatives to using isoproterenol in a life threatening situation may not be satisfactory.