Cisapride
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of cisapride and astemizole is contraindicated.
Clarithromycin
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and clarithromycin is contraindicated.
Efavirenz
Adverse Effect: Efavirenz causes inhibition of isoenzyme CYP3A4 Astemizole is mainly metabolized via CYP3A4 so it leads to reducing the clearance of Astemizole resulting in serious adverse events. Clinical Management: Avoid concomitant use of Astemizole and Efavirenz.
Erythromycin
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and erythromycin is contraindicated.
Fluconazole
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and fluconazole is not recommended due to the potential for serious, even fatal, cardiac effects.
Fluoxetine
Adverse Effect: cardiotoxicity (QT interval prolongation, torsades de pointes, cardiac arrest) Clinical Management: Concomitant use of astemizole and fluoxetine is not recommended.
Frusemide
Hypokalaemia induced by diurectic
Itraconazole
Adverse Effect: An increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and itraconazole is contraindicated.
Ketoconazole
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and ketoconazole is contraindicated.
Pimozide
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: Pimozide is contraindicated in individuals with congenital QT syndrome, patients with a history of cardiac arrhythmias, or patients taking other drugs which may prolong the QT interval.
Quinine
Adverse Effect: increased astemizole serum concentrations and potential cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: Concurrent administration of astemizole and quinine is contraindicated. Severe cardiotoxicity, including electrocardiographic abnormalities, torsades de pointes, ventricular arrhythmias, and cardiac arrest, have occurred in cases of high serum concentrations of astemizole.
Roxithromycin
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of astemizole and roxithromycin is not recommended.
Sertraline
Adverse Effect: cardiotoxicity (QT interval prolongation, torsades de pointes, cardiac arrest) Clinical Management: Concomitant use of astemizole and sertraline is not recommended.
Sotalol
Adverse Effect: an increased risk of QT prolongation and ventricular arrhythmias Clinical Management: Concomitant therapy with astemizole and sotalol should be undertaken with caution. Monitor patients closely for changes in the ECG.
Sparfloxacin
Adverse Effect: prolongation of the QTc interval and/or torsades de pointes Clinical Management: Sparfloxacin is contraindicated in individuals with known QTc prolongation or in patients being treated concurrently with drugs that are known to increase the QTc interval and/or cause torsades de pointes.
Trifluopromazine
Adverse Effect: Increased risk of cardiac arrhythmias Clinical Management: Avoid the combination if possible |