Findings in a large cohort study suggest that using lansoprazole together with ceftriaxone may increase the risk of ventricular arrhythmia, cardiac arrest, and in-hospital mortality, compared with alternative proton pump inhibitors.
Heart Attack
Ceftriaxone and lansoprazole are two of the medications that are commonly prescribed by doctors. Researchers have observed that people admitted to internal medicine wards in hospitals are often placed on this combination. Ceftriaxone is an antibiotic while lansoprazole is a proton pump inhibitor (PPI)
PPIs are a class of drugs for treating heartburn and acid-related conditions. Ceftriaxone is best known under the brand name Prevacid.
Researchers observed that using the heartburn medication together with ceftriaxone made patients more likely to experience abnormal heartbeats, cardiac arrest, and death. Their retrospective cohort study included more than 31,000 patients.
The results of this study appeared in the journal JAMA Network Open. They suggest that steering clear of the combination may reduce the risk of ventricular arrhythmia, cardiac arrest, and death.
Prolonged QT intervals
It is not uncommon for drug combinations to be associated with an increased risk of some sort. In the case of the ceftriaxone-lansoprazole combination, research has shown that it could prolong the QT interval.
QT interval refers to the duration of ventricular electrical systole. In other words, it is the time from when the heart begins to squeeze to when it stops relaxing and gets ready to beat again. A prolonged QT interval is an abnormal heart rhythm that can be captured on an electrocardiogram.
The prolonged corrected QT (QTc) intervals observed with lansoprazole are not seen in the concurrent use of ceftriaxone with other PPIs, including omeprazole and pantoprazole.
Read Also: Using Proton Pump Inhibitors for More than 4.4 Years Increases Risk of Dementia by 33% Study Shows
While it was known that the ceftriaxone-lansoprazole combination may cause sizeable increases in the QT interval, it was not clear if this was clinically important in terms of patient outcomes.
Increased risk from a ceftriaxone-lansoprazole combination
The research team in this study wanted to find out whether the risk of ventricular arrhythmia, cardiac arrest, and in-hospital mortality rises with concomitant lansoprazole in adult patients receiving ceftriaxone therapy.
The cohort study included 31,152 adult inpatients receiving treatment in 13 Canadian hospitals. It was conducted between January 2015 and December 2021. These subjects received the antibiotic with lansoprazole or another PPI. The lansoprazole group had 3,747 patients while the other PPI group included 27,405 patients.
Results showed that 126 (3.4 percent) of those in the lansoprazole group had ventricular arrhythmia or cardiac arrest. By contrast, 319 (1.2 percent) in the other PPI group experienced the same.
In-hospital mortalities within the lansoprazole group were 746 (19.9 percent of patients) and 2,762 (10.1 percent) within the alternative PPI group.
The adjusted increase in the risk of ventricular arrhythmia or cardiac arrest in the lansoprazole group was 1.7 percent. This was 7.4 percent for in-hospital mortality in the same group.
Read Also: Curcuma Shows Promising Results Against Indigestion, Rivaling Proton Pump Inhibitors
The findings, researchers stated, imply that the combination of ceftriaxone and lansoprazole should be avoided. However, there is still a need to replicate these findings in other settings and populations.
References
Anthony D. et al (2023). Ceftriaxone and the Risk of Ventricular Arrhythmia, Cardiac Arrest, and Death Among Patients Receiving Lansoprazole. JAMA Network Open. 2023;6(10):e2339893. https://doi.org/10.1001/jamanetworkopen.2023.39893
FEEDBACK:
