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Cardiac death risk 5x greater with concurrent oral erythromycin and CYP3A inhibitors
Concurrent use of oral erythromycin and strong inhibitors of CYP3A should be avoided, according to research published in The New England Journal of Medicine.
Concurrent use of oral erythromycin and strong inhibitors of CYP3A should be avoided, according to research published in TheNew England Journal of Medicine.
Researchers found that the rate of sudden death from cardiac causes was 5 times as high (incidence-rate ratio, 5.35; 95% CI, 1.72–16.64; P=.004) among patients who concurrently used erythromycin and CYP3A inhibitors (nitroimidazole antifungal agents, diltiazem, verapamil, troleandomycin), compared to those who had not used CYP3A inhibitors or the study antibiotic medications. The rate of sudden death from cardiac causes was twice as high (incidence-rate ratio, 2.01; 95% CI, 1.08–3.75; P=.03) among patients currently using erythromycin (n=5,305 person-years) as those who had not used any of the study antibiotic medications. There was no significant increase in the risk of sudden death among former users of erythromycin (n=111,779 person-years) (incidence-rate ratio, 0.89; 95% CI, 0.72–1.09; P=.26) or among those who were currently using amoxicillin (n=6,846 person-years) (incidence-rate ratio, 1.18; 95% CI, 0.59–2.36; P=.65).
The population-based study included 1,476 cases of sudden death from cardiac causes and 1,249,943 person-years of follow-up among a Tennessee Medicaid cohort between January 1, 1988, and December 31, 1993. Participants were aged 15 to 84 years (mean age 45; 70% female), not residing in a long-term care facility, and had no life-threatening noncardiac illness. Sudden death was defined as a sudden fatal condition caused by ventricular tachyarrhythmia in the absence of a known noncardiac condition.
SOURCE Ray WA, Murray KT, Meredith S, Narashimhulu SS, Hall K, Stein CM. Oral erythromycin and the risk of sudden death from cardiac causes. N Engl J Med. 2004;351:1089–1096.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
