Clinical hypotension with Co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients

A retrospective chart review

Swapnil Hiremath, Marcel Ruzicka, Shankar Prasad Nagaraju, Brendan B. McCormick

Research output: Contribution to journalArticle

Abstract

Background: Macrolide antibiotics inhibit the cytochrome p450 enzyme system, which metabolizes calcium-channel blockers. This may result in a clinically significant interaction, causing hypotension in patients co-prescribed these two drugs. Since these drugs are frequently used in the haemodialysis population, we studied the effect of their co-prescription on actual blood pressure. Methods: A retrospective chart review of all haemodialysis patients was conducted to identify patients co-prescribed a macrolide and a dihydropyridine calcium-channel blocker. Blood pressure measurements before and during the macrolide co-prescription were abstracted and compared using a student's t test. Results: We identified 154 haemodialysis patients concurrently prescribed a macrolide antibiotic and a dihydropyridine calcium-channel blocker. There was no significant difference in episodes of intra-dialytic hypotension or actual blood pressure measurements in the period before macrolide co-prescription and the period during macrolide co-prescription. Conclusion: In contrast to hospitalized patients receiving dihydropyridine calcium-channel blockers, concurrent administration of a macrolide antibiotic for infection did not result in hypotension in haemodialysis outpatients. Further research should be undertaken before a change in clinical practice against their co-prescription is considered.

Original languageEnglish
Pages (from-to)989-993
Number of pages5
JournalDrug Safety
Volume36
Issue number10
DOIs
Publication statusPublished - 01-10-2013

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Macrolides
Calcium Channel Blockers
Hypotension
Prescriptions
Renal Dialysis
Anti-Bacterial Agents
Blood pressure
Pressure measurement
Blood Pressure
Cytochrome P-450 Enzyme System
Pharmaceutical Preparations
Outpatients
Students
Infection
Research
Population
1,4-dihydropyridine

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology
  • Toxicology

Cite this

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abstract = "Background: Macrolide antibiotics inhibit the cytochrome p450 enzyme system, which metabolizes calcium-channel blockers. This may result in a clinically significant interaction, causing hypotension in patients co-prescribed these two drugs. Since these drugs are frequently used in the haemodialysis population, we studied the effect of their co-prescription on actual blood pressure. Methods: A retrospective chart review of all haemodialysis patients was conducted to identify patients co-prescribed a macrolide and a dihydropyridine calcium-channel blocker. Blood pressure measurements before and during the macrolide co-prescription were abstracted and compared using a student's t test. Results: We identified 154 haemodialysis patients concurrently prescribed a macrolide antibiotic and a dihydropyridine calcium-channel blocker. There was no significant difference in episodes of intra-dialytic hypotension or actual blood pressure measurements in the period before macrolide co-prescription and the period during macrolide co-prescription. Conclusion: In contrast to hospitalized patients receiving dihydropyridine calcium-channel blockers, concurrent administration of a macrolide antibiotic for infection did not result in hypotension in haemodialysis outpatients. Further research should be undertaken before a change in clinical practice against their co-prescription is considered.",
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Clinical hypotension with Co-prescription of macrolide antibiotics and calcium-channel blockers in haemodialysis patients : A retrospective chart review. / Hiremath, Swapnil; Ruzicka, Marcel; Nagaraju, Shankar Prasad; McCormick, Brendan B.

In: Drug Safety, Vol. 36, No. 10, 01.10.2013, p. 989-993.

Research output: Contribution to journalArticle

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AU - McCormick, Brendan B.

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