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Interazioni tra farmaci

Amiodarone + Levofloxacin

Gravità: Maggiore

Amiodarone and Levofloxacin: major interaction.

Ultimo aggiornamento Fonti: US FDA label

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Sintesi

Both drugs prolong the QT interval, and combined use raises the risk of torsades de pointes and other ventricular arrhythmias. The risk is higher with bradycardia, hypokalemia, hypomagnesemia, structural heart disease, older age and female sex. Amiodarone's very long half-life means the risk persists for weeks after stopping.

Cosa significa questa interazione in parole semplici

Amiodarone and Levofloxacin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Amiodarone belongs to Cardiovascular; Levofloxacin belongs to Anti Bacterial.

Livello di evidenza: High

Perché avviene

Pharmacodynamic additive QT prolongation through blockade of the IKr (hERG) potassium current by both drugs.

Cosa fare

Avoid the combination if possible and choose an antibiotic with less QT effect. If it must be used, obtain a baseline ECG and repeat it after starting, correct potassium and magnesium, and stop other QT-prolonging drugs.

Cosa chiedere al farmacista

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Riferimenti

Domande frequenti

Can I take Amiodarone with Levofloxacin?

MediHelp rates the interaction as major. Amiodarone and Levofloxacin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, and combined use raises the risk of torsades de pointes and other ventricular arrhythmias. The risk is higher with bradycardia, hypokalemia, hypomagnesemia, structural heart disease, older age and female sex. Amiodarone's very long half-life means the risk persists for weeks after stopping.

How serious is the interaction between Amiodarone and Levofloxacin?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible and choose an antibiotic with less QT effect. If it must be used, obtain a baseline ECG and repeat it after starting, correct potassium and magnesium, and stop other QT-prolonging drugs.

What other medicines interact with Levofloxacin?

MediHelp also lists interactions of Levofloxacin with, for example, Dronedarone, Ibutilide, Thioridazine. The full list is on the Levofloxacin page.

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