Tachycardia: Medication and pacemaker interactions

Medicines for tachycardia that may interact with other medicines and with pacemakers and ICDs

Medicine	Important medicine interactions	Effect on pacemakers and ICDs
Amiodarone	Increases the effect of digoxin and warfarin	At high doses, may increase energy requirements on ICDs
Disopyramide	More potential for side effects when given with phenobarbital, phenytoin, or rifampin
Flecainide	Increases the effect of digoxin
Ibutilide	Prolongs the heart's QT interval	Unknown
Lidocaine	More potential for side effects when given with propranolol, metoprolol, or cimetidine
Mexiletine	Increases the effect of theophylline Less effective when given with phenobarbital, phenytoin, or rifampin	Not predictable
Procainamide	More potential for side effects when given with cimetidine, alcohol, or amiodarone
Propafenone	Increases the effect of digoxin, theophylline, and warfarin Less effective when given with phenobarbital, phenytoin, or rifampin More potential for side effects when given with cimetidine
Quinidine	Increases the effect of digoxin and warfarin More potential for side effects when given with heparin, verapamil, or cimetidine Less effective when given with phenobarbital, phenytoin, or rifampin
Sotalol	Increases the effect of other beta-blockers	May decrease energy requirements on ICDs

Author:	Monica Rhodes	Last Updated: September 26, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Laurence Epstein, MD - Cardiac Electrophysiologist
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