Comparative Pharmacology
Head-to-head clinical analysis: BRETYLIUM TOSYLATE IN DEXTROSE 5 IN PLASTIC CONTAINER versus BRETYLOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BRETYLIUM TOSYLATE IN DEXTROSE 5 IN PLASTIC CONTAINER versus BRETYLOL.
BRETYLIUM TOSYLATE IN DEXTROSE 5% IN PLASTIC CONTAINER vs BRETYLOL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Bretylium tosylate inhibits norepinephrine release from adrenergic nerve terminals by blocking neuronal reuptake and causing initial norepinephrine release followed by depletion. It also exhibits class III antiarrhythmic activity by prolonging the action potential duration and refractory period in cardiac Purkinje fibers and ventricular muscle.
Bretylium tosylate is an adrenergic neuron blocking agent that inhibits norepinephrine release and enhances its reuptake, resulting in postganglionic sympathetic blockade. It also has direct antiarrhythmic effects by increasing the ventricular fibrillation threshold.
For ventricular tachycardia/fibrillation: 5 mg/kg IV over 8-10 minutes, then 5-10 mg/kg IV q6-8h. For continuous infusion: 1-2 mg/min IV.
Intravenous: 5-10 mg/kg over 10 minutes, then 5-10 mg/kg every 6-8 hours as needed for arrhythmias. Intramuscular: 5-10 mg/kg, may repeat every 6-8 hours.
None Documented
None Documented
Terminal half-life: 7-11 hours (normal renal function); prolonged in renal impairment (up to 16-32 hours in anuria)
Terminal elimination half-life is 7-11 hours in normal renal function; prolonged in renal impairment (up to 30 hours)
Renal: >80% unchanged; biliary/fecal: minimal (<5%)
Primarily renal excretion of unchanged drug (80-90%); minor biliary/fecal elimination (10-20%)
Category C
Category C
Antiarrhythmic (Class III)
Antiarrhythmic (Class III)