Theophylline Fatal interaction with ciprofloxacin: 00 case report

A 65-year-old woman with a history of left hemiplegia, atrial fibrillation, congestive cardiac failure and inoperable carcinoma of the breast was prescribed ciprofloxacin 250 mg bid and slow-release theophylline ('Uniphyllin Continus') 600 mgjday for a chest infection. In the preceding year she had been taking digoxin 0.25 mg, bumetanide 1 mg and tamoxifen 40 mg daily.

Five days after commencing treatment, the patient collapsed and was admitted. She was conscious but unable to communicate and had frequent epileptic seizures. ECG revealed fast atrial fibrillation and HR was 160/min. The patient was treated for 1 hour with IV digoxin 0.5mg and SC diazepam 1 Omg but her condition remained unchanged with continuing seizures. IV phenytoin was administered, abolishing the seizures, but she remained deeply unconscious for another 6 hours until she died.

Holden R. Probable fatal interaction between ciprolloxacin and theophylline. British Medical Journal 297: 1339, 19 Nov 1988 o:m

10 REACTIONS" 17 Dec 1988 0157-7271!88/1217-0010/0$01.00/0 © ADIS Press