The Potential Role of Verapamil Against Fluconazole-Induced Torsade de Pointes: A Critical Review
Abstract
Background and aims: Fluconazole (FZL) is a broad-spectrum antifungal drug associated with certain serious adverse effects such as polymorphic ventricular arrhythmia due to QT prolongation. Torsade de Pointes (TdP) is a unique type of polymorphic ventricular arrhythmia due to QT prolongation. It has been shown that the calcium-channel blocker verapamil is effective in the management of TdP. Therefore, the present critical review aims to discuss and explain the possible role of verapamil in the prevention of FZL-induced TdP.
Methods: Databases of Scopus, Cochran, Embase, PubMed, and CENTRAL were examined to recognize suitable publications. Screened articles were designated rendering to exact eligibility criteria including original articles such as prospective and retrospective studies recognizing the role verapamil in the prevention of FZL-induced TdP.
Results: The use of FZL is linked with the development of TdP and prolongation of QT, and verapamil use could be effective in the management of TdP. In addition, verapamil has antifungal effects, affects the pharmacokinetics and pharmacodynamics of FZL. Verapamil inhibits the propagation of TdP by inhibiting the deregulation of repolarization early after depolarization in the heart.
Conclusions: This critical review suggests that combination of verapamil with FZL leads to more beneficial effects by increasing the antifungal activity of FZL with a significant reduction the development of TdP which is a serious adverse effect of…
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