I. THE FOLLOWING MEDICATIONS ALTER HEART RATE RESPONSE AND/OR METABOLIC
RESPONSE TO EXERCISE. Therefore, we suggest that they be discontinued prior to Dobutamine and Exercise Stress imaging at the discretion of the referring doctor. (In some patients, discontinuation may be unsafe. In others, the test is being done to assess medication effects.). IT IS NOT NECESSARY TO DISCONTINUE THESE MEDICATIONS BEFORE PHARMACOLOGIC STRESS TEST WITH ADENOSINE.
(Tenormin - should be weaned, Tenoretic)
(Norvasc & Lotensin - ace inhibitor)
(Calcium & channel blocker, ace inhibitor)
Isosorbide dinitrate (Isordil, Sorbitrate, Ismo, Dilatate SR, Monoket, Imdur)
NGT ointment (Nitro-Bid paste, Transderm-Nitro, Nitro-Dur)
II. XANTHINE DERIVATIVES: Xanthine derivatives must be discontinued before dipyridamole or
adenosine stress, since they inhibit the pharmacologic response. These medications can be restarted after the post stress images are completed (i.e., before returning for the delayed image set). If the referring physician does not feel it is safe to discontinue xanthine derivatives, some other forms of stress testing (exercise or dobutamine) must be considered. It is not necessary to discontinue xanthine derivatives before exercise or dobutamine stress.
Coffee, tea, colas, chocolate or other caffeine containing drinks or foods
Theophylline (Elixophyllin, Slo-Phyllin, Theo-Dur, Unidur, Slobid) 24
III. ORAL PERSANTINE: Oral Persantine (dipyridamole) should be discontinued 12 hours before
pharmacologic stress testing, at the discretion of the referring physician. The purpose of this is to avoid inadvertently high levels of dipyridamole when the standard IV stress test is administered.
1. These drugs must be discontinued 24-48 hours before a dipyridamole or adenosine thallium
Aminophylline/Theophylline Containing Products:
2. A few medications that contain caffeine should also be avoided 4-6 hours before the test:
Prescription: Non-Prescription:
3. Patients taking oral dipyridamole (Persantine) should not take the medicine on the morning of
study. (Restart after both image sets have been made.)
MEDICATIONS THAT DO NOT INTERFERE WITH DIPYRIDAMOLE-THALLIUM
Inhaler OK; check with DR regarding holding if p.o.
3. ALUPENT Relaxes bronchial smooth muscle 4. ATROVENT Bronchodilator 5. AZMACORT
6. BECLOVENT (Vanceril) Steroid 7. BECONASE (Beclovent, Vanceril) Steroid 8. CROMOLYN (Intal) Anti-asthmatic 9. HYDROCODONE Narcotic analgesic cough suppressant 10. INTAL (Cromolyn) Anti-asthmatic 11 . MAXAIR Bronchodilator 12. PROVENTIL See Albuterol 13. SEREVENT Bronchodilator 14. TORNALATE Bronchodilator 15. TRENTAL (Pentoxifylline)
Xanthine derivative - dilates peripheral vessels. An
16. VANCERIL (Beclovent, Beconase) Steroid 17. VENTOLIN Bronchodilator (beta-blocker)
MEDICATIONS THAT DO NOT INTERFERE WITH STRESS THALLIUM OR DIPYRIDAMOLE THALLIUM
1. ACE INHIBITORS and ANGOTENSIN RECEPTOR BLOKERS for hypertension:
Amiodarone (Cordarone) Procainamide (Procan, Pronestyl) Disopyramide (Norpace) Encainide (Enkaid) Quinidine (Duraquin, Quinaglute, Quinidex) Flecainide (Tambocor) Tocainide (Tonocard) Mexiletine (Mexitil)
Enduronyl Prinzide Furosemide (Lasix) Triamterene (Dyrenium) Lozol Zaroxolyn Maxzide HCTZ (hydrochlorothiazide)
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