Rythmodan

Overdose

There is no specific antidote for disopyramide. Prostigmine derivatives can be used to treat anticholinergic effects. Symptomatic supportive measures may include : early gastric lavage ; administration of a cathartic followed by activated charcoal by mouth or stomach tube ; IV administration of isoprenaline, other vasopressors and/or positive inotropic agents ; if needed - infusion of lactate and/or magnesium, electro-systolic assistance, cardioversion, insertion of an intra-aortic balloon for counterpulsion and mechanically assisted ventilation. Haemodialysis, haemofiltration or haemoperfusion with activated charcoal has been employed to lower the serum concentrations of the drug.

Shelf life

PVC Blister :           36 months

Rythmodan price

Average cost of Rythmodan 100 mg per unit in online pharmacies is from 0.76$ to 0.84$, per pack from 64$ to 71$.

Contraindications

Disopyramide is contra-indicated in un-paced second or third degree atrioventricular block; bundle-branch block associated with first-degree atrioventricular block ; unpaced bifasicular block; pre-existing long QT syndromes; severe sinus node dysfunction ; severe heart failure, unless of secondary to cardiac arrhythmia ; hypersensitivity to disopyramide. It is also contra-indicated in concomitant administration with other anti-arrhythmics or other drugs liable to provoke ventricular arrythmias, especially Torsade de Pointes. The sustained release formulation is contra-indicated in patients with renal or hepatic impairment.

Incompatibilities

Not known.

List of excipients

Maize starch

Magnesium stearate

STA-RX 1500 (pregelatinised starch)

Talc.

Capsule shell:

Gelatin

Indigo carmine,

Iron oxide and

Titanium dioxide (E171)

Pharmaceutical form

Capsule.

Undesirable effects

In some cases, severe hypoglycaemia resulted in coma.

Very rarely: cholestatic jaundice, headache, dizzy sensation, neutropenia.

Rapid infusion may cause profuse sweating.

Reporting of suspected adverse reactions

Reporting of suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard

Preclinical safety data

Not applicable.

Therapeutic indications

Rythmodan is used in the treatment of cardiac arrhythmias as follows:-

1. The prevention and treatment of arrhythmias occurring after myocardial infarction.

2. Maintenance of normal rhythm following electroconversion eg atrial fibrillation, atrial flutter.

3. Persistent ventricular extrasystoles.

4. Control of arrhythmias following the use of digitalis or similar glycosides.

5. Suppression of arrhythmias during surgical procedures eg cardiac catheterisation.

6. The prevention of paraxysmal supraventricular tachycardia.

7. Other types of arrhythmias e.g. atrial extrasystoles, Wolff-Parkinson-White Syndrome.

Pharmacodynamic properties

Class 1 anti-arrhythmic agent.

It decreases membrane responsiveness, prolongs the effective refractory period (ERP) and slows automaticity in cells with augmented automaticity. Effective refractory period of the atrium is lengthened, ERP of the A-V node is shortened and conduction in accessory pathways is prolonged.

Disopyramide is a myocardial depressant and has anti-cholinergic effects.

Pharmacokinetic properties

Elimination phase of plasma t1/2: 5-8 hours. Increased in hepatic impairment, cardiac and hepatic disease.

Protein binding: 50 - 60%. Saturable and concentration dependent.

Volume of distribution: Variable according to method of determination.

Metabolism: Approximately 25% of a dose metabolised to a mono-N-dealkylated derivative. Additional 10% as other metabolites.

Excretion: 75% unchanged drug via urine, remainder in faeces mono-N-dealkylated metabolite 25% in urine, 64% via faeces.

Date of revision of the text

1 August 2013

Name of the medicinal product

Rythmodan 100mg Capsules.

Marketing authorisation holder

Sanofi-aventis

One Onslow Street

Guildford

Surrey GU1 4YS

UK

Special precautions for storage

Do not store above 25°C

Nature and contents of container

Glass Bottle containing 100 capsules

PVC Blister containing 84 capsules.

Marketing authorisation number(s)

PL 04425/0607

Special warnings and precautions for use

Effects on ability to drive and use machines

Some adverse reactions may impair the patients ability to concentrate and react, and hence the ability to drive or operate machinery..

Dosage (Posology) and method of administration

Route of administration

Oral

300 mg to 800mg daily in divided doses.

Children :

Not recommended as insufficient data available.

Elderly

A dose reduction due to reduced renal and hepatic function in the elderly (especially elderly non-smokers) should be considered

Special precautions for disposal and other handling

None.

Date of first authorisation/renewal of the authorisation

12 February 2009