[Drug-induced heart failure (excluding that caused by anthracyclines)].
The principal drugs implicated in or disclosing cardiac insufficiency are drawn from a review of the literature and observations by the French national pharmacovigilance database, from 1984 to April 2003. Several pharmacological classes are identified: in addition to antimitotic drugs, such as anthracyclines, many drugs are implicated in cardiac insufficiency, e.g. immunomodulators, anti-inflammatory drugs (including coxibs), antiarrhythmic drugs, anaesthetic drugs, antipsychotic drugs, and antidiabetic drugs (including glitazones). It is usual to classify these drugs according to three categories: (i) drugs likely to cause cardiac insufficiency de novo (such as cyclophosphamide, paclitaxel, mitoxantrone, interferons, interleukin-2 etc.); (ii) drugs likely to worsen preexisting cardiac insufficiency (such as antiarrhythmics, beta-blockers, calcium antagonists, nonsteroidal and steroidal anti-inflammatory drugs, sympathomimetic drugs etc.); and (iii) drugs only occasionally causing cardiac insufficiency. This review shows that this classification is, in fact, artificial. If cardiac toxicity is a constant concern when using antimitotic drugs or some immunomodulator drugs, it is advisable to exercise caution in the use of many other drugs when treating patients with cardiac insufficiency, even if the clinical situation is well controlled. In particular, drug-drug interactions and patient medical history must be taken into account.
Libersa
Christian
C
Laboratoire de Pharmacologie, Faculté de Médecine, Lille, France. clibersa@chru-lille.fr
Gautier
Sophie
S
Said
Nabil Ait
NA
Ferez
Laurent
L
Caron
Jacques
J
D000276:Adjuvants, Immunologic / Q000009:adverse effects; D000777:Anesthetics / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000009:adverse effects; D016208:Databases, Factual; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000139:chemically induced* / Q000453:epidemiology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D011358:Product Surveillance, Postmarketing
D000276:Adjuvants, Immunologic; D000777:Anesthetics; D000889:Anti-Arrhythmia Agents; D000928:Antidepressive Agents; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents