The Journal of Emergency Medicine
Volume 22, Issue 3 , Pages 247-249 , April 2002

Symptomatic bradycardia secondary to interaction between topical timolol maleate, verapamil, and flecainide: a case report

  • Travis Minish, BSc, MD

      Affiliations

    • Department of Emergency Medicine, Health Sciences Center, Winnipeg, Manitoba, Canada
    • ,
  • Anthony Herd, BSc, MD (CCFP(EM))

      Affiliations

    • Corresponding Author InformationReprint Address: Anthony Herd, BSc, MD, Adult Emergency Unit, Health Sciences Center, GF-201, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
    • Department of Emergency Medicine, Health Sciences Center, Winnipeg, Manitoba, Canada

Received 6 February 2001 ,Revised 19 June 2001 ,Accepted 29 June 2001.

References 

  1. Sinclair NI, Benzie JL. Timolol eye drops and verapamil—a dangerous combination. Med J Austral. 1983;12:548
  2. Dinai Y, Sharir M, Naveh N, et al.  Bradycardia induced by interaction between quinidine and opthalmic timolol. Ann Intern Med. 1985;103:890–891
  3. Pringle SD, MacEwen CJ. Severe bradycardia due to interaction of timolol eye drops and verapamil. Br Med J. 1987;295:155–156
  4. Koch-Weser J, Frushman WH. Beta-adrenoceptor antagonists (new drugs and new indications). N Engl J Med. 1981;305:500–506
  5. Alvan G, Calissendorf B, Seidma P, et al.  Absorption of ocular timolol. Clin Pharmacokinet. 1980;5:95–100
  6. Van Buskirk EM, Fraunfelder FT. Timolol and glaucoma. Arch Opthalm. 1981;99:696
  7. McMahon CD, Shaffer RN, Hoskins HD. Adverse effects experienced by patients using timolol. Am J Opthalmol. 1979;88:736–738
  8. Findlayin G, Gillen G, Elliot AT, et al.  The treatment of angina pectoris with calcium channel and β-blockers (efficacy and effect on cardiac function). J Am Coll Cardiol. 1984;3:482
  9. Hutchinson SJ, Lorimer AR, Lakhdar A, et al.  Beta-blockers and verapamil—a cautionary tale. Br Med J. 1984;289:659–660
  10. Jowes FL, Ekberg NL. Exacerbation of asthma with timolol. N Engl J Med. 1979;3015:270
  11. Echt D, Leibson P, Mitchell L, et al.  Mortality and morbidity in patients receiving encainide, flecainide, or placebo (the Canadian Arrhythmia Suppression Trial). N Engl J Med. 1991;324:781–788

☆ Clinical Communications is coordinated by Ron M. Walls, md, of Brigham and Women’s Hospital and Harvard University Medical School, Boston, Massachusetts

PII: S0736-4679(01)00476-0

The Journal of Emergency Medicine
Volume 22, Issue 3 , Pages 247-249 , April 2002

Article Tools

* Image Usage & Resolution