Reactions 1704, p23 - 2 Jun 2018 Blood pressure decreased: case report A 69-year-old man experienced a decrease in blood pressure following concurrent administration of alfuzosin and voriconazole [routes, dosages, duration of treatments to reaction onsets and outcome not stated]. The man had a medical history of acute myeloid leukaemia and urinary disorders. Due to invasive pulmonary aspergillosis he received treatment with voriconazole. He was also receiving treatment with alfuzosin for the urinary disorders for a year. When he visited the regular pharmacist, a drug interaction between alfuzosin and voriconazole was detected. The potent inhibitor of cytochrome (CYP) 3A4 (voriconazole) are contraindicated with the urologic alpha-blocker (alfuzosin). The treatment with voriconazole was initiated during the hospitalisation and a drop in blood pressure was noted. The pharmacist had a discussion with the haematologist, who had prescribed voriconazole to the patient and informed about the contraindication. The man’s treatment with alfuzosin was discontinued and he was treated with tamsulosin for the underlying urinary disorders. Author comment: At most, it is possible to suggest a decrease in the dosage of alpha-blocker when faced with a patient in whom side effects such as dizziness or orthostatic hypotension occur when a potent inhibitor is introduced. Voriconazole was started in hospital, the initial hospital treatment of the aspergillosis was able to detect a drop in blood pressure and educate the patient on the reasons for or against the interruption alfuzosin. Bensalah N, et al. How to act when an alpha-blocker is associated with a potent inhibitor of CYP3A4. [Review] [French]. Progres en Urologie 27: 275-282, No. 5, Apr 2017. Available from: URL: http://doi.org/10.1016/j.purol.2017.02.003 [French; summarised from a translation] - France 803324049 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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