Antibiotics and Heart Health: Concerns About Side Effects and Interactions

Questions about the side effects of antibiotic medications?

Hello, Dr.
He! About a year and a half ago, I underwent catheter ablation surgery to treat premature ventricular contractions (PVCs).
I have been under continuous follow-up (every three months), and after a 24-hour Holter monitor test, my doctor indicated that while I still have PVCs, there has been significant improvement.
My medication was adjusted from half a tablet of Dronedarone and two tablets of Bisoprolol daily to one tablet of Bisoprolol daily.
Recently, I visited the ENT department due to a flare-up of sinusitis, and the doctor prescribed Cinalone (Ciprofloxacin) 250 mg, two tablets twice a day for treatment.
At that time, I did not inform the doctor about my ongoing cardiac issues.
After checking, I found that Ciprofloxacin has a potential side effect of QT prolongation or ventricular arrhythmias, although the probability is unclear.

Since I am unsure whether the ENT doctor reviewed my cardiology records (and I also forgot to mention it), I would like to ask you, Dr.
He, whether this medication truly poses such side effects and if taking this antibiotic for a week would affect my current arrhythmia management.
Additionally, is there any interaction between Ciprofloxacin and Bisoprolol? Thank you, Dr.
He!

Sam, 30~39 year old female. Ask Date: 2022/03/22

Dr. He Dongjin reply Cardiology

Hello, Cipro has side effects such as QT prolongation or ventricular arrhythmias, but it has minimal interactions with heart medications.
If you are concerned about taking half a dose of heart medication, it may be best to pause it for now.
Changhua Hospital cares about your well-being.

Reply Date: 2022/03/22

More Info

Dear Patient,
Thank you for your inquiry regarding the potential interactions and side effects of the antibiotic Cipro (Ciprofloxacin) in relation to your heart health, particularly after your recent cardiac procedures. It is essential to understand how medications can affect your heart, especially given your history of ventricular premature contractions (VPCs) and the medications you are currently taking.

Ciprofloxacin, a fluoroquinolone antibiotic, is known to have several side effects, one of which includes the potential to prolong the QT interval on an electrocardiogram (ECG). This prolongation can lead to a type of arrhythmia known as Torsades de Pointes, which can be serious. However, the incidence of this side effect is relatively low, and it is more commonly seen in patients who have pre-existing conditions that predispose them to QT prolongation, such as electrolyte imbalances, existing heart conditions, or those taking other medications that also prolong the QT interval.

Given your history of heart issues and the medications you are currently taking, it is wise to be cautious. Heart medications like "心康樂" (likely a beta-blocker) can have interactions with other drugs, but they are generally well-tolerated. However, it is crucial to monitor your heart rhythm closely while taking Ciprofloxacin, especially since you have a history of VPCs. If you notice any unusual symptoms such as palpitations, dizziness, or fainting, you should seek medical attention immediately.

Regarding the duration of treatment, taking Ciprofloxacin for one week is typically considered safe for most patients, but individual responses can vary. It is essential to communicate with your healthcare provider about your cardiac history, as they may want to monitor you more closely during this time. If you have not already done so, I recommend informing your ENT specialist about your heart condition and the medications you are taking, as this can help them make more informed decisions regarding your treatment.

In terms of interactions with "心康樂," there is no well-documented direct interaction between Ciprofloxacin and beta-blockers. However, since both can affect heart rhythm, it is prudent to monitor your heart rate and rhythm during this period. If you have any concerns, your cardiologist may suggest performing an ECG or a Holter monitor test to ensure that your heart rhythm remains stable while on this antibiotic.

In conclusion, while Ciprofloxacin can potentially affect heart rhythm, the risk is generally low, especially if you are monitored closely. Always communicate openly with your healthcare providers about all medications you are taking and any changes in your health status. If you have further concerns or symptoms, do not hesitate to reach out to your cardiologist for personalized advice.

Wishing you good health and a speedy recovery from your sinus infection.

Best regards.

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