Journal article
Torsades de pointes associated with methadone and voriconazole
BMJ case reports, Vol.2009(dec21 1), pp.bcr0720092119-bcr0720092119
2009
DOI: 10.1136/bcr.07.2009.2119
PMCID: PMC3028474
PMID: 22190985
Abstract
This report concerns a case of torsades de pointes (TdP) associated with the concomitant administration of methadone and voriconazole in a patient with comorbid medical conditions. A 57-year-old man, with a medical history of human immunodeficiency virus, infective endocarditis, hepatitis C and orbital Aspergillus infection, was admitted to the intensive care unit following several episodes of TdP. The patient was being treated with methadone for opioid addiction and had started taking voriconazole 2 weeks prior for orbital Aspergillosis. He experienced multiple episodes of TdP with a prolonged QTc interval (>600 ms). The pronounced inhibitory impact of voriconazole on methadone metabolism via the cytochrome P450 (CYP)2B6 isoenzyme was identified as a probable cause of the arrhythmia. Voriconazole was subsequently temporarily withheld and the methadone dose was significantly reduced. The patient received an implantable cardioverter-defibrillator, did not experience additional episodes of TdP during hospitalisation, and was discharged from the hospital on day 13.
Details
- Title: Subtitle
- Torsades de pointes associated with methadone and voriconazole
- Creators
- Jennifer A Reinhold - University of the SciencesCynthia A Sanoski - Thomas Jefferson UniversityAndrea M Russo - Cooper University HospitalJoshua M Cooper - University of PennsylvaniaSarah A Spinler - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- BMJ case reports, Vol.2009(dec21 1), pp.bcr0720092119-bcr0720092119
- DOI
- 10.1136/bcr.07.2009.2119
- PMID
- 22190985
- PMCID
- PMC3028474
- NLM abbreviation
- BMJ Case Rep
- ISSN
- 1757-790X
- eISSN
- 1757-790X
- Language
- English
- Date published
- 2009
- Academic Unit
- Pharmacy; Pharmacy Practice and Science
- Record Identifier
- 9984721126602771
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