盐酸文拉法辛缓释胶囊致低钠血症1例分析  

One case of hyponatremia induced by venlafaxine hydrochloride sustained-release capsules

作　　者：张弦 曲建昌 赵强 徐锌 马瑞 ZHANG Xian;QU Jianchang;ZHAO Qiang;XU Xin;MA Rui(Department of Pharmacy,the 305th Hospital of PLA,Beijing 100017,China;Department of Endocrinology,the 305th Hospital of PLA,Beijing 100017,China)

机构地区：[1]中国人民解放军第三〇五医院药局,北京100017 [2]中国人民解放军第三〇五医院内分泌科,北京100017

出　　处：《中国药物警戒》2024年第7期819-821,共3页Chinese Journal of Pharmacovigilance

基　　金：国家科技重大专项重大新药创制(2019ZX09201005);2024年第三〇五医院自主科研基金(24ZZJJLW-005)。

摘　　要：目的探讨文拉法辛导致低钠血症的不良反应及影响因素,为临床安全用药提供参考。方法通过对1例使用盐酸文拉法辛缓释胶囊导致低钠血症病例进行分析,检索同类文献发表情况,并提出用药建议。结果患者长期使用文拉法辛治疗前庭性偏头痛5年后反复出现低钠血症,停用文拉法辛和对应补钠治疗后血钠逐渐恢复至正常,考虑为文拉法辛引起低钠血症。结论文拉法辛是临床上用于抑郁症治疗的主要药物之一,医生应关注文拉法辛引起低钠血症的风险,熟悉该药的适应证、禁忌证、药物相互作用和疗程,特别是高龄、女性、使用利尿剂等药物和既往有低钠血症病史的患者,用药期间定期监测电解质,从小剂量开始给药,尽早发现药品不良反应,确保患者用药安全。Objective To explore the adverse reactions and influencing factors of hyponatremia caused by venlafaxine and provide reference for safe clinical use of venlafaxine.Methods One case of hyponatremia caused by venlafaxine hydrochloride sustained-release capsules was analyzed and medications were recommended after related literature was reviewed.Results One patient who had been treated with venlafaxine for vestibular migraine for five years developed recurring hyponatremia.After discontinuation of venlafaxine and sodium supplementation therapy,the serum level of sodium gradually returned to normal,suggesting that venlafaxine had caused hyponatremia.Conclusion Venlafaxine is widely used in the treatment of depression.Doctors should be alert to the risk of hyponatremia caused by venlafaxine,have a good knowledge of the indications,contraindications,drug interactions and treatment courses of venlafaxine,and use this drug cautiously among such vulnerable populations as the elderly,females,those using diuretics,and those with a history of hyponatremia.Regular monitoring of electrolytes during medication,starting with small doses,early detection,and management of adverse drug reactions are essential to patients’safety during medication.

关 键 词：文拉法辛 选择性5-羟色胺再摄取抑制剂 抗抑郁药物 低钠血症 抗利尿激素不适当分泌综合征 药品不良反应 

分 类 号：R971[医药卫生—药品] R994.11[医药卫生—药学]