Comparative Pharmacology
Head-to-head clinical analysis: BRETYLIUM TOSYLATE IN DEXTROSE 5 versus BRETYLIUM TOSYLATE IN DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BRETYLIUM TOSYLATE IN DEXTROSE 5 versus BRETYLIUM TOSYLATE IN DEXTROSE 5 IN PLASTIC CONTAINER.
BRETYLIUM TOSYLATE IN DEXTROSE 5% vs BRETYLIUM TOSYLATE IN DEXTROSE 5% IN PLASTIC CONTAINER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Bretylium tosylate is an antiarrhythmic agent that prolongs the action potential duration and refractory period in cardiac tissue. It initially causes release of norepinephrine from sympathetic nerve endings, followed by inhibition of norepinephrine release. It has class III antiarrhythmic properties and also exhibits adrenergic blockade.
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.
Intravenous: 5-10 mg/kg infused over 10-30 minutes, may repeat at 30-minute intervals up to a total of 30 mg/kg; maintenance: 1-2 mg/min as continuous IV infusion or 5-10 mg/kg every 6 hours by intermittent infusion. Intramuscular: 5-10 mg/kg undiluted, repeat every 1-2 hours as needed.
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.
None Documented
None Documented
Terminal elimination half-life is approximately 7-11 hours in patients with normal renal function, but can be prolonged to >24 hours in renal impairment or anuria, necessitating dose adjustment.
Terminal half-life: 7-11 hours (normal renal function); prolonged in renal impairment (up to 16-32 hours in anuria)
Primarily excreted unchanged by the kidneys via glomerular filtration and tubular secretion; >70% of an administered dose recovered in urine within 24 hours; negligible biliary/fecal elimination.
Renal: >80% unchanged; biliary/fecal: minimal (<5%)
Category C
Category C
Antiarrhythmic (Class III)
Antiarrhythmic (Class III)