Topic: Anyone on two drugs that prolong the QT interval (like Zith + Diflucan)?
Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
I frequently run my drugs on www.drugs.com's Interactions Checker.
I am on Qualaquin now, and I was thinking of asking to add Zithromax back in, because I think it was helping my Bartonella.
So I ran this combo on drugs.com, and got the result that they moderately interact because they both can prolong the QT interval.
I was wondering if your LLMD's often prescribe two such drugs together. Zithromax and Diflucan is a good example. Here is what drugs.com says when I run Zith with Diflucan:
"MONITOR: Theoretically, concurrent use of two or more drugs that can cause QT interval prolongation may increase the risk of ventricular arrhythmias, including ventricular tachycardia and torsades de pointes, due to additive arrhythmogenic potential related to their effects on cardiac conduction. The risk of an individual agent or a combination of these agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). MANAGEMENT: Caution and clinical monitoring are recommended if multiple agents associated with QT interval prolongation are prescribed together. Patients should be advised to seek medical attention if they experience symptoms that could indicate the occurrence of torsades de pointes such as dizziness, palpitations, or syncope."
I'm wondering how big of a deal this really is. I don't really understand how bad it is to prolong this interval, and what the risks are.
But notice the last sentence above, mentions dizziness, palpitations, etc. I don't really have those symptoms often.
Just trying to see if anyone here has spoken with their LLMD about this, and if it's a concern, or if the benefits of combining the two drugs outweighs the potential risk.
Like is this something where I could monitor it myself, and if my chest hurts, I'd know to stop the combo? Or could I just have a heart attack? Like how serious is this?
Obviously my doctor would have to agree to it, so I won't be starting any combos on my own.
Posts: 4590 | From Midwest | Registered: Jun 2008
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Hoosiers51
Frequent Contributor (1K+ posts)
Member # 15759
posted
Just noticed that Levaquin and Zithromax also carry this warning when used together. But in that description, it said it was dose-dependent, I believe.
Posts: 4590 | From Midwest | Registered: Jun 2008
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sammy
Frequent Contributor (5K+ posts)
Member # 13952
posted
My LLMD had me stop taking the quinolone (Factive)when I needed to take a round of diflucan this summer.
Read up on prolonged QT intervals. It can cause sudden death. Not something I want to risk.
Posts: 5237 | From here | Registered: Nov 2007
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posted
For over a year I was on diflucan, combined at various times with ketek, cipro, and factive (one at a time). I had an EKG every month or two. I had no heart troubles. (Unfortunately, no improvement either -- gut syx, in fact, ended up a lot worse.)
Posts: 845 | From Eastern USA | Registered: Jul 2006
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