Debates over whether hydroxychloroquine should be taken to help lessen the duration and impact of COVID-19 have revolved around the drug’s reputation for causing cardiac events such as abnormal heart rhythms or beats and cardiac arrest.
Because of this, the U.S. Food and Drug Administration has revoked emergency use authorization for the drug in treating COVID-19.
Another drug, azithromycin—a commonly-prescribed antibiotic—also is being investigated as a potential treatment for COVID-19.
Azithromycin’s association with cardiac events also has been debated.
In 2012, the FDA issued a warning for azithromycin stating that it had been linked to cardiac events, but subsequent studies have yielded mixed results.
In a new study, researchers found that drug azithromycin by itself is not linked to an increase in cardiac events.
However, if the drug is taken with certain other drugs that affect the electrical functioning of the heart, then cardiac events increased.
The researchers found that if taken together with drugs that affect the electrical impulses of the heart, the combination is linked with a 40% increase in cardiac events, including fainting, heart palpitations, and even cardiac arrest.
The findings could give researchers and clinicians looking at azithromycin as a potential treatment for COVID-19 pause.
The research was conducted by a team from the University of Illinois Chicago.
Drugs that affect the electrical impulses of the heart, specifically the interval in the electrical rhythm called the QT interval, are called QT-prolonging drugs.
These drugs include blood pressure medications such as ACE inhibitors and beta-blockers, some antidepressants, anti-malaria drugs such as hydroxychloroquine and chloroquine, opioid medications, and even muscle relaxers.
Because QT-prolonging drugs are used so commonly, the new findings suggest that doctors prescribing azithromycin should be sure that patients are not also taking a QT-prolonging drug.
One author of the study is Haridarshan Patel, a researcher in the department of pharmacy systems, outcomes, and policy.
The study is published in JAMA Network Open.
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