A rare complication of coronary vasospasm associated with concomitant use of ergotamine, cobicistat, and darunavir
نویسندگان
چکیده
Ergotism is a rare cause of peripheral vasoconstriction with varying presentation depending on the affected vessels. Coronary vasospasm rare, potentially fatal manifestation ergotism. Cytochrome P-450 isoenzyme CYP3A metabolizes ergot alkaloids and their derivatives; thus, concomitant use ergotamine inhibitors significantly increases ergotism risk. The antiretroviral drug darunavir boosted cobicistat potently inhibits CYP3A. A few deleterious interactions are described in literature when combining human immunodeficiency virus protease inhibitors. Herein, we describe patient who presented to emergency department profound coronary arising from ergotamine’s interaction cobicistat. Emergency angiography revealed no critical atherosclerotic stenosis, but prolonged artery spasm. After prompt cardiopulmonary resuscitation, intravenous vasodilator treatment, 14-day extracorporeal membrane oxygenation application, fully recovered was discharged. Concomitant derivatives could be disastrous for patients treated cobicistat-boosted darunavir.
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ژورنال
عنوان ژورنال: Antiviral Therapy
سال: 2022
ISSN: ['2040-2058', '1359-6535']
DOI: https://doi.org/10.1177/13596535211068957