Important Information for Patients with Brugada Syndrome Or Brugada ECG Pattern 1

BC INHERITED St. Paul’s Hospital (Vancouver) Royal Jubilee Hospital (Victoria) BC Children’s Hospital ARRHYTHMIA Ph: 604-682-2344 Ext. 66766 Ph: 250-727-4461 Ph: 604-875-2295 PROGRAM

Important Information for Patients with Brugada Syndrome or Brugada ECG Pattern 1. Avoid all drugs listed below and appearing on the website: www.brugadadrugs.org 2. Treat a fever with acetaminophen (Tylenol) 3. Avoid big meals and excess alcohol 4. Report fainting/blackout spells/seizures 5. Carry a copy of your ECG in your wallet

List of Drugs to be Avoided by Patients with Brugada Syndrome or Brugada ECG Pattern – reviewed November 2014 *This list is not comprehensive. Please consult www.brugadadrugs.org for the most up to date information. Patients with a diagnosis of Brugada syndrome OR who have a type I ECG pattern (appearing spontaneously on ECG or following a procainamide challenge) should review ALL new medications (prescription or over the counter) with their health care provider.

Drugs with RELATIVE/THEORETICAL CONTRAINDICATION Drugs with ABSOLUTE CONTRAINDICATION

PRESCRIPTION DRUGS PRESCRIPTION DRUGS Amiodarone ( Cordarone ) Ketamine Acetycholine Carbamazepine (Tegretol)** Lidocaine (Zylocaine) *** Ajmaline (Gilurytmal) Cibenzoline (Cipralen) Maprotiline Amitriptyline (Elavil) Cyamemazine (Cianatil) Metoclopramide (Maxeran) Bupivacaine (Marcaine) Disopyramide Paroxetine ( Paxil) Clomipramine (Anafranil) Dosulepine Perphenazine Desipramine (Pentofran) Doxepin Phenytoin ( Dilantin ) Ergonovine Edrophonium (Enlon) Propranolol Lithium Fluoxetine (Prozac) Thioridazine Loxapine (Cloxazepine) Fluvoxamine (Luvox) Tramadol Flecainide (Tambocor) Imipramine Verapamil Nortriptyline (Pamelor) Indapamide Oxcarbazepine (Trileptal) Pilsicainide (Sunrhythm) Procainamide (Pronestyl) Procaine (Novocain) Propafenone (Rythmol) Propofol (Diprivan) Trifluoperazine (Fluoperazine)

STREET DRUGS/OTHER SUBSTANCES OVER-THE-COUNTER DRUGS

Cocaine (blow, C, coke, crack, rock, snow) Dimenhydrinate (Gravol) Alcohol Diphenhydramine (Benedryl) Terfenadine/Fexofenadine (Allegra)

** Carbamazepine is structurally similar to oxcarbazepine, which is on the contraindicated list. *** Lidocaine use for local anesthesia (i.e. by dentists) does appear to be safe when combined with adrenaline/epinephrine (i.e. xylocaine **** Not a Providence Health Care approved educational material For more information, please consult www.brugadadrugs.org Postema PG, Wolper C, Amin AS, Probst V, Borggrefe M, Roden DM, Priori SG, Tan HL, Hiraoka M, Brugada J, Wilde AA. Drugs and Brugada syndrome patients: review of the literature, recommendations and an up-to-date website ( www.brugadadrugs.org ). Heart Rhyhtm 2009;6(9): 1335-1341.