Drug General Information (ID: DDIS4X68UF)
Drug Name			Carteolol (ophthalmic)		Drug Info		Flecainide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Antiarrhythmic Agents
Structure

Mechanism of Carteolol (ophthalmic)-Flecainide Interaction (Severity Level: Moderate)
Increased risk of cardiac depression Click to Show/Hide Mechanism Graph
Drug Name		Carteolol (ophthalmic)				Flecainide
Mechanism		Cardiac depressant effects				Cardiac depressant effects
Key Mechanism Factor 1
		Factor Name		Cardiac depression
		Factor Description		Cardiac depression may manifest as negative heart rate, negative conduction, and negative contractility. Symptoms include: excessive or more than normal sleep, irritability, loss of interest in activities, and fatigue.
Mechanism Description		Increased risk of cardiac depression by the combination of Carteolol (ophthalmic) and Flecainide

Recommended Action
Management		Careful monitoring of the patient's hemodynamic status is recommended during concomitant administration. The same precaution should be observed when beta blocker ophthalmic solutions are used, since they are systemically absorbed and can produce clinically significant systemic effects even at low or undetectable plasma levels. Patients should be advised to promptly report symptoms such as dizziness, slow or irregular heartbeats, syncope, or palpitations.

References
1	Minish T, Herd A "Symptomatic bradycardia secondary to interaction between topical timolol maleate, verapamil, and flecainide: a case report." J Emerg Med 22 (2002): 247-9. [PMID: 11932086]
2	Lewis GP, Holtzman JL "Interaction of flecainide with digoxin and propranolol." Am J Cardiol 53 (1984): b52-7
3	Holtzman JL, Kvam DC, Berry DA, et al "The pharmacodynamic and pharmacokinetic interaction of flecainide acetate with propranolol: effects on cardiac function and drug clearance." Eur J Clin Pharmacol 33 (1987): 97-9