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...

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Main Authors: Guzmán, Carlos E., Guzmán Moreno, Carla Gabriela, Assad Morell, José Luis, Carrizales Sepúlveda, Edgar Francisco
Format: Article
Language:English
Published: Oxford University Press 2021
Subjects:
Online Access:http://eprints.uanl.mx/27810/1/27810.pdf
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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.
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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
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