Flecainide toxicity associated with the use of goji berries: a case report
Background: Goji berries (GB), usually marketed as a ‘superfruit’, are a widely used herbal supplement. As with other herbal remedies, the use of GB might be associated with herb–drug interactions, increasing plasma levels of other drugs and causing adverse events. Here, we present the case of a pat...
| Autores principales: | , , , |
|---|---|
| Formato: | Artículo |
| Lenguaje: | inglés |
| Publicado: |
Oxford University Press
2021
|
| Materias: | |
| Acceso en línea: | http://eprints.uanl.mx/27810/1/27810.pdf |
| _version_ | 1824420829326213120 |
|---|---|
| author | Guzmán, Carlos E. Guzmán Moreno, Carla Gabriela Assad Morell, José Luis Carrizales Sepúlveda, Edgar Francisco |
| author_facet | Guzmán, Carlos E. Guzmán Moreno, Carla Gabriela Assad Morell, José Luis Carrizales Sepúlveda, Edgar Francisco |
| author_sort | Guzmán, Carlos E. |
| collection | Repositorio Institucional |
| description | Background: Goji berries (GB), usually marketed as a ‘superfruit’, are a widely used herbal supplement. As with other herbal remedies, the use of GB might be associated with herb–drug interactions, increasing plasma levels of other drugs and causing adverse events. Here, we present the case of a patient that developed flecainide toxicity secondary to an herb–drug interaction, associated with the use of GB to prevent COVID-19.
Case summary: A 75-year-old female presented to the emergency department with fainting. She was taking flecainide for the treatment of atrial extrasystoles diagnosed 2 years previously, and she was using a tea of GB for the prevention of COVID-19. The admission electrocardiogram showed a wide complex polymorphic tachycardia that was considered and treated as flecainide toxicity. The patient had a favourable evolution and was discharged 48 h after admission.
Discussion: Flecainide toxicity is uncommon and needs timely recognition and treatment; it is usually secondary to overdose and renal or hepatic failure. In our case, toxicity was associated with GB use, probably by inhibition of CYP2D6 which is the main enzyme associated with the metabolism of flecainide. Clinicians need to be aware of the possible interactions between herbal remedies (in this case used for the prevention of COVID-19) and cardiovascular drugs that are used to treat chronic cardiovascular diseases. |
| format | Article |
| id | eprints-27810 |
| institution | UANL |
| language | English |
| publishDate | 2021 |
| publisher | Oxford University Press |
| record_format | eprints |
| spelling | eprints-278102024-07-31T21:35:46Z http://eprints.uanl.mx/27810/ Flecainide toxicity associated with the use of goji berries: a case report Guzmán, Carlos E. Guzmán Moreno, Carla Gabriela Assad Morell, José Luis Carrizales Sepúlveda, Edgar Francisco R Medicina en General Background: Goji berries (GB), usually marketed as a ‘superfruit’, are a widely used herbal supplement. As with other herbal remedies, the use of GB might be associated with herb–drug interactions, increasing plasma levels of other drugs and causing adverse events. Here, we present the case of a patient that developed flecainide toxicity secondary to an herb–drug interaction, associated with the use of GB to prevent COVID-19. Case summary: A 75-year-old female presented to the emergency department with fainting. She was taking flecainide for the treatment of atrial extrasystoles diagnosed 2 years previously, and she was using a tea of GB for the prevention of COVID-19. The admission electrocardiogram showed a wide complex polymorphic tachycardia that was considered and treated as flecainide toxicity. The patient had a favourable evolution and was discharged 48 h after admission. Discussion: Flecainide toxicity is uncommon and needs timely recognition and treatment; it is usually secondary to overdose and renal or hepatic failure. In our case, toxicity was associated with GB use, probably by inhibition of CYP2D6 which is the main enzyme associated with the metabolism of flecainide. Clinicians need to be aware of the possible interactions between herbal remedies (in this case used for the prevention of COVID-19) and cardiovascular drugs that are used to treat chronic cardiovascular diseases. Oxford University Press 2021-06-01 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/27810/1/27810.pdf http://eprints.uanl.mx/27810/1.haspreviewThumbnailVersion/27810.pdf Guzmán, Carlos E. y Guzmán Moreno, Carla Gabriela y Assad Morell, José Luis y Carrizales Sepúlveda, Edgar Francisco (2021) Flecainide toxicity associated with the use of goji berries: a case report. European Heart Journal Case Reports, 5 (6). pp. 1-6. ISSN 2514-2119 https://academic.oup.com/ehjcr/article/5/6/ytab204/6290388?login=true doi:10.1093/ehjcr/ytab204 |
| spellingShingle | R Medicina en General Guzmán, Carlos E. Guzmán Moreno, Carla Gabriela Assad Morell, José Luis Carrizales Sepúlveda, Edgar Francisco Flecainide toxicity associated with the use of goji berries: a case report |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | Flecainide toxicity associated with the use of goji berries: a case report |
| title_full | Flecainide toxicity associated with the use of goji berries: a case report |
| title_fullStr | Flecainide toxicity associated with the use of goji berries: a case report |
| title_full_unstemmed | Flecainide toxicity associated with the use of goji berries: a case report |
| title_short | Flecainide toxicity associated with the use of goji berries: a case report |
| title_sort | flecainide toxicity associated with the use of goji berries a case report |
| topic | R Medicina en General |
| url | http://eprints.uanl.mx/27810/1/27810.pdf |
| work_keys_str_mv | AT guzmancarlose flecainidetoxicityassociatedwiththeuseofgojiberriesacasereport AT guzmanmorenocarlagabriela flecainidetoxicityassociatedwiththeuseofgojiberriesacasereport AT assadmorelljoseluis flecainidetoxicityassociatedwiththeuseofgojiberriesacasereport AT carrizalessepulvedaedgarfrancisco flecainidetoxicityassociatedwiththeuseofgojiberriesacasereport |