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Inicio Medicina Clínica (English Edition) Heart failure induced by itraconazole
Journal Information
Vol. 148. Issue 2.
Pages 69-70 (January 2017)
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Vol. 148. Issue 2.
Pages 69-70 (January 2017)
Clinical report
DOI: 10.1016/j.medcle.2016.09.041
Heart failure induced by itraconazole
Insuficiencia card??aca secundaria a tratamiento con itraconazol
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Ana Rodrigo-Troyanoa,
Corresponding author
a.rodrigotroyano@hotmail.com

Corresponding author.
, Marta M. Mediavillab, No?? Garinb, Rosa G??ella
a Servicio de Neumolog??a, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Servicio de Farmacia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Abstract
Introduction and objective

Itraconazole is an antifungal imidazole used for the treatment of aspergillosis. Evidence supporting the association between itraconazole and the onset of congestive heart failure (CHF) is limited and is based on cases reported after drug market release.

Case report

We report the case of a 76-year-old man with hypertension and COPD GOLD D who experienced heart failure after receiving a new line of treatment with itraconazole. The patient's symptoms resolved completely after the drug's withdrawal and initiation of treatment with diuretic therapy. Using validated algorithms, we concluded that there was a probable association between itraconazole and the onset of CHF.

Conclusions

The association between the administration of itraconazole and the onset of CHF is difficult to prove. Further observational studies are needed to assess this association. However, based on the available evidence, we should consider this possible adverse effect and even contraindicate this treatment in patients with a structural heart disease.

Keywords:
Heart failure
Itraconazole
Drug-related adverse reactions
Resumen
Introducción y objetivo

Itraconazol es un antifúngico imidazólico para el tratamiento de la aspergilosis. La evidencia que respalda la asociación entre itraconazol y el desarrollo de insuficiencia cardíaca congestiva (ICC) es limitada y se basa en los casos notificados poscomercialización del fármaco.

Caso clínico

Presentamos el caso de un varón de 76 años, hipertenso, con EPOC GOLD D, que presenta un inicio de insuficiencia cardíaca tras la introducción de tratamiento con itraconazol. Tras la retirada del fármaco y tratamiento diurético muestra resolución completa del cuadro clínico. Tras utilizar varios algoritmos validados sobre causalidad de efectos adversos se concluyó como probable la asociación entre itraconazol y el desarrollo de ICC en este caso.

Conclusiones

La asociación entre la administración de itraconazol y el desarrollo de ICC es una relación causal difícil de demostrar. Son necesarios estudios observacionales dirigidos a evaluar tal asociación. No obstante, con la evidencia disponible debemos considerar la posibilidad de dicho efecto adverso e incluso valorar la contraindicación en pacientes con antecedentes de cardiopatía estructural.

Palabras clave:
Insuficiencia card??aca
Itraconazol
Reacciones adversas a medicamentos

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