洛哌丁胺心脏毒性的研究进展

Research Progress of Cardiac Toxicity of Loperamide

目的分析洛哌丁胺的心脏毒性及其影响因素,为合理用药提供参考。方法检索国内外文献,对洛哌丁胺引起心脏毒性的报道进行统计与分析。结果我国尚无洛哌丁胺引起心脏毒性的报道。国外文献研究表明,大剂量服用洛哌丁胺引起严重的心脏毒性,表现为晕厥、心脏骤停、QT间期延长、尖端扭转性室性心动过速等,甚至引起死亡。结论超剂量滥用、合并使用CYP3A4/CYP2C8和/或P-糖蛋白抑制剂、低龄是洛哌丁胺心脏毒性的危险因素。应严格按照说明书规定和医生处方的剂量用药,2岁以下儿童不应服用洛哌丁胺,应注意合并用药的风险。

Objective To provide references for rational drug use through analyzing the cardiac toxicity of loperamide and the influencing factors. Methods References at home and abroad about the cardiac toxicity of loperamide were summarized and analyzed. Results The cardiac toxicity caused by loperamide hasn＇t been reported in China. However, foreign literatures shows that higher than recommended doses of loperamide can cause serious cardiac events, including syncope, cardiac arrest, QT prolongation, torsades de pointes ventricular tachycardia and even death. Conclusion The main risk factors for cardiac toxicity of loperamide are the high dose abuse, combined with inhibitors of CYP3A4/CYP2C8 and/or P-glycoprotein, and the low age. Patients should only take loperamide in the dose prescribed by doctors or according to the label. Loperamide is not recommended for use in children under 2 years. More attentions should be paid to the risk of the combined medication.