QTc prolongation during ciprofloxacin and fluconazole combination therapy: prevalence and associated risk factors

Berger, F.; Monadian, Nico; Groot, Natasja M.S. de; Santbergen, Bart; Sijs, Heleen van der; Becker, Matthijs L.; Broers, Annoek E.C.; Gelder, Teun van; Bemt, Patricia M. L. A. van den

doi:10.1111/bcp.13457

Cited by 17 publications

(24 citation statements)

References 42 publications

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“…Several lines of evidence indicate that a great number of DDIs may often occur by two or more mechanisms acting in concert [29], which makes the prediction of DDIs in patients treated with CDK4/6 inhibitors more complex. For example, combination of fluoroquinolones and azoles can be used as prophylaxis or treatment of infections in neutropenic cancer patients [55]. Unfortunately, many of these drugs have QTc prolonging potential [55] and the use of this combination should be avoided in at-risk patients for long QT syndrome, including those receiving ribociclib.…”

Section: Complex Ddismentioning

confidence: 99%

“…For example, combination of fluoroquinolones and azoles can be used as prophylaxis or treatment of infections in neutropenic cancer patients [55]. Unfortunately, many of these drugs have QTc prolonging potential [55] and the use of this combination should be avoided in at-risk patients for long QT syndrome, including those receiving ribociclib. Beside representing an additional risk factor for QT prolongation per se, the torsadogenic potential of ribociclib may be further increased as a consequence of azole-mediated CYP3A4 inhibition.…”

Section: Complex Ddismentioning

confidence: 99%

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Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Fogli

Curigliano

et al. 2019

Cancer Treatment Reviews

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CDK4/6 inhibitors are a new class of anticancer drugs used for the treatment of women with hormone receptorpositive, human epidermal growth factor receptor 2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy. Polypharmacy is a well-known problem in advanced cancer causing potential drug-drug interactions (DDIs), which, in turn, may limit the therapeutic value of CDK4/6 inhibitors. Therefore, understanding the mechanisms underlying potential DDIs in patients taking CDK4/6 inhibitors may be useful in decision-making processes and represent an important step towards treatment personalization. The present review is aimed at describing the potential DDIs that might occur in breast cancer patients receiving CDK4/6 inhibitors based on direct evidence from the literature and mechanistic considerations tailored on specific class of drugs used in combination.

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Section: Complex Ddismentioning

confidence: 99%

Section: Complex Ddismentioning

confidence: 99%

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Fogli

Curigliano

et al. 2019

Cancer Treatment Reviews

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“…Such interactions are commonly found as case reports, as it is unethical to design studies to confirm these serious risks in clinical studies. However, for some DDIs it is possible to study the clinical manifestation of a potential DDI in an observational study using real-world drug utilization data 202 . Secondly, selection of the ABs included in this review was based on their frequent use in COPD and therefore information for other ABs used for COPD comorbidities, such as atypical Mycobacterium spp., is limited, and this may restrict the scope of application of this review.…”

Section: Discussionmentioning

confidence: 99%

Improving antibacterial prescribing safety in the management of COPD exacerbations: systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD patients

Wang

Bahar

Jansen

et al. 2019

Journal of Antimicrobial Chemotherapy

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BackgroundGuidelines advise the use of antibacterials (ABs) in the management of COPD exacerbations. COPD patients often have multiple comorbidities, such as diabetes mellitus and cardiac diseases, leading to polypharmacy. Consequently, drug–drug interactions (DDIs) may frequently occur, and may cause serious adverse events and treatment failure.Objectives(i) To review DDIs related to frequently prescribed ABs among COPD patients from observational and clinical studies. (ii) To improve AB prescribing safety in clinical practice by structuring DDIs according to comorbidities of COPD.MethodsWe conducted a systematic review by searching PubMed and Embase up to 8 February 2018 for clinical trials, cohort and case–control studies reporting DDIs of ABs used for COPD. Study design, subjects, sample size, pharmacological mechanism of DDI and effect of interaction were extracted. We evaluated levels of DDIs and quality of evidence according to established criteria and structured the data by possible comorbidities.ResultsIn all, 318 articles were eligible for review, describing a wide range of drugs used for comorbidities and their potential DDIs with ABs. DDIs between ABs and co-administered drugs could be subdivided into: (i) co-administered drugs altering the pharmacokinetics of ABs; and (ii) ABs interfering with the pharmacokinetics of co-administered drugs. The DDIs could lead to therapeutic failures or toxicities.ConclusionsDDIs related to ABs with clinical significance may involve a wide range of indicated drugs to treat comorbidities in COPD. The evidence presented can support (computer-supported) decision-making by health practitioners when prescribing ABs during COPD exacerbations in the case of co-medication.

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“…As the prevalence of QTc prolongation in patients varies from 5% to 11% [ 33 ], based on previously published data which has confirmed that the prolonged QTc interval is a predictor of cardiovascular events [ 19 , 20 , 21 ], we decided to avoid administering any drug influencing the extension of the QTc interval. Due to the increasing rate of resistance to fluoroquinolones and their potential negative effect on ECG alterations, we introduced the prophylaxis of UTI with fosfomycine tromethamine [ 33 , 34 ]. Such a strategy enabled the exclusion of the potential negative influence of antibiotic prophylaxis on ECG, and could be more effective in the context of UTI prevention.…”

Section: Discussionmentioning

confidence: 99%

Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

Miotła

Olejniczak

Futyma

et al. 2018

JCM

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The prevalence of overactive bladder (OAB) increases with age and can be associated with other co-morbidities, such as cardiac arrhythmia. Unfortunately, commonly used anticholinergic drugs for OAB can affect the cardiovascular system, leading to tachycardia. However, there are no data, which consider the influence of intradetrusor onabotulinumtoxinA injections on heart function in idiopathic OAB patients. The aim of the present study was to evaluate the influence of intradetrusor onabotulinumtoxinA injections on electrocardiogram (ECG) parameters. Additionally, changes in ECG were analyzed in OAB patients without cardiac arrhythmia. Thirty-one patients with cardiac arrhythmia and 31 participants without irregular heart rate (HR) completed the study. ECG measurements were performed in supine positions 2 h before onabotulinumtoxinA injections, 1 h after treatment, and at 2 weeks of follow-up. At week 6, a phone-call survey was conducted to collect data about adverse events. OnabotulinumtoxinA injections were performed with rigid cystoscopy under local anesthesia. We did not observe any clinically significant changes in the analyzed ECG parameters between consecutive measurements. While a slight increase of HR was observed in patients without cardiac arrhythmia, it remained within normal range. Intravesical onabotulinumtoxinA injections are, hence, safe for female patients with cardiac arrhythmia and do not significantly influence changes in ECG.

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QTc prolongation during ciprofloxacin and fluconazole combination therapy: prevalence and associated risk factors

Cited by 17 publications

References 42 publications

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Drug-drug interactions in breast cancer patients treated with CDK4/6 inhibitors

Improving antibacterial prescribing safety in the management of COPD exacerbations: systematic review of observational and clinical studies on potential drug interactions associated with frequently prescribed antibacterials among COPD patients

Can Intradetrusor OnabotulinumtoxinA Injections Alter Heart Function in Patients with Cardiac Arrhythmia?

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