Rifampicin reverses nicardipine effect inducing uncontrolled essential hypertension.
Fiche publication
Date publication
avril 2017
Journal
Fundamental & clinical pharmacology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr LESSINGER Jean-Marc
Tous les auteurs :
Cordeanu EM, Gaertner S, Faller A, Mirea C, Lessinger JM, Kemmel V, Stephan D
Lien Pubmed
Résumé
Dihydropyridine calcium-channel blockers are a known substrate for the cytochrome P450 isoform 3A4. Rifampicin, an antitubercular agent, is one of the most potent inducers of hepatic and intestinal CYP3A4 thus increasing dihydropyridine metabolism. We report a case of a 67-year-old hypertensive female treated with a 4-drug antihypertensive regimen including a dihydropyridine (nicardipine 50mg bid), who was admitted for septic arthritis of the knee requiring antibiotic treatment with teicoplanin 400mg od and rifampicin 600mg bid. Six days after rifampicin initiation, she presented with Posterior Reversible Encephalopathy Syndrome due to uncontrolled hypertension. We hypothesized that disequilibrium of previously controlled hypertension was partially due to nicardipine ineffectiveness. Plasma nicardipine concentration was assessed through high performance liquid chromatography 5 hours after co-administration of the two drugs and proved undetectable. This article is protected by copyright. All rights reserved.
Mots clés
CYP3A4, arterial hypertension, dihydropyridine, hepatic inducer, rifampicin
Référence
Fundam Clin Pharmacol. 2017 Apr;: