These agents are broken down in the liver. Thus, patients with liver disease or those using drugs that interfere with liver enzymes, such as the antibiotic erythromycin, may be predisposed to arrhythmias. Patients taking agents with a similar chemical structure — fluconazole, itraconazole, and metronidazole (Flagyl) — may have a greater predisposition to developing bother¬some, and even serious, abnormal heart rhythms. Patients with heart disease, those on diuretics or agents that reduce the levels of potassium in the blood, should not take astemizole or terfenadine. The antibiotics erythromycin, azithromycin, and clarithromycin or similar types of antibiotics should not be taken concurrently.
Newer histamine antagonists such as cetirizine and loratadine have not been noted to cause serious arrhyth¬mias, but surveillance and caution are needed in patients with heart disease or in those taking diuretics and other substances that can lower blood potassium.

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• BIBLIOGRAPHY
  Khan, M. Gabriel Effects of Drug Interactions. In Cardiac Drug Therapy, sixth edition. W. B. Saunders, Philadelphia, 2003.

Проктология проктолог поликлиника. Улица академика Янгеля.