For patients with the Brugada syndrome a number of drugs are contraindicated or to avoid.
On the website www.brugadadrugs.org you can look up a regularly updated list of these drugs. In any case, this list should be discussed with your treating cardiologist.
DRUGS TO BE AVOIDED :
Antiarrhythmic drugs*: Ajmaline, Allapinine, Ethacizine, Flecainide, Pilsicainide, Procainamide, Propafenone
Psychotropic drugs: Amitriptyline, Clomipramine, Desipramine, Lithium, Loxapine, Nortriptyline,Oxcarbazepine, Trifluoperazine
Anesthetics / analgesics*: Bupivacaine, Procaine, Propofol
Other substances: Acetylcholine, Alcohol (toxicity), Cannabis, Cocaine, Ergonovine
*For advice please visit www.brugadadrugs.org/emergencies
DRUGS PREFERABLY AVOIDED:
Antiarrhythmic drugs: Amiodarone, Cibenzoline, Disopyramide, Lidocaine*, Propranolol, Verapamil,Vernakalant
Psychotropic drugs: Bupropion, Carbamazepine, Clothiapine, Cyamemazine, Dosulepine, Doxepine,Fluoxetine, Fluvoxamine, Imipramine, Lamotrigine, Maprotiline, Paroxetine, Perphenazine,Phenytoin, Thioridazine
Anesthetics / analgesics: Ketamine, Tramadol
Other substances: Demenhydrinate, Diphenhydramine, Edrophonium, Indapamide, Metoclopramide,Terfenadine/Fexofenadine
* Lidocaine use for local anesthesia (e.g. by dentists) does seem to be safe if the amount administrated is low and if it is combined with adrenaline (epinephrine) which results in a local effect only.
Further, in case of fever, close (electrocardiographic) monitoring is appropriate in combination with
lowering of the body temperature (e.g. by using Paracetamol/Acetaminophen).
Please be aware of the active drugs in medicines that contain a combination of drugs. Further, the
presence or absence of a particular drug on this list do not preclude a certain harmful or safe use of
that particular drug in this patient respectively.
For the most recent recommendations (and the disclaimer) on drugs to be avoided by Brugada
syndrome patients, please visit http://www.brugadadrugs.org .