Amiodarone Rifampicin Drug-Drug Interaction Management With Therapeutic Drug Monitoring

Therapeutic Drug Monitoring
Thijs H Oude MunninkKris L L Movig

Abstract

The authors present a case of a 69-year-old man with arrhythmogenic right ventricular cardiomyopathy controlled with amiodarone and an infected orthopedic prosthesis requiring treatment with rifampicin. This combination involves a pharmacokinetic drug-drug interaction leading to subtherapeutic drug concentrations of amiodarone and its active metabolite. The long half-life of amiodarone and its active metabolite in combination with the late onset and offset of cytochrome P4503A (CYP3A4) induction by rifampicin makes this a challenging drug-drug interaction to cope with in clinical practice. Before, during, and after rifampicin treatment, the serum concentrations of amiodarone and its active metabolite were measured and the amiodarone dose was adjusted accordingly. The amiodarone dose required to maintain effective concentrations was 450% of the initial dose. The drug-drug interaction between amiodarone and rifampicin is relevant, both clinically and pharmacokinetically, and can be managed by dose adjustments of amiodarone based on serum concentrations.

References

Apr 12, 2000·British Journal of Clinical Pharmacology·C C LibersaM A Lhermitte
Mar 31, 2009·Toxicology in Vitro : an International Journal Published in Association with BIBRA·Miia TurpeinenOlavi Pelkonen
Aug 31, 2014·Toxicology in Vitro : an International Journal Published in Association with BIBRA·Ana FerreiraGilberto Alves

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antiarrhythmic Agents: Mechanisms of Action

Understanding the mechanism of action of antiarrhythmic agents is essential in developing new medications as treatment of cardiac arrhythmias is currently limited by the reduced availability of safe and effective drugs. Discover the latest research on Antiarrhythmic Agents: Mechanism of Action here.

Arrhythmogenic Right Ventricular Dysplasia

Arrhythmogenic right ventricular dysplasia is a congenital cardiomyopathy that is characterized by infiltration of adipose and fibrous tissue into the right ventricle wall and loss of myocardial cells. Primary injuries usually are at the free wall of the right ventricular and right atria resulting in ventricular and supraventricular arrhythmias. Discover the latest research on arrhythmogenic right ventricular dysplasia here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Related Papers

The New England Journal of Medicine
Domenico CorradoHugh Calkins
The New England Journal of Medicine
Domenico CorradoHugh Calkins
The New England Journal of Medicine
Michael A Kohn, Thomas B Newman
The Israel Medical Association Journal : IMAJ
G Fontaine
The Journal of Pathology
A H LeeP J Gallagher
© 2022 Meta ULC. All rights reserved