利福平联合用药致高血压1例分析  

Rifampin Combined Therapy Inducing Hypertension:A Case Report Analysis

作　　者：蔡颖 郭新红[1,2] 贾运涛[3] 王秀玲 文强 王新春[1,2] CAI Ying;GUO Xinhong;JIA Yuntao;WANG Xiuling;WEN Qiang;WANG Xinchun(The First Affiliated Hospital of Shihezi University Medical College,Shihezi,Xinjiang,China 832008;School of Pharmacy,Shihezi University,Shihezi,Xinjiang,China 832003;Department of Pharmacy,Children's Hospital Affiliated to Chongqing Medical University,National Clinical Research Center for Child Health and Diseases,Key Laboratory of Pediatric Developmental Diseases,Ministry of Education,Key Laboratory of Pediatric Metabolic and Inflammatory Diseases,Chongqing,China 400014)

机构地区：[1]石河子大学医学院第一附属医院,新疆石河子832008 [2]石河子大学药学院,新疆石河子832003 [3]重庆医科大学附属儿童医院药学部·国家儿童健康与疾病临床医学研究中心·儿童发育疾病研究教育部重点实验室·儿童代谢与炎症性疾病重庆市重点实验室,重庆400014

出　　处：《中国药业》2025年第6期123-128,共6页China Pharmaceuticals

摘　　要：目的为临床安全使用利福平提供参考。方法回顾性分析1例利福平联合用药后血压异常升高患儿的诊疗过程,结合文献资料分析患儿使用利福平发生高血压的机制,综合药品说明书及Lexicomp与Medscape药物相互作用在线数据库等分析利福平及与其代谢重叠联用药物的药物相互作用(DDI),对利福平(单药及联合用药)与高血压不良反应进行关联性评价。结果利福平致高血压与影响肝药酶CYP3A4的诱导效应有关。利福平与硝苯地平、氨氯地平、美托洛尔联用均提示存DDI风险,特别是硝苯地平;利福平单用或与硝苯地平、氨氯地平、美托洛尔联用导致高血压的关联性评价结果均为“可能有关”。结论利福平与降压药联用时宜优先选择血管紧张素转化酶抑制剂或利尿剂,同时关注利福平本身可能导致的升高血压作用。临床发生可疑药物相互作用时可结合单药的药品不良反应和多药间的药物相互作用等方面来分析。Objective To provide a reference for the clinical safe use of rifampin.Methods A retrospective analysis was conducted on a child who developed hypertension after combined therapy with rifampin.The mechanisms of hypertension caused by rifampin were analyzed in conjunction with the literature.Drug-drug interactions(DDIs)between rifampin and medications with overlapping metabolism were assessed using the drug package insert and online databases such as Lexicomp and Medscape.The relationship between rifampin(both monotherapy and combined therapy)and hypertension as an adverse drug reaction was evaluated.Results Rifampin-induced hypertension is related to its induction effect on the liver enzyme CYP3A4.DDIs were identified between rifampin and nifedipine,amlodipine,and metoprolol,especially with nifedipine.The association between rifampin monotherapy or combined use with nifedipine,amlodipine,and metoprolol leading to hypertension was considered″likely related″.Conclusion When combining rifampin with antihypertensive drugs,angiotensin-converting enzyme inhibitors or diuretics should be prioritized,and attention should be given to the potential hypertensive effect of rifampin itself.Clinical suspected drug interactions should be analyzed by considering adverse drug reactions of single drugs and DDIs between multiple medications.

关 键 词：利福平 高血压 药品不良反应 药物相互作用 药学监护 

分 类 号：R969.3[医药卫生—药理学]