BETA BLOCKERS AND DISOPYRAMIDE

Severe bradycardia has been described after the use of disopyramide with beta blockers including practolol (3 cases, 1 fatal) pindolol (1 fatal case) and metoprolol (1 case). Another patient given disopyramide and intravenous sotalol developed asystole (see also drugs that prolong the QT interval). Oral propranolol and disopyramide have been given to healthy subjects without any increase in negative inotropic effects or pharmacokinetic changes.
The manufacturers of disopyramide suggest that the combination of disopyramide and beta blockers should generally be avoided.