Tsifi Angeliki, Papaxoinis George, Diamantopoulos Panagiotis, Mantzourani Marina, Antoniadou Vasiliki, Halioti Asimina, Gogas Helen
First Department of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
J Chemother. 2019 Nov-Dec;31(7-8):424-427. doi: 10.1080/1120009X.2019.1665875. Epub 2019 Sep 13.
In the current report we present the case of a patient experiencing a life-threatening drug-drug interaction involving the concurrent administration of capecitabine and brivudine. A 65- year-old female with metastatic breast cancer was commenced on brivudine for Herpes Zoster, while on capecitabine treatment, by a physician unfamiliar with the potential repercussions of this drug-drug interaction. As a result, she developed skin rash, severe oral mucositis, and severe and prolonged pancytopenia. These side effects were attributed to a serious interaction of capecitabine with brivudine, resulting in inhibition of dihydropyrimidine dehydrogenase. The patient was admitted for supportive care including intravenous hydration, parenteral nutrition, mouth care solutions, fluconazole, antimicrobial therapy, filgrastim, red blood cell and platelet transfusions. She successfully recovered and was discharged on the 26 day after her admission. Drug-drug interactions can be serious, even life-threatening; thus the physicians should be cautious when prescribing new drugs.
在本报告中，我们介绍了一例患者，该患者因同时服用卡培他滨和溴夫定而发生危及生命的药物相互作用。一名65岁的转移性乳腺癌女性患者正在接受卡培他滨治疗，此时一名不熟悉这种药物相互作用潜在影响的医生开始给她使用溴夫定治疗带状疱疹。结果，她出现了皮疹、严重的口腔黏膜炎以及严重且持续时间较长的全血细胞减少症。这些副作用归因于卡培他滨与溴夫定的严重相互作用，导致二氢嘧啶脱氢酶受到抑制。患者入院接受支持治疗，包括静脉补液、肠外营养、口腔护理溶液、氟康唑、抗菌治疗、非格司亭、红细胞和血小板输注。她成功康复，并在入院后第26天出院。药物相互作用可能很严重，甚至危及生命；因此医生在开新药时应谨慎。
