You're not logged in. Please log in to earn stock or Bitcoin rewards on your prescription purchase.
Bretylium Tosylate
Bretylium Tosylate is an antiarrhythmic medication used primarily for the treatment of life-threatening ventricular arrhythmias, such as ventricular fibrillation and ventricular tachycardia, particularly when other treatments have failed. It belongs to the class of Class III antiarrhythmics, which work by prolonging the action potential and refractory period of cardiac cells, helping to restore and maintain normal heart rhythm.
Bretylium was once widely used in emergency settings but is now less commonly used due to the availability of newer antiarrhythmics.
Oops! We currently don’t have the pricing information for this drug.
But we're continually improving our service to help you save and earn rebates on your medications. If your drug isn't listed on NiHowdy, you can still present your NiHowdy savings card at the pharmacy. We'll work to secure any eligible rebates for that drug and pass the savings back to you retroactively.
Members have saved
$NaN
using our savings card for instant savings.
Don't pay full retail price and miss out on potential savings. Try it now—you have nothing to lose!
NaNM
worth of Satoshi has been rewarded to our members.
Everyone who signs up enjoys the benefits of earning FREE Bitcoin with every purchase.
Frequently Asked Questions
How quickly does Bretylium Tosylate work?
Bretylium Tosylate works within minutes when given intravenously. Its effects can last several hours, and continuous monitoring is required during treatment.
Why is Bretylium no longer commonly used?
Bretylium has largely been replaced by newer antiarrhythmic drugs like amiodarone and lidocaine, which have fewer side effects and are more effective in many cases. However, it is still used in some situations when other drugs are ineffective or unavailable.
Can Bretylium be used for atrial arrhythmias?
Bretylium is not typically used for atrial arrhythmias, as it is specifically indicated for life-threatening ventricular arrhythmias like ventricular fibrillation and ventricular tachycardia.
What should I do if I experience side effects after receiving Bretylium?
Patients who experience side effects such as dizziness, nausea, severe hypotension, or difficulty breathing while receiving Bretylium should inform their healthcare provider immediately, as close monitoring is essential.
Is Bretylium safe during pregnancy?
The safety of Bretylium during pregnancy has not been well established. It is generally reserved for life-threatening situations where the benefits outweigh potential risks.
Comprehensive Drug Guide
How Does Bretylium Tosylate Work?
Bretylium Tosylate works by inhibiting the release of norepinephrine from sympathetic nerve terminals, which leads to an initial rise in blood pressure followed by a reduction in sympathetic stimulation. It blocks the reuptake of norepinephrine, causing a stabilization of the cardiac action potential. This prolongs the refractory period of the heart muscle, which helps to correct abnormal heart rhythms like ventricular tachycardia and ventricular fibrillation.
What is Bretylium Tosylate Used For?
Ventricular Fibrillation: Used when ventricular fibrillation is unresponsive to defibrillation or other medications.
Ventricular Tachycardia: For the treatment of life-threatening ventricular tachycardia, particularly when other medications have not been effective.
Common Dosages
Bretylium Tosylate is available by prescription only and is administered intravenously or intramuscularly in hospital or emergency care settings. It is not classified as a controlled substance.
Administration: Bretylium Tosylate is administered by healthcare professionals in an emergency setting, typically in a hospital intensive care unit or emergency room. It can be given either intravenously (IV) or intramuscularly (IM).
Duration of Action: The onset of action is within minutes after IV administration, with effects lasting several hours depending on the dosage. Continuous monitoring of the patient is required during administration.
Typical Dosing
FDA Approved Indications
The typical dosage of Bretylium Tosylate depends on the route of administration and the clinical situation:
- Intravenous (IV) Administration: Initial bolus dose of 5 to 10 mg/kg administered over 8 to 10 minutes, followed by maintenance infusions if needed.
- Intramuscular (IM) Administration: 5 to 10 mg/kg as a single dose for urgent cases when IV access is not available.
Dosage can be adjusted based on the patient's response and clinical condition.
Who Shouldn't Take Bretylium Tosylate?
Bretylium Tosylate is contraindicated in patients with:
- Hypersensitivity or allergy to bretylium.
- Severe hypotension or shock, as the drug can cause an initial drop in blood pressure.
- A history of pheochromocytoma, a tumor of the adrenal glands that can cause dangerous hypertension when exposed to certain medications.
Advice From The Pharmacist
Patients receiving Bretylium Tosylate should be closely monitored, but general advice includes:
- Continuous cardiac monitoring is essential during and after administration due to the risk of severe arrhythmias, blood pressure changes, and other cardiovascular effects.
- Be prepared for the possibility of an initial rise in blood pressure, followed by a significant drop. This requires careful blood pressure management and the potential use of vasopressors.
- Due to its potential side effects, Bretylium is reserved for situations where other antiarrhythmics have failed or are not available.
Side Effects of Bretylium Tosylate
Common Side Effects
- Hypotension (low blood pressure)
- Nausea and vomiting
- Dizziness or lightheadedness
- Bradycardia (slow heart rate)
- Shortness of breath
Uncommon/Severe Side Effects
- Severe Hypotension: Bretylium can cause a rapid and severe drop in blood pressure, particularly after initial doses. Vasopressors may be needed to support blood pressure.
- Ventricular Arrhythmias: Paradoxically, in some patients, Bretylium can worsen ventricular arrhythmias or cause new arrhythmias.
- Syncope (fainting): Due to blood pressure changes.
- Respiratory Depression: Although rare, breathing difficulties can occur.
Risks and Warnings of Bretylium Tosylate
Hypotension: Bretylium often causes an initial drop in blood pressure after administration. In patients with already low blood pressure or heart failure, this can be dangerous, and additional medications may be required to stabilize blood pressure.
Arrhythmias: Bretylium can cause or exacerbate arrhythmias in certain cases. Patients should be closely monitored for worsening arrhythmias during and after administration.
Careful Monitoring: Patients should be under continuous cardiac and blood pressure monitoring while receiving Bretylium due to the potential for serious cardiovascular effects.
Interactions with Bretylium Tosylate
Common Drug Interactions
Bretylium Tosylate may interact with other medications, including:
- Digitalis Glycosides: May increase the risk of arrhythmias.
- Beta-Blockers: Can enhance the blood pressure-lowering effects of Bretylium, increasing the risk of severe hypotension.
- Diuretics: May exacerbate the risk of electrolyte imbalances, which can worsen arrhythmias.
Patients should inform their healthcare provider of all medications they are taking, especially those that affect heart rate, rhythm, or blood pressure.
Alternatives to Bretylium Tosylate
Alternative treatments for life-threatening ventricular arrhythmias include:
- Amiodarone: A Class III antiarrhythmic used to treat various types of arrhythmias, including ventricular fibrillation and ventricular tachycardia.
- Lidocaine: A Class Ib antiarrhythmic used in emergency settings for ventricular arrhythmias.
- Procainamide: A Class Ia antiarrhythmic used for both atrial and ventricular arrhythmias.
- Defibrillation: For ventricular fibrillation, defibrillation is the first-line treatment before considering antiarrhythmic medications.
The choice of treatment depends on the clinical situation, the patient’s underlying health conditions, and the response to initial treatments.
