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Clinical hypotension with co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients: a retrospective chart review.
Drug Saf. 2013 Oct; 36(10):989-93.DS

Abstract

BACKGROUND

Macrolide antibiotics inhibit the cytochrome p450 enzyme system, which metabolizes calcium-channel blockers. This may result in a clinically significant interaction, causing hypotension in patients co-prescribed these two drugs. Since these drugs are frequently used in the haemodialysis population, we studied the effect of their co-prescription on actual blood pressure.

METHODS

A retrospective chart review of all haemodialysis patients was conducted to identify patients co-prescribed a macrolide and a dihydropyridine calcium-channel blocker. Blood pressure measurements before and during the macrolide co-prescription were abstracted and compared using a student's t test.

RESULTS

We identified 154 haemodialysis patients concurrently prescribed a macrolide antibiotic and a dihydropyridine calcium-channel blocker. There was no significant difference in episodes of intra-dialytic hypotension or actual blood pressure measurements in the period before macrolide co-prescription and the period during macrolide co-prescription.

CONCLUSION

In contrast to hospitalized patients receiving dihydropyridine calcium-channel blockers, concurrent administration of a macrolide antibiotic for infection did not result in hypotension in haemodialysis outpatients. Further research should be undertaken before a change in clinical practice against their co-prescription is considered.

Authors+Show Affiliations

The Renal Hypertension Unit, Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada, shiremath@toh.on.ca.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23873482

Citation

Hiremath, Swapnil, et al. "Clinical Hypotension With Co-prescription of Macrolide Antibiotics and Calcium-channel Blockers in Haemodialysis Patients: a Retrospective Chart Review." Drug Safety, vol. 36, no. 10, 2013, pp. 989-93.
Hiremath S, Ruzicka M, Nagaraju SP, et al. Clinical hypotension with co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients: a retrospective chart review. Drug Saf. 2013;36(10):989-93.
Hiremath, S., Ruzicka, M., Nagaraju, S. P., & McCormick, B. B. (2013). Clinical hypotension with co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients: a retrospective chart review. Drug Safety, 36(10), 989-93. https://doi.org/10.1007/s40264-013-0088-9
Hiremath S, et al. Clinical Hypotension With Co-prescription of Macrolide Antibiotics and Calcium-channel Blockers in Haemodialysis Patients: a Retrospective Chart Review. Drug Saf. 2013;36(10):989-93. PubMed PMID: 23873482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical hypotension with co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients: a retrospective chart review. AU - Hiremath,Swapnil, AU - Ruzicka,Marcel, AU - Nagaraju,Shankar Prasad, AU - McCormick,Brendan B, PY - 2013/7/23/entrez PY - 2013/7/23/pubmed PY - 2014/5/7/medline SP - 989 EP - 93 JF - Drug safety JO - Drug Saf VL - 36 IS - 10 N2 - BACKGROUND: Macrolide antibiotics inhibit the cytochrome p450 enzyme system, which metabolizes calcium-channel blockers. This may result in a clinically significant interaction, causing hypotension in patients co-prescribed these two drugs. Since these drugs are frequently used in the haemodialysis population, we studied the effect of their co-prescription on actual blood pressure. METHODS: A retrospective chart review of all haemodialysis patients was conducted to identify patients co-prescribed a macrolide and a dihydropyridine calcium-channel blocker. Blood pressure measurements before and during the macrolide co-prescription were abstracted and compared using a student's t test. RESULTS: We identified 154 haemodialysis patients concurrently prescribed a macrolide antibiotic and a dihydropyridine calcium-channel blocker. There was no significant difference in episodes of intra-dialytic hypotension or actual blood pressure measurements in the period before macrolide co-prescription and the period during macrolide co-prescription. CONCLUSION: In contrast to hospitalized patients receiving dihydropyridine calcium-channel blockers, concurrent administration of a macrolide antibiotic for infection did not result in hypotension in haemodialysis outpatients. Further research should be undertaken before a change in clinical practice against their co-prescription is considered. SN - 1179-1942 UR - https://www.unboundmedicine.com/medline/citation/23873482/Clinical_hypotension_with_co_prescription_of_macrolide_antibiotics_and_calcium_channel_blockers_in_haemodialysis_patients:_a_retrospective_chart_review_ L2 - https://dx.doi.org/10.1007/s40264-013-0088-9 DB - PRIME DP - Unbound Medicine ER -