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Cordarone IV Intravenous and Flagyl

Determining the interaction of Cordarone IV Intravenous and Flagyl and the possibility of their joint administration.

Check result:

Cordarone IV Intravenous <> Flagyl

Relevance: 15.03.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ask your doctor before using amiodarone together with metroNIDAZOLE. Taking these drugs together can cause a serious heart rhythm disorder. Call your doctor if you have symptoms of dizziness, fainting, fast or pounding heartbeat, chest pain, or feeling short of breath. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: QT interval prolongation and torsade de pointes have been reported with the coadministration of metronidazole and amiodarone. A 71-year-old woman developed marked QTc prolongation (625 ms) and torsade de pointes ventricular tachycardia when she received both metronidazole and amiodarone for the treatment of pseudomembranous colitis and paroxysmal atrial fibrillation. The patient recovered following defibrillation and withdrawal of both medications. An interaction was suspected based on the strong temporal relation between administration of the two drugs and development of the arrhythmia. The authors suggest inhibition of CYP450 3A4 metabolism by metronidazole as a possible mechanism of interaction. However, some studies have found no effect of metronidazole on CYP450 3A4 activity.

MANAGEMENT: Until more information is available, it may be appropriate to monitor QT interval on the ECG if amiodarone is used in combination with metronidazole. Patients treated on an outpatient basis should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, palpitations, or syncope.

References

"Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
Kounas SP, Letsas KP, Sideris A, Efraimidis M, Kardaras F "QT interval prolongation and torsades de pointes due to a coadministration of metronidazole and amiodarone." Pacing Clin Electrophysiol 28 (2005): 472-3
Haas CE, Kaufman DC, DiCenzo RC "Effects of metronidazole on hepatic CYP3A4 activity." Pharmacotherapy 21 (2001): 1192-5
Wang JS, Backman JT, Kivisto KT, Neuvonen PJ "Effects of metronidazole on midazolam metabolism in vitro and in vivo." Eur J Clin Pharmacol 56 (2000): 555-9
Trivier JM, Libersa C, Belloc C, Lhermitte M "Amiodarone N-deethylation in human liver microsomes: involvement of cytochrome P450 3A enzymes (first report)." Life Sci 52 (1993): pl91-6

Cordarone IV Intravenous

Generic Name: amiodarone

Brand name: Pacerone, Cordarone, Nexterone

Synonyms: Cordarone IV (Intravenous)

What is Cordarone IV Intravenous?

Flagyl

Generic Name: metronidazole

Brand name: Flagyl, FIRST Metronidazole, Flagyl 375, MetroGel

Synonyms: n.a.

What is Flagyl?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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