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Calcium channel blockers + macrolides: elderly patients hospitalised for low blood pressure.
Prescrire Int. 2012 Jul; 21(129):182.PI

Abstract

Macrolides that inhibit cytochrome P450 isoenzyme CYP 3A4 can lead to the accumulation of calcium channel blockers metabolised by the same isoenzyme and therefore an increase in their dose-related adverse effects. A Canadian case-control study examined the relationship between macrolide use and hospitalisation for hypotension (including shock) among 7100 elderly patients who were also taking a calcium channel blocker. The results showed more exposure to certain macrolides immediately prior to hospitalisation for hypotension than during an earlier control period; these macrolides included erythromycin (odds ratio (OR) = 5.8; 95% confidence interval: 2.3 to 15) and clarithromycin (OR = 3.7, 95% CI: 2.3 to 6.1). No such increase was found with azithromycin. In practice, patients treated with a calcium channel blocker should not be prescribed erythromycin or clarithromycin, but rather an antibiotic with similar efficacy but a lower risk of interaction.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22852287

Citation

"Calcium Channel Blockers + Macrolides: Elderly Patients Hospitalised for Low Blood Pressure." Prescrire International, vol. 21, no. 129, 2012, p. 182.
Calcium channel blockers + macrolides: elderly patients hospitalised for low blood pressure. Prescrire Int. 2012;21(129):182.
(2012). Calcium channel blockers + macrolides: elderly patients hospitalised for low blood pressure. Prescrire International, 21(129), 182.
Calcium Channel Blockers + Macrolides: Elderly Patients Hospitalised for Low Blood Pressure. Prescrire Int. 2012;21(129):182. PubMed PMID: 22852287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcium channel blockers + macrolides: elderly patients hospitalised for low blood pressure. PY - 2012/8/3/entrez PY - 2012/8/3/pubmed PY - 2012/8/22/medline SP - 182 EP - 182 JF - Prescrire international JO - Prescrire Int VL - 21 IS - 129 N2 - Macrolides that inhibit cytochrome P450 isoenzyme CYP 3A4 can lead to the accumulation of calcium channel blockers metabolised by the same isoenzyme and therefore an increase in their dose-related adverse effects. A Canadian case-control study examined the relationship between macrolide use and hospitalisation for hypotension (including shock) among 7100 elderly patients who were also taking a calcium channel blocker. The results showed more exposure to certain macrolides immediately prior to hospitalisation for hypotension than during an earlier control period; these macrolides included erythromycin (odds ratio (OR) = 5.8; 95% confidence interval: 2.3 to 15) and clarithromycin (OR = 3.7, 95% CI: 2.3 to 6.1). No such increase was found with azithromycin. In practice, patients treated with a calcium channel blocker should not be prescribed erythromycin or clarithromycin, but rather an antibiotic with similar efficacy but a lower risk of interaction. SN - 1167-7422 UR - https://www.unboundmedicine.com/medline/citation/22852287/Calcium_channel_blockers_+_macrolides:_elderly_patients_hospitalised_for_low_blood_pressure_ L2 - https://medlineplus.gov/lowbloodpressure.html DB - PRIME DP - Unbound Medicine ER -