A cura di Alessandra Russo. Specialista in Tossicologia Medica. Messina
|
Principio attivo |
Effetto |
|
Atorvastatina (1,2) |
Possibile aumento del rischio di rabdomiolisi |
|
Digossina (3-5) |
Possibile tossicità da digossina (vomito, aritmie cardiache) |
|
Diidroergotamina (6) |
Possibile aumento del rischio di ergotismo acuto (nausea, vomito, ischemia vasospastica) |
|
Disopiramide (7) |
Possibile aumento del rischio di prolungamento dell’intervallo QT e di gravi aritmie cardiache |
|
Donepezil (8,9) |
Possibile aumento del rischio di prolungamento dell’intervallo QT e di torsione di punta |
|
Idrossiclorochina (10-12) |
Possibile aumento del rischio di prolungamento dell’intervallo QT |
|
Lofexidina (13) |
Possibile aumento del rischio di prolungamento dell’intervallo QT |
|
Lovastatina (1,2) |
Possibile aumento del rischio di rabdomiolisi |
|
Metilergometrina (14) |
Possibile aumento del rischio di ergotismo acuto (nausea, vomito, ischemia vasospastica) |
|
Rifabutina (14) |
Possibile aumento del rischio di tossicità da rifabutina (rash, disturbi gastrointestinali, alterazioni ematologiche) |
|
Simvastatina (1,2) |
Possibile aumento del rischio di rabdomiolisi |
|
Teofillina (14) |
Possibile aumento delle concentrazioni seriche di teofillina |
|
Warfarin (15,16) |
Possibile aumento del rischio di sanguinamento |
Bibliografia
- Strandell J, et al. Rhabdomyolysis a result of azithromycin and statins: an unrecognized interaction. Br J Clin Pharmacol 2009; 68: 427-434.
- Patel AM, et al. Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study. Ann Intern Med 2013; 158: 869-876.
- Gomes T, et al. Macrolide-induced digoxin toxicity: a population-based study. Clin Pharmacol Ther 2009; 86: 383-386.
- Hughes J. Inhibition of P-glycoprotein-mediated efflux of digoxin and its metabolites by macrolide antibiotics. J Pharmacol Sci 2010; 113: 315-324.
- Ten Eick A, Sallee D, Preminger T et al: Possible drug interaction between digoxin and azithromycin in a young child. Clin Drug Invest 2000; 20: 61-64.
- Product Information: Migranal(R), dihydroergotamine. Xcel Pharmaceuticals, Inc., San Diego, CA, 07/2002.
- Granowitz E, et al. Potentially fatal interaction between azithromycin and disopyramide. PACE 2000; 23: 1433-1435.
- Takaya T, et al. Torsades de Pointes with QT prolongation related to donepezil use. J Cardiol 2009; 54: 507-511.
- Tanaka A. Donepezil-induced adverse side effects of cardiac rhythm: 2 cases report of atrioventricular block and Torsade de Pointes. Intern Med 2009; 48: 1219-1223.
- Chen CY. Chronic hydroxychloroquine use associated with QT prolongation and refractory ventricular arrhythmia. Clin Toxicol (Phila) 2006; 44: 173-175.
- Bessiere F, et al. Assessment of QT intervals in a case series of patients with coronavirus disease 2019 (COVID-19) infection treated with hydroxychloroquine alone or in combination with azithromycin in an intensive care unit. JAMA Cardiol 2020 May 1; e201787.
- Mercuro NJ, et al. Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020 May 1; e201834.
- Product Information: LUCEMYRA(TM) oral tablets, lofexidine oral tablets. US WorldMeds LLC (per FDA), Louisville, KY, May, 2018.
- Product Information: Zithromax(R), azithromycin. Pfizer Labs, NY, NY, 12/2001.
- Lane MA. Serious bleeding events due to warfarin and antibiotic co-prescription in a cohort of veterans. Am J Med 2014; 127: 657-663.
- Baillargeon J, et al. Concurrent use of warfarin and antibiotics and the risk of bleeding in older adults. Am J Med 2012; 125: 183-189.
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