Sparfloxacin Amiodarone

If patient is taking agents capable of significantly prolonging QTc interval (e.g., pimozide thioridazine selected antiarrhythmics such as quinidine, disopyramide, amiodarone, and sotalol selected antibiotics such as moxifloxacin and sparfloxacin)... 

Clinically important, potentially hazardous interactions with amiodarone, bepridil, cisapride, disopyramide, droperidol, erythromycin, flecainide, levodopa, pentamidine, procainamide, quinidine, sotalol, sparfloxacin, terfenadine, thioridazine... 

Clinically important, potentially hazardous interactions with abacavir, amiodarone, bretylium, chlorpromazine, ciprofloxacin, disopyramide, enoxacin, fluphenazine, gatifloxacin, lomefloxacin, mesoridazine, moxifloxacin, norfloxacin, ofloxacin, phenothiazines, procainamide, prochlorperazine, promethazine, quinidine, quinolones, sotalol, sparfloxacin, thioridazine, trifluoperazine... 

Leukopenia, eosinophilia, and mild elevations in serum transaminases occur rarely. Prolongation of the QT interval has been observed with sparfloxacin and to a lesser extent with gati-floxacin and moxifloxacin. Quinolones probably should be used only with caution in patients who are taking certain antiarrhythmics, including amiodarone, quinidine, and procainamide (see Chapter 34). 

Torsade de pointes has been reported in two patients taking amiodarone and levofloxacin. Post-marketing surveillance identifled two cases with amiodarone and sparfloxacin. An increased risk of this arrhythmia would also be expected if amiodarone is used with gatifloxacin or moxifloxacin. 

During post-marketing surveillance of sparfloxacin in France over a period of 8 months (about 750 000 patients) serious adverse cardiovascular effects were reported in 7 patients. All 7 patients had underlying risk factors including 3 patients who were also receiving amiodarone. Offhese, 2 patients had documented QT prolongation and ventricular tachycardia. ... 

Amiodarone can prolong the QT interval and increase the risk of torsade de pointes. Of the quinolones used clinically, gatifloxacin, moxifloxacin, and sparfloxacin are known to prolong the QT interval (see Table 9.2 , (p.257)). There is also evidence that levofloxacin may prolong the QT in-terval. ... 

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