General Toxicity Notes
Blood levels most often the best guide to therapy. Half-life may be prolonged in heart failure or with reduced hepatic blood flow.
Half-Life (Normalesrd) Hours
6.0-13.6/16-32
Plasma Protein Binding %
6
Volume Of Distribution L/Kg
8.2
Dose For Normal Renal Function
5-30 mg/kg load, then 5-10 mg IV q6h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
25-50% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
25% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: None
Supplement For Dialysis [Recommendation Level]: Pd
PD: None
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [D]
References
Adir J, Narang PK, Josselson J. Nomogram for bretylium dosing in renal impairment. Ther Drug Monit. 1985; 7: 265-8. [PMID: 4049461] / Josselson J, Narang PK, Adir J, Yacobi A, Sadler JH. Bretylium kinetics in renal insufficiency. Clin Pharmacol Ther. 1983; 33: 144-50. [PMID: 6822027] / Rapeport WG. Clinical pharmacokinetics of bretylium. Clin Pharmacokinet. 1985; 10: 248-56. [PMID: 3893841]
Toxicity Notes
Hypotension.