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- Title
Torsades de Pointes Ventricular Tachycardia Induced by Clarithromycin and Disopyramide in the Presence of Hypokalemia.
- Authors
Hayashi, Yuji; Ikeda, Uichi; Hashimoto, Tohru; Watanabe, Tokumitsu; Mitsuhashi, Takeshi; Shimada, Kazuyuki
- Abstract
We report a 76-year-old woman who developed TdP ventricular tachycardia induced by combined use of clarithromycin and disopyramide. She had a history of myocardial infarction 5 years earlier and has taken disopyramide for supraventricular arrhythmias. In addition, she had taken clarithromycin for upper respiratory tract infection. On admission, an EGG showed prolongation of QTc interval to 0.71 seconds and self-terminating TdP occurred several times. Disopyramide was metabolized by the cytochrome enzyme GYP3A4 and clarithromycin competitively inhibits this enzyme, probably resulting in an increase in plasma concentration of disopyramide. We should consider this possibility when prescribing clarithromycin in combination with antiarrhythmic agent disopyramide.
- Subjects
TACHYCARDIA; HEART diseases; MYOCARDIAL infarction; CORONARY disease; DISOPYRAMIDE; ACETAMIDE; HEART beat; HYPOKALEMIA
- Publication
Pacing & Clinical Electrophysiology, 1999, Vol 22, Issue 4, p672
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1999.tb00512.x