CMAJ Readers' Forum

Terfenadine and SSRIs

Online posting: July 25, 1997
Published in print: Oct. 15, 1997 (CMAJ 1997;157:1019)
Re: Terfenadine therapy: Can we justify the risks?, by Robert Rangno, CMAJ 1997;157:37-8 [full text / résumé]
Dr. Rangno correctly points out that certain drugs and foods that inhibit the enzyme CYP3A4 may, when combined with terfenadine, prolong the QT interval and predispose the patient to ventricular arrythmias. He fails to include antidepressants, both tricyclics and selective serotonin reuptake inhibitors (SSRIs, especially fluvoxamine, nefazodone and fluoxetine), which all inhibit the CYP3A4 enzyme.

The increasingly popular SSRIs must be included in the list of drugs that should not be combined with terfenadine.

Gitta Tafler, BA, MD
Toronto, Ont.
gitta45@astral.magic.ca

CMAJ CMAJ email    GO TO CMAJ Readers' Forum    GO TO CMAJ home page