Re: Cardizem, rythmol, and dig.....oh my
Did your nurse verify the order? The usual IVP dose for A-Fib is 0.25 mg/kg, with a follow-up of 0.35 mg/kg
after 15 minutes. Was it a bariatric patient? Also, according to ePocrates, mixing the 3 drugs decreases the clearance of both dig and rythmol.
Monitor/Modify Tx 1. Cardizem <-> digoxin
monitor levels, ECG: combo may incr. digoxin levels, risk of toxicity, AV block (clearance decreased, additive effects)
2. digoxin <-> Rythmol
monitor levels: combo may incr. digoxin levels, risk of toxicity (clearance, volume of distribution decreased)
Caution Advised 3. Cardizem <-> Rythmol
caution advised: combo may incr. propafenone levels, risk of adverse effects (hepatic metab. inhibited)
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