Fatal Combination of Antibiotic and Calcium Channel Blocker Agents

Abstract

pyridines, particularly nifedipine, as the calcium-channel blockers, are associated with the highest risk acute kidney injury (OR, 5.33), with an absolute risk increase of 0.63%. The risk with nifedipine was followed by felodipine and amlodipine (3). The researchers previously confirmed that there are no significant differences between clarithromycin and azithromycin regarding the rates of 30-day hospitalization rate of patients with acute kidney injuries, in the absence of other interacting medications. The use of calcium-channel blockers alone, 90 days prior to the antibiotic administration, did not affect the 30-day outcomes (3). Due to the role of kidneys in eliminating clarithromycin, the guidelines called to reduce the antibiotic dose for patients with chronic kidney disease, but the researches showed that this rarely occurs in routine practices (3). Clarithromycin may be the top choice antibiotic in some cases, particularly in severely immunosuppressed patients, such as patients with AIDS, or in the treatment of extremely drug-resistant microbe, but in these cases, it is perfectly feasible to take the patient off the calcium-channel blockers. Drug-drug interactions are usually under-recognized by doctors, but newer electronic prescribing programs with specific interaction recognition software will significantly de crease this risk (5).