Where did bretylium go?

Question

Not considering efficacy; Is it true that bretylium is off the ACLS guidelines because the supply/availability has been exhausted? Remember I am not questioning it's effectiveness, just the fact that supposedly it is no longer available? And then, what does "NO LONGER AVAILABLE" mean?

Answer 1

This topic will help you out:

NOTE: This drug is discontinued in the United States.

What should my health care professional know before I receive bretylium? (Back to top)
They need to know if you have any of these conditions:
•other heart problems
•kidney disease
•an unusual or allergic reaction to bretylium, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine? (Back to top)
Bretylium is for injection into a muscle or injection or infusion into a vein. It is given by a health-care professional in a hospital or clinic setting.

What if I miss a dose? (Back to top)
This does not apply.

What drug(s) may interact with bretylium? (Back to top)
•arsenic trioxide
•astemizole
•bepridil
•certain antibiotics (such as clarithromycin, erythromycin, gatifloxacin, grepafloxacin, levofloxacin, moxifloxacin, sparfloxacin)
•cisapride
•digoxin
•ginger
•guanethidine
•hawthorn
•medicines for colds or breathing difficulties (including asthma)
•medicines for mental depression such as tricyclic antidepressants
•medicines for mental problems or psychotic disturbances
•medicines to control heart rhythm
•pimozide
•probucol
•some medicines for weight control or dieting
•terfenadine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from receiving bretylium? (Back to top)
Side effects that you should report to your prescriber or health care professional as soon as possible:
•chest pain
•difficulty breathing
•dizziness, faintness, or lightheadedness
•fever
•nausea, vomiting
•slow, fast, or irregular heartbeat

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•diarrhea
•headache
•hiccups
•skin rash
•stomach pain

What should I watch for while taking bretylium? (Back to top)
You may get dizzy; to avoid a sudden drop in blood pressure and fainting spells, do not stand or sit up quickly, especially if you are an older person, until you know how bretylium affects you.

Answer 2

It's no longer being sold in the US. That's what "no longer available" means. It went off ACLS because it didn't really prove to be effective. Having said that, a lot of drugs go on and off the guidelines.