Disopyramide
- Atc Codes:C01BA03
- CAS Codes:22059-60-5#3737-09-5
- PHARMGKB ID:22059-60-5#3737-09-5
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Belgium: Rythmodan; Finland: Disomet; France: Isorythm, Rythmodan; Germany: Norpace; Greece: Dicorynan, Ritmodan, Rythmodan, Rythmodul; Hungary: Palpitin; Ireland: Rythmodan; Italy: Ritmodan; Luxembourg: Dirytmin, Rythmodan; Malta: Disopyramide, Rythmodan; Netherlands: Disopyramide, Ritmoforine; Poland: Disocor-Zakłady Farm, Rythmodan; Spain: Dicorynan; Sweden: Durbis; UK: Rythmodan.
North America
Canada: Rythmodan; USA: Disopyramide, Norpace.
Latin America
Brazil: Dicorantil F; Mexico: Biolytan, Dimodan.
Asia
Japan: Chiyoban, Disopyran, Disopyra R, Fanmil, Kafier, Lispine, Mycorten R, Norpace, Postormin, Rislamid R, Rizoramid, Rythmodan, Sopyrat, Tailinder.
Drug combinations
Chemistry
Disopyramide Phosphate: C~21~H~29~N~3~O H~3~PO~4~. Mw: 437.47. (1) 2-Pyridineacetamide, α-[2-[bis(1-methylethyl)amino]ethyl]-α-phenyl-, (±)-, phosphate (1:1); (2)(±)-α-[2-(Diisopropylamino)ethyl]-α-phenyl-2-pyridineacetamide phosphate (1:1). CAS-22059-60-5; CAS-3737-09-5 (disopyramide)(1978).
Pharmacologic Category
Antiarrhythmic Agents; Class Ia Antiarrhythmics. (ATC-Code: C01BA03).
Mechanism of action
Decreases myocardial excitability and conduction velocity. Reduces disparity in refractory period between normal and infarcted myocardium. Possesses anticholinergic, peripheral vasoconstrictive, and negative inotropic effects.
Therapeutic use
Suppression and prevention of unifocal and multifocal ventricular premature complexes, coupled ventricular premature complexes and/or paroxysmal ventricular tachycardia in primary arrhythmias or arrhythmias secondary to coronary artery disease.
Pregnancy and lactiation implications
Disopyramide phosphate should be used during pregnancy only when potential benefits justify the possible risks to the fetus. It is not known whether use of the drug during labor or delivery could have any immediate or delayed adverse effects on mother or fetus, affect the duration of labor, or increase the likelihood of forceps delivery or other obstetric intervention. Disopyramide is distributed into milk. Use with caution during lactation.
Unlabeled use
Conversion and prevention of the recurrence of atrial fibrillation, atrial flutter, and paroxysmal atrial tachycardia to normal sinus rhythm. Hypertrophic obstructive cardiomyopathy.
Contraindications
Hypersensitivity to disopyramide or any component of the formulation. Cardiogenic shock. Pre-existing second- or third-degree heart block (except in patients with a functioning artificial pacemaker). Congenital QT syndrome. Sick sinus syndrome.
Warnings and precautions
Hypotension or proarrhythmic effects might occur during initiation of therapy. In atrial fibrillation or flutter, the AV node should be blocked before initiating. Avoid use in benign prostatic hypertrophy and/or urinary retention, glaucoma, or myasthenia gravis (due to anticholinergic effects). Use with caution in bundle branch block or heart block. Correct electrolyte disturbances, especially hypokalemia or hypomagnesemia, prior to use and throughout therapy. Use with caution in heart failure (may precipitate or exacerbate condition), hepatic impairment, renal impairment (extended release form is not recommended for CrCl <40 mL/minute), or in Wolff-Parkinson-White syndrome. Avoid concurrent use with other drugs known to prolong QTc interval or decrease myocardial contractibility. Antiarrhythmic agents should be reserved for life-threatening ventricular arrhythmias.