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QTc prolongation and torsades de pointes due to a coadministration of fluoxetine and amiodarone in a patient with implantable cardioverter-defibrillator Case report and review of the literature

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单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Pharm, Wuhan, Hubei, Peoples R China [2]Huazhong Univ Sci & Technol, Dept Endocrinol, Puai Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China [3]Shanghai Jiao Tong Univ, Sch Med, Renji Hosp, Dept Pharm, Shanghai 200127, Peoples R China
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关键词: adverse drug reaction amiodarone drug-drug interaction fluoxetine torsades de pointes

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Rationale: Drug-induced prolongation of the corrected QT interval (QTc) may lead to serious and potentially life-threatening ventricular tachyarrhythmia, such as torsades de pointes (Tdp), which is worthy of clinical attention. Here, we report 1 case of Tdp after a coadministration of fluoxetine and amiodarone. Patient concerns: A 62-year-old Chinese male who placed with the implanted cardioverter-defibrillator (ICD) appeared the QTc prolongation and Tdp after the concurrent administration of fluoxetine and amiodarone. Diagnoses: Torsades de pointes (Tdp). Interventions: The patient was treated with magnesium and potassium immediately. Her ICD-brady pacing mode was reprogrammed to 90 bpm. Meanwhile, both of fluoxetine and amiodarone were discontinued. Outcomes: The further episodes of Tdp were prevented. After a few days, the QTc gradually decreased without clinically significant arrhythmias. Lessons: The present case demonstrates that a potential drug-drug interaction (DDI) may lead to a life-threatening drug adverse reaction (ADR) especially in special subjects. Therefore, clinicians should closely monitor the electrocardiogram (ECG) when QTc-prolonging agents are given to patients with cardiac abnormalities, and avoid combining 2 QTc-prolonging drugs.

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出版当年[2016]版:
大类 | 2 区 医学
小类 | 2 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2015]版:
Q2 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q2 MEDICINE, GENERAL & INTERNAL

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第一作者单位: [1]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Pharm, Wuhan, Hubei, Peoples R China
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