Major
Established
描述
Both azithromycin and hydroxychloroquine independently prolong the cardiac QT interval; concurrent use substantially raises the risk of torsades de pointes and sudden cardiac death.
机制
Both drugs block cardiac hERG (IKr) potassium channels, prolonging ventricular repolarization in an additive or supra-additive manner.
临床意义
This combination received global attention during the COVID-19 pandemic when pharmacovigilance data showed excess arrhythmia-related deaths.
处理措施
Avoid concurrent use; obtain baseline and follow-up ECG if co-prescription is unavoidable, correct electrolytes, and avoid other QT-prolonging drugs.