Abstract

A REPORT ON CLOZAPINE AND FELODIPINE INDUCED ADVERSE EFFECTS IN A PATIENT WITH ERYTHROMYCIN TOXICITY

Mohammad Arief*, Harika Bheemavarapu, Tye Sok Cin, Syed Ahmed Iizhar

Abstract

Objective To report a case of clozapine, felodipine induced adverse effects in a patient with erythromycin toxicity. Case summary A 52years old, Malaysian male, who is hypertensive, schizophrenic, on regular use of felodipine (5mg), clozapine (300mg), for the past 6years was presented to the emergency department of a public hospital in Malaysia due to attempted suicide at his home. The day prior to admission, patient allegedly consumed 10 tablets of 500mg erythromycin, 8 tablets of 5mg felodipine. Discussion Upon admission, patient’s vital parameters were abnormal. He also presented with severe ankle edema, dizziness, and hypotension with random blood glucose level of 260mg/dl. Moreover, he had one episode of seizure attack in the emergency department. Conclusion This case represents a good example for erythromycin induced drug interaction leading to side effects produced by two other drugs co-administered. Adverse effects were treated successfully and further monitoring was done by the clinical pharmacist.

Keywords: Therapeutic Drug Monitoring; Postural hypotension; hepatic enzyme CYP3A4; Erythromycin estolate; Schizophrenia.