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Other drugs: Digoxin: During multiple oral dosage of Tambocor to healthy subjects stabilized on a maintenance dose of digoxin, a 13% ± 19% increase in plasma digoxin levels occurred at six hours postdose. These small changes in digoxin levels should be of no clinical consequence for patients receiving chronic digitalis preparation without adverse effects.
Propranolol: During coadministration of Tambocor and propranolol, plasma Tambocor levels are about 20% higher and propranolol levels are about 30% higher, in comparison to control values. These small changes should be of no clinical consequence. In a formal interaction study conducted in healthy males, Tambocor and propranolol were each found to have slight negative inotropic effects on cardiac function; when administered together these effects were never any more than additive. The effects of concomitant administration of Tambocor and propranolol on the PR Interval were less than additive. While these effects were of little clinical consequence in the healthy subjects in this study, the possibility of exaggerated effects from this combination in patients with reduced left ventricular function should be borne in mind. Experience in patients receiving concomitant beta-blockers has not revealed any adverse effects.
Disopyramide, Verapamil: There has been no experience with the coadministration of Tambocor and either disopyramide or verapamil. Because both of these drugs have negative inotropic properties and the effects of coadministration with Tambocor are unknown, neither disopyramide nor verapamil should be administered concurrently with Tambocor unless, in the judgement of the physician, the benefit of this combination outweighs the risks.
Other drugs: Although formal interaction studies have not been conducted with Tambocor and other drugs. Tambocor is not extensively bound to plasma proteins and consequently interactions with other drugs which are highly protein bound (e.g. Anticoagulants) would not be expected. Tambocor has been used.
