QT interval prolongation and torsades de pointes due to a coadministration of metronidazole and amiodarone.
This report documents the occurrence of torsades de pointes (TdP) caused by marked QT interval prolongation in the case of a 71-year-old woman receiving both metronidazole and amiodarone for the treatment of pseudomembranous colitis and paroxysmal atrial fibrillation. The case highlights a previously unknown drug interaction. The role of inhibition of cytochrome P-450 CYP3A4 is discussed.
Kounas
Stavros P
SP
Second Department of Cardiology, Evagelismos Hospital, Athens, Greece. skounas@hol.gr
Letsas
Konstantinos P
KP
Sideris
Antonios
A
Efraimidis
Michalis
M
Kardaras
Fotios
F
D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000188:drug therapy; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced*; D008795:Metronidazole / Q000008:administration & dosage* / Q000009:adverse effects; D016171:Torsades de Pointes / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D000890:Anti-Infective Agents; D008795:Metronidazole; D000638:Amiodarone