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Norpace oral

Selected Antiarrhythmics/Quinidine

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of your medicines affect your heart's rhythm.

What might happen:

You may be at an increased risk of a life-threatening irregular heartbeat.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together.If you experience an irregular heartbeat or any dizziness or fainting episodes, contact your doctor. Your doctor may need to adjust your dose of quinidine. This effect may be worse if you are also taking moricizine, procainamide, or disopyramide.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.


1.Tartini R, Kappenberger L, Steinbrunn W, Meyer UA. Dangerous interaction between amiodarone and quinidine. Lancet 1982 Jun 12;1(8285):1327-9.
2.Saal AK, Werner JA, Greene HL, Sears GK, Graham EL. Effect of amiodarone on serum quinidine and procainamide levels. Am J Cardiol 1984 May 1; 53(9):1264-7.
3.Cordarone X (amiodarone hydrochloride) Australian prescribing information. Sanofi-Synthelabo Australia Pty Limited Augsut 15, 2007.
4.Cordarone (amiodarone hydrochloride) US prescribing information. Wyeth Pharmaceuticals January, 2014.
5.Tartini R, Kappenberger L, Steinbrunn W. Harmful interactions of amiodarone and class I anti-arrhythmia agents. Schweiz Med Wochenschr 1982 Nov 6;112(45):1585-7.
6.Kerin NZ, Ansari-Leesar M, Faitel K, Narala C, Frumin H, Cohen A. The effectiveness and safety of the simultaneous administration of quinidine and amiodarone in the conversion of chronic atrial fibrillation. Am Heart J 1993 Apr;125(4):1017-21.
7.Tran HT, Chow MS, Kluger J. Amiodarone induced torsades de pointes with excessive QT dispersion following quinidine induced polymorphic ventricular tachycardia. Pacing Clin Electrophysiol 1997 Sep;20(9 Pt 1):2275-8.
8.Genth S, Darius H, Zotz R, Treese N, Himmrich E, Meyer J. Torsade de pointes during quinidine and amiodarone therapy. Med Klin (Munich) 1996 Mar 15;91(3):171-3.
9.Reingardene DI. Ventricular fibrillation caused by the combined administration of amiodarone and quinidine. Kardiologiia 1989 Jul; 29(7):121-4.
10.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
11.Rythmodan (disopyramide) Australian prescribing information. Aventis Pharma Pty Ltd. September 22, 2000.
12.Tikosyn (dofetilide) US prescribing information. Pfizer Inc. December, 2013.
13.Corvert (ibutilide fumarate) US prescribing information. Pharmacia & Upjohn Company July, 2002.
14.Fragakis N, Papadopoulos N, Papanastasiou S, Kozirakis M, Maligkos G, Tsaritsaniotis E, Katsaris G. Efficacy and safety of ibutilide for cardioversion of atrial flutter and fibrillation in patients receiving amiodarone or propafenone. Pacing Clin Electrophysiol 2005 Sep; 28(9):954-61.
15.Glatter K, Yang Y, Chatterjee K, Modin G, Cheng J, Kayser S, Scheinman MM. Chemical cardioversion of atrial fibrillation or flutter with ibutilide in patients receiving amiodarone therapy. Circulation 2001 Jan 16;103(2):253-7.
16.Rythmol (propafenone hydrochloride) US prescribing information. Abbott Laboratories March, 2013.
17.Funck-Brentano C, Kroemer HK, Pavlou H, Woosley RL, Roden DM. Genetically-determined interaction between propafenone and low dose quinidine: role of active metabolites in modulating net drug effect. Br J Clin Pharmacol 1989 Apr;27(4):435-44.
18.Gonzalez FJ, Skoda RC, Kimura S, Umeno M, Zanger UM, Nebert DW, Gelboin HV, Hardwick JP, Meyer UA. Characterization of the common genetic defect in humans deficient in debrisoquine metabolism. Nature 1988 Feb 4; 331(6155):442-6.
19.Klein RC, Huang SK, Marcus FI, Horwitz L, Fenster PE, Rushforth N, Kirsten EB. Enhanced antiarrhythmic efficacy of propafenone when used in combination with procainamide or quinidine. Am Heart J 1987 Sep; 114(3):551-8.
20.Lau CP, Chow MS, Tse HF, Tang MO, Fan C. Control of paroxysmal atrial fibrillation recurrence using combined administration of propafenone and quinidine. Am J Cardiol 2000 Dec 15;86(12):1327-32.
21.Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012 Sep-Oct; 19(5):735-43.

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