Antibiotic Interaction May Raise Heart Death Risk 5 Fold

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Antibiotic Interaction May Raise Heart Death Risk

 

By Gene Emery

 

BOSTON (Reuters) - Doctors have known for years that

the antibiotic erythromycin can, in rare cases, spark

an abnormal and sometimes fatal heartbeat. But

combining it with several common drugs may

dramatically increase that risk, researchers warned on

Wednesday.

 

Their analysis of 1,476 sudden deaths in Tennessee

found a fivefold increase in the chance of dropping

dead from a heart attack among people taking

erythromycin plus one of a handful of drugs.

 

Yet even erythromycin, if used alone, doubled the risk

of sudden death, said the team, led by Wayne Ray of

the Vanderbilt University School of Medicine in

Nashville.

 

" We were very surprised. We were expecting maybe a

slight increase in deaths, if anything, " he told

Reuters.

 

The drug is a general-purpose antibiotic that is

 

commonly prescribed. Between 1970 and 1996, 49 cases

of erythromycin-related fatal or life-threatening

heart rhythm problems were reported to the U.S. Food

and Drug Administration (news - web sites).

 

More recently, research has shown that some drugs can

double the time it takes for the body to break down

erythromycin, increasing the risk that the antibiotic

will disrupt the heart's rhythm.

 

But until the new study, published in this week's

edition of the New England Journal of Medicine (news -

web sites), the scope of the erythromycin risk had not

been assessed.

 

" People knew that, in theory, this might pose a

problem, but this is the first study to document

serious outcomes, " Ray said.

 

Two of the drugs found to interact with erythromycin

are fairly common.

 

One is diltiazem, also known as Cardizem, which is

prescribed to fight the chest pain of angina, lower

high blood pressure and, at times, restore circulation

to fingers and toes in people with Raynaud's syndrome.

Diltiazem is also sold under the brand names Tiazac

and Dilacor.

 

The second drug is verapamil, sold under brand names

like Calan and Isoptin. It is also used for heart and

blood pressure problems, but can be prescribed for

migraines, asthma, manic depression, and panic

attacks.

 

The problem also applies to fungus-fighting drugs that

contain nitromidazole. Once seldom used, those

medicines are often given to people with HIV (news -

web sites), the AIDS (news - web sites) virus. They

have generic names like fluconazole, ketoconazole and

itraconazole, Ray said.

 

But it's not just the drugs that enhance the risk of

erythromycin, Ray said. Drinking grapefruit juice also

keeps the antibiotic in the body longer and may pose a

risk.

 

" The typical person and their doctor should just avoid

these combinations whenever possible, " he said.