Arrhythmia Medications
Amiodarone (Cordarone)
Calcium Channel Blockers-(See Blood Pressure Lowering Medications)
Digoxin (Digoxin, Lanoxin, Lanoxicaps)
Disopyramide (Norpace)
Lidocaine (Xylocaine)
Mexiletine (Mexitil)
Quinidine Sulfate (Quinidex)
Quinidine Gluconate Quinaglute)
Procainamide (Procan SR, Pronestyl)
Nutritional Considerations:
Avoid alcohol. (Pronksy 1999)
Avoid caffeine. (Brinker 1998)
Take with food if stomach upset occurs. (Pronsky 1999)
Magnesium and potassium levels must be monitored periodically while taking amiodarone. (Pronsky 1999)
Mineral imbalances can create a dangerous effect on the body when combined with Lanoxin. High calcium levels, low potassium levels or low magnesium levels can create a toxic effect. Low calcium levels can reduce the effect of Lanoxin. The levels of these minerals must be monitored periodically while taking lanoxin. (Holt 1998) (Mindell 1998) (Schwinger 1992) (Whang 1985)
Grapefruit juice interferes with the metabolism and clearance of quinidine. Avoid while taking this medication. (Damkier 1999) (Ha 1995) (Min 1996)
Herbal Considerations:
Do not use night-blooming cereus with any antiarrhythmics because it may increase side effects of the drugs. (Blumenthal 1998)
Avoid Ginseng (Panax ginseng and Panax quinquefolium roots as well as Ganoderma lucidum) with antiarrhythmics, because they may cause changes in heart rhythm. (Newall 1996) (Wang WK, 1994)
Avoid thornapple with antiarrhythmics due to its cardiac activity. (Brinker 1998)
Avoid natural licorice products and ma huang with antiarrhythmics because they may affect heart rhythm. (Blumenthal 1998) (Brinker 1998) (Newall 1996) (Pronsky 1999).
Avoid these herbs: aloe, buckthorn, cascara sagrada, rhubarb, senna or caffeine containing herbs, like cocoa, cola, guarana, horsetail, mate, and tea leaves with antiarrhythmics because they can cause potassium loss and toxicity. (Blumenthal 1998) (Brinker 1998)
Lily of the valley roots, Pleurisy root, and Squill bulb leaf scales are all considered cardiotonic herbs and should be avoided with these drugs. (Blumenthal 1998)(Newall 1996)
Sarsaparilla can cause increased absorption of digitalis glycosides and should not be used together. (Blumenthal 1998)
References:
Blumenthal, M (Ed.): The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council. Austin, TX. 1998.
Brinker, F. Herb Contraindications and Drug Interactions. Eclectic Institute, 1998.
Damkier P, Hansen LL, Brosen K. Effect of diclofenac, disulfiram, itraconazole, grapefruit juice and erythromycin on the pharmacokinetics of quinidine. Br J Clin Pharmacol 1999;48(6):829-838.
Ha HR, Chen J, Leuenberger PM, Freiburghaus AU, Follah F. In vitro inhibition of midazolam and quinidine metabolism by flavonoids. Eur J Clin Pharmacol. 1995;48:367-71
Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 94.
Mindell, E, Hopkins V: Prescription Alternatives. New Canaan, CT: Keats Publishing, Inc, 1998; p. 107.
Min DI, Ku YM, Geraets DR, Lee HC. Effect of grapefruit juice on the pharmacokinetics and pharmacodynamics of quinidine in healthy volunteers. J Clin Pharmacol. 1996;36:469-76
Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
Pronsky, ZM, et al: Food-Medication Interactions, Pottstown, PA, 1999.
Schwinger RH, Eromann E: Heart failure and electrolyte disturbances, Methods find Exp Clin Pharmacol, 1992, 14(4): 315-25
Wang DJ, Chu KM, Chen JD, et al. Drug interaction between digoxin and bisacodyl. J Formes Med Assoc 1990;89:913, 915-19 [in Chinese].
Whang R, Oei TO, Watanabe A. Frequency of hypomagnesaemia in hospitalized patients receiving digitalis. Arch Intern Med 1985;145:655-56.
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