Potentially fatal interaction between azithromycin and disopyramide.
A patient on disopyramide developed disopyramide toxicity when treated concurrently with azithromycin. Evidence of toxicity included an elevated serum disopyramide level and ventricular tachycardia requiring cardioversion. The azalide antibiotic presumably inhibited dealkylation of disopyramide to its major metabolite, mono-N-dealkyldisopyramide. Physicians should avoid using azithromycin in patients on disopyramide. If this drug combination is unavoidable, disopyramide levels must be closely monitored.
Granowitz
E V
EV
Department of Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA. eric.granowitz@bhs.org
Tabor
K J
KJ
Kirchhoffer
J B
JB
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D017963:Azithromycin / Q000009:adverse effects* / Q000493:pharmacokinetics; D002372:Cat-Scratch Disease / Q000150:complications / Q000188:drug therapy; D004206:Disopyramide / Q000009:adverse effects* / Q000493:pharmacokinetics; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006801:Humans; D019462:Syncope, Vasovagal / Q000150:complications / Q000188:drug therapy; D017180:Tachycardia, Ventricular / Q000139:chemically induced
D000889:Anti-Arrhythmia Agents; D000900:Anti-Bacterial Agents; D017963:Azithromycin; D004206:Disopyramide