Voriconazole Combined with Clopidogrel and Pantoprazole Induced Hepatic Dysfunction and Aggravated Myocardial Injury: a Case Report
YAN Le-hao
LIU Hong-tao
LIAN Yu-fei
QIU Zhi-hong
Abstract：Objective To investigate whether there was incompatibility among Voriconazole combined with Clopidogrel and Pantoprazole in order to provide reference for rational drug use.Methods Clinical data of 1 patient with hepatic dysfunction and aggravated myocardial injury induced by use of Voriconazole combined with Clopidogrel and Pantoprazole was retrospectively analyzed.Results The patient took medications such as Clopidogrel (75 mg/d) and Pantoprazole (60 mg/d) for acute non ST-elevation myocardial infarction, and Voriconazole (200 mg/d) was added on the 5th d medications because of pulmonary fungal infection.On the 9thd treatment, the patient felt exceeding acratia on the 4th d Voriconazole medication, and laboratory examinations showed that aspartate aminotransferase (AST) was 798 U/L, alanine aminotransferase (ALT) was 832 U/L, and troponin was 0.567 μg/L.The diagnosis did not exclude drug-induced liver injury and aggravated myocardial injury.Drug gene detection was performed at once, and CYP2C19 was found *1*1 wild type, and then Voriconazole was stopped.Micafungin Sodium was used for anti-fungi therapy.On the 14thd treatment, laboratory examinations showed that AST was 33 U/L on the 5th d after stopping Voriconazole, ALT was 38 U/L, and troponin was 0.14 μg/L, and the indexes of liver function and myocardial injury were back to normal.On the 35th d treatment, dyspnea and chest pain symptoms were relieved, and the patient was discharged.Conclusion Voriconazole combined with Clopidogrel and Pantoprazole may be incompatible.
Keywords：VoriconazoleClopidogrelPantoprazoleDrug-induced liver injuryCardiomyopathies
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 57-59 )