A case of complete atrioventricular block with extremely high blood concentration of azelnidipine

Abstract Background Azelnidipine, a dihydropyridine calcium channel blocker (CCB), has less adverse effects (e.g. hot flushes and reflex tachycardia) compared to other dihydropyridine CCBs. Azelnidipine has been reported to reduce heart rate as opposed to inducing tachycardia. No evidence of bradyca...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Naohito Ide, Ayaka Mochizuki, Yoshiyuki Kagawa, Masaharu Ito
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Azelnidipine Adverse events Calcium channel blocker Complete atrioventricular block Drug interaction Simvastatin Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/2f3bbe61056444408595b97b917db2e7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2f3bbe61056444408595b97b917db2e7
record_format	dspace
spelling	oai:doaj.org-article:2f3bbe61056444408595b97b917db2e72021-12-05T12:03:12ZA case of complete atrioventricular block with extremely high blood concentration of azelnidipine10.1186/s40780-021-00230-x2055-0294https://doaj.org/article/2f3bbe61056444408595b97b917db2e72021-12-01T00:00:00Zhttps://doi.org/10.1186/s40780-021-00230-xhttps://doaj.org/toc/2055-0294Abstract Background Azelnidipine, a dihydropyridine calcium channel blocker (CCB), has less adverse effects (e.g. hot flushes and reflex tachycardia) compared to other dihydropyridine CCBs. Azelnidipine has been reported to reduce heart rate as opposed to inducing tachycardia. No evidence of bradycardia or complete atrioventricular block (CAVB) with azelnidipine treatment has been reported. Case presentation In the present study, a 92-year-old woman was diagnosed with CAVB while taking azelnidipine and simvastatin for an extended period of time, and referred to our medical center. It was thought that the CAVB may have been an adverse effect of azelnidipine treatment. Specifically, it was considered that in this patient, one of the causes might be the concomitant use of simvastatin inhibiting the metabolism of azelnidipine by cytochrome P450 enzyme 3A4. Consequently, it was suggested to the patient’s physician that the patient’s serum azelnidipine levels be measured and treatment with azelnidipine and simvastatin be discontinued. The patient’s serum concentration of azelnidipine at the time of her visit to our center was 63.4 ng/mL, higher than the normal acceptable level. There was no occurrence of CAVB for 4 weeks, to present, following discontinuation of azelnidipine and simvastatin treatment. Conclusions Azelnidipine has a different mechanism of action that other CCBs. In very rare cases, it may cause CAVB when combined with CYP3A4 inhibitors. If a patient taking azelnidipine is diagnosed with CAVB, physicians should suspect that the condition may be an adverse effect of azelnidipine and should consider discontinuing azelnidipine. And, in the elderly, it is necessary to avoid concomitant use of CYP3A4 inhibitors.Naohito IdeAyaka MochizukiYoshiyuki KagawaMasaharu ItoBMCarticleAzelnidipineAdverse eventsCalcium channel blockerComplete atrioventricular blockDrug interactionSimvastatinTherapeutics. PharmacologyRM1-950Pharmacy and materia medicaRS1-441ENJournal of Pharmaceutical Health Care and Sciences, Vol 7, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Azelnidipine Adverse events Calcium channel blocker Complete atrioventricular block Drug interaction Simvastatin Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441
spellingShingle	Azelnidipine Adverse events Calcium channel blocker Complete atrioventricular block Drug interaction Simvastatin Therapeutics. Pharmacology RM1-950 Pharmacy and materia medica RS1-441 Naohito Ide Ayaka Mochizuki Yoshiyuki Kagawa Masaharu Ito A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
description	Abstract Background Azelnidipine, a dihydropyridine calcium channel blocker (CCB), has less adverse effects (e.g. hot flushes and reflex tachycardia) compared to other dihydropyridine CCBs. Azelnidipine has been reported to reduce heart rate as opposed to inducing tachycardia. No evidence of bradycardia or complete atrioventricular block (CAVB) with azelnidipine treatment has been reported. Case presentation In the present study, a 92-year-old woman was diagnosed with CAVB while taking azelnidipine and simvastatin for an extended period of time, and referred to our medical center. It was thought that the CAVB may have been an adverse effect of azelnidipine treatment. Specifically, it was considered that in this patient, one of the causes might be the concomitant use of simvastatin inhibiting the metabolism of azelnidipine by cytochrome P450 enzyme 3A4. Consequently, it was suggested to the patient’s physician that the patient’s serum azelnidipine levels be measured and treatment with azelnidipine and simvastatin be discontinued. The patient’s serum concentration of azelnidipine at the time of her visit to our center was 63.4 ng/mL, higher than the normal acceptable level. There was no occurrence of CAVB for 4 weeks, to present, following discontinuation of azelnidipine and simvastatin treatment. Conclusions Azelnidipine has a different mechanism of action that other CCBs. In very rare cases, it may cause CAVB when combined with CYP3A4 inhibitors. If a patient taking azelnidipine is diagnosed with CAVB, physicians should suspect that the condition may be an adverse effect of azelnidipine and should consider discontinuing azelnidipine. And, in the elderly, it is necessary to avoid concomitant use of CYP3A4 inhibitors.
format	article
author	Naohito Ide Ayaka Mochizuki Yoshiyuki Kagawa Masaharu Ito
author_facet	Naohito Ide Ayaka Mochizuki Yoshiyuki Kagawa Masaharu Ito
author_sort	Naohito Ide
title	A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
title_short	A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
title_full	A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
title_fullStr	A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
title_full_unstemmed	A case of complete atrioventricular block with extremely high blood concentration of azelnidipine
title_sort	case of complete atrioventricular block with extremely high blood concentration of azelnidipine
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2f3bbe61056444408595b97b917db2e7
work_keys_str_mv	AT naohitoide acaseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT ayakamochizuki acaseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT yoshiyukikagawa acaseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT masaharuito acaseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT naohitoide caseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT ayakamochizuki caseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT yoshiyukikagawa caseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine AT masaharuito caseofcompleteatrioventricularblockwithextremelyhighbloodconcentrationofazelnidipine
_version_	1718372305699078144

A case of complete atrioventricular block with extremely high blood concentration of azelnidipine

Ejemplares similares