Arrhythmic Side Effect of Itraconazole Monotherapy: A Case Report

A 39-year-old woman treated with itraconazole for onychomycosis developed palpitation and dizziness during her treatment. Premature ventricular contractions (PVC) were detected during monitoring in the emergency room. Twenty-four hour holter electrocardiogram revealed aberrant premature atrial contractions (PACs) and PVCs. Corrected QT interval was in normal limits. After discontinuing the therapy, her complaints disappeared couple of days later. Her 24-h holter ECG displayed no PACs or PVCs. In this case the etiology of extra systoles is not wellknown. She did not have any other infection or used any other medication which may interfere with the metabolism of itraconazole. Enhanced cardiac automaticity may be a probable mechanism instead of more commonly encountered QT prolongation. Cardiac side-effects of itraconazole is rare but may be life threatening. Arrhythmic side effects should be monitored carefully even in otherwise healthy patients.