Drug interactions between amiodarone and Flagyl
Results for the following 2 drugs: |
|
|---|---|
| amiodarone | |
| Flagyl (metronidazole) | |
Interactions between your selected drugs
amiodarone ⇔ metronidazole
Applies to: amiodarone and Flagyl (metronidazole)
MONITOR: QT interval prolongation and torsade de pointes have been reported with the coadministration of metronidazole and amiodarone. A 71-year-old woman developed marked QTc prolongation (625 ms) and torsade de pointes ventricular tachycardia when she received both metronidazole and amiodarone for the treatment of pseudomembranous colitis and paroxysmal atrial fibrillation. The patient recovered following defibrillation and withdrawal of both medications. An interaction was suspected based on the strong temporal relation between administration of the two drugs and development of the arrhythmia. The authors suggest inhibition of CYP450 3A4 metabolism by metronidazole as a possible mechanism of interaction. However, some studies have found no effect of metronidazole on CYP450 3A4 activity.
MANAGEMENT: Until more information is available, it may be appropriate to monitor QT interval on the ECG if amiodarone is used in combination with metronidazole. Patients treated on an outpatient basis should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.
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