Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
bretylium
Adrenergic modulation, K+ channel blocker · Antiarrhythmic
Adrenergic modulation, K+ channel blockerAntiarrhythmicATC C01BC01
CDSCO approvedATC C01BC01
EXCRETION
—
not curated
INTERACTIONS
6 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AmisulprideSevereDatabaseDDInter
- ArbutamineSevereDatabaseDDInter
- DisopyramideSevereDatabaseDDInter
- DofetilideSevereDatabaseDDInter
Mechanism
Bretylium prolongs cardiac action potentials, likely through block of K+ channels. It interferes with norepinephrine reuptake by sympathetic neurons, initially causing norepinephrine release and inhibition of subsequent reuptake.
Indications
Ventricular fibrillationPrevention of ventricular fibrillation recurrence
Dosing
- Adult
- Loading: 150–300 mg (IV). Maintenance: 1–4 mg/min (IV).
- Renal adjustment
- Reduction of maintenance infusion rate recommended in patients with renal failure.
Pharmacokinetics
Onset
Lag time of ~2 h between peak plasma concentrations and peak prolongation of ventricular refractoriness (suggests distribution to peripheral tissues).
Half-life
7–15 h
Protein binding
Not specified
Metabolism
Not significant
Contraindications
- Aortic/subaortic stenosis
- Digitalis intoxication (theoretical, due to increased arrhythmias with norepinephrine release)
Side effects
Common
Hypotension
Serious
- Transient hypertension (initial norepinephrine release)
- Increased arrhythmias (initial norepinephrine release)
- Marked hypertension if normal doses of catecholamines are administered (due to sympathetic denervation)
- Torsades de pointes (unusual)
Drug interactions
Arbutamine
Severe
Database
Clinical effect not specified
Source: DDInter
Disopyramide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Dofetilide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ibutilide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Propafenone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Amoxapine
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Clomipramine
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Desipramine
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Doxepin
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Imipramine
Moderate
Textbook
Inhibition of bretylium's hypotensive effects.
The antiarrhythmic effects of bretylium may be preserved despite inhibition of its hypotensive effects.
Source: G&G 14e · p686
Related guidelines
Ask House about bretylium
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team