TY - JOUR
AU1 - Bebawi, Emmanuel
AU2 - Jouni, Suhail
AU3 - Tessier, Andrée-Anne
AU4 - Frenette, Anne
AU5 - Brindamour, Dave
AU6 - Doré, Maxime
AB - To report a sinus bradycardia induced by metoprolol and terbinafine drug–drug interaction and its management. A 63 year-old Caucasian man on metoprolol 200 mg/day for stable coronary artery disease was prescribed a 90-day course of oral terbinafine 250 mg/day for onychomycosis. On the 49th day of terbinafine therapy, he was brought to the emergency room for a decrease of his global health status, confusion and falls. The electrocardiogram revealed a 37 beats/min sinus bradycardia. A score of 7 on the Naranjo adverse drug reaction probability scale indicates a probable relationship between the patient’s sinus bradycardia and the drug interaction between metoprolol and terbinafine. The heart rate ameliorated first with a decrease in the dose of metoprolol. It was subsequently changed to bisoprolol and the heart rate remained normal. By inhibiting the cytochrome P450 2D6, terbinafine had decreased metoprolol’s clearance, leading in metoprolol accumulation which has resulted in clinically significant sinus bradycardia.
TI - A metoprolol–terbinafine combination induced bradycardia
JF - European Journal of of Drug Metabolism and Pharmacokinetics
DO - 10.1007/s13318-014-0205-x
DA - 2014-06-04
UR - https://www.deepdyve.com/lp/springer-journals/a-metoprolol-terbinafine-combination-induced-bradycardia-unKzY0r7S9
SP - 295
EP - 299
VL - 40
IS - 3
DP - DeepDyve
ER -