Astemizole-induced torsades de pointes in a patient with vasospastic angina.
Astemizole (Hismanal), an antihistamine agent, has been reported to be associated with ventricular arrhythmias. In this paper we present a case of QT prolongation and torsades de pointes (TdP) in a 77-year-old woman who had been taking astemizole (10 mg/day) for 6 months because of allergic skin disease. At the time of admission, the serum concentration of astemizole and its metabolites was markedly elevated at 15.85 ng/ml, approximately 3 times the normal level. The patient was also taking cimetidine, a known inhibitor of cytochrome P-450 enzymatic activity, and during her admission was diagnosed as having vasospastic angina. To the best of our knowledge, this is the first report of astemizole-induced QT prolongation and TdP in Japan.
Ikeda
S
S
Department of Internal Medicine, Sasebo City General Hospital, Nagasaki, Japan.
Oka
H
H
Matunaga
K
K
Kubo
S
S
Asai
S
S
Miyahara
Y
Y
Osaka
A
A
Kohno
S
S
D000368:Aged; D000788:Angina Pectoris, Variant / Q000150:complications* / Q000503:physiopathology; D018926:Anti-Allergic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016589:Astemizole / Q000009:adverse effects* / Q000627:therapeutic use; D003329:Coronary Vasospasm / Q000503:physiopathology; D005260:Female; D006801:Humans; D012871:Skin Diseases / Q000150:complications / Q000188:drug therapy*; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000503:physiopathology
D018926:Anti-Allergic Agents; D016589:Astemizole