Amiodarone interaction
- PDF / 184,145 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 65 Downloads / 236 Views
1
★XS
Interaction with concomitant zolpidem leading to QT interval prolongation and torsade de pointes (first report) in an elderly patient?: case report A 67-year-old woman developed QT interval prolongation and torsade de points during treatment with zolpidem for insomnia and amiodarone for palpitations. The woman, who had a prosthetic mitral valve and a history of congestive heart failure, started receiving zolpidem [dosage not stated] and, 3 weeks later, presented with palpitations. An ECG showed a sinus rhythm with left bundle branch block and a QTc interval of 440ms. She had global wall motion abnormalities of the left ventricle with an ejection fraction of 45%. Holter monitoring recorded premature ventricular complexes, couplets and episodes of trigeminy and bigeminy, and she started receiving IV amiodarone 900 mg/day after an initial 450mg bolus. On day 4, during Holter monitoring, a marked QTc interval prolongation (565ms) was recorded and she subsequently developed torsade de points degenerated to ventricular fibrillation [duration of treatment before reaction onset not clearly stated]. The woman was defibrillated to restore sinus rhythm. Zolpidem and amiodarone were immediately discontinued. Her QTc interval gradually decreased to its initial length during the following days. After 6 months follow-up, she was in good clinical condition. Author comment: "Our case highlights a potential drug interaction between zolpidem and amiodarone. . . Although a direct proarrhythmic effect of amiodarone appears the most possible explanation of torsade de pointes, electrophysiological effects of zolpidem . . . could not be excluded. . . the onset of zolpidem administration was clinically associated with the presence of palpitations". Letsas KP, et al. QT interval prolongation and Torsades de Pointes in a patient receiving zolpidem and amiodarone. Cardiology 105: 146-147, No. 3, 2006 801043459 Greece
» Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of an interaction between amiodarone and zolpidem. The WHO Adverse Drug Reactions database contained 585 reports involving the concomitant use of zolpidem and amiodarone.
0114-9954/10/1117-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 2 Sep 2006 No. 1117
Data Loading...
