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
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
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved