[Iatrogenic acute renal failure caused by overdosage of flecainide acetate].
BACKGROUND
Rapid degradation of renal function may occur in patients given drug regimens combining a converting enzyme inhibitor, a diuretic and a nonsteroidal anti-inflammatory drug.


METHODS
A patient given flecainide and an enalapril /hydrochlorothiazide combination in a well-tolerated long-term regimen suddenly developed acute renal failure when a nonsteroidal anti-inflammatory drug was introduced leading to an overdose of the anti-arrhythmic drug.


CONCLUSIONS
A poor understanding of the elimination routes for anti-arrhythmic drugs and the risks involved when combined with nonsteroidal anti-inflammatory drugs modifying glomerular hemodynamics can lead to dangerous prescriptions and life-threatening situations in patients on multiple drug regimens.
Meurin
P
P
Centre de Réadaptation cardiaque de la Brie, Villeneuve-Saint-Denis.
Larrazet
F
F
Weber
H
H
Bourmayan
C
C
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000506:poisoning*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D004232:Diuretics; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D004656:Enalapril / Q000008:administration & dosage; D005424:Flecainide / Q000008:administration & dosage / Q000506:poisoning*; D006327:Heart Block / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007049:Iatrogenic Disease; D007213:Indomethacin / Q000008:administration & dosage; D008297:Male; D010489:Periarthritis / Q000150:complications / Q000188:drug therapy; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage
D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D004656:Enalapril; D005424:Flecainide; D007213:Indomethacin