Fatal lactic acidosis precipitated by nifedipine in a patient treated with disulfiram and antiretrovirals.
A 43 year old man with HIV and HCV infection and liver cirrhosis developed fatal lactic acidosis within five days from starting nifedipine for arterial hypertension. Multiple drug interactions, current and accumulated drug toxicities and the reduced liver function, might in combination have led to the acute lactic acidosis.
Moling
Oswald
O
Division of Infectious Diseases, Ospedale Generale, Bolzano 39100, Italy. molosw@hotmail.com
Rimenti
Giovanni
G
Pristerà
Raffaele
R
Vedovelli
Claudio
C
Pagani
Leonardo
L
Spoladore
Greta
G
Mian
Peter
P
D000140:Acidosis, Lactic / Q000139:chemically induced* / Q000378:metabolism; D000328:Adult; D000427:Alcohol Deterrents / Q000009:adverse effects* / Q000493:pharmacokinetics; D000437:Alcoholism / Q000150:complications / Q000188:drug therapy; D044966:Anti-Retroviral Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D023241:Antiretroviral Therapy, Highly Active; D004221:Disulfiram / Q000009:adverse effects* / Q000493:pharmacokinetics; D004347:Drug Interactions; D017809:Fatal Outcome; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000188:drug therapy*; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced; D009543:Nifedipine / Q000009:adverse effects* / Q000493:pharmacokinetics
D000427:Alcohol Deterrents; D044966:Anti-Retroviral Agents; D000959:Antihypertensive Agents; D009543:Nifedipine; D004221:Disulfiram