Coadministration of metronidazole and amiodarone can lead to severe QT prolongation and torsades de pointes, likely via CYP3A4 inhibition.
May warrant QT monitoring with coadministration; leaves open confirmation and prevalence in larger studies.
This report documents the occurrence of torsades de pointes (TdP) caused by marked QT interval prolongation in the case of a 71-year-old woman receiving both metronidazole and amiodarone for the treatment of pseudomembranous colitis and paroxysmal atrial fibrillation. The case highlights a previously unknown drug interaction. The role of inhibition of cytochrome P-450 CYP3A4 is discussed.
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Kounas et al. (2005) studied this question.
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