TITLE:
Ciprofloxacin Cardiotoxicity and Hepatotoxicity in Humans and Animals
AUTHORS:
Elias Adikwu, Nelson Brambaifa
KEYWORDS:
Ciprofloxacin; Cardiotoxicity; Hepatotoxicity; Humans; Animals
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.3 No.2,
April
25,
2012
ABSTRACT: Ciprofloxacin
is generally well tolerated; the most common adverse effects include gastro intestinal tract, central
nervous system and hematological system effects. Recently rising cases of
Ciprofloxacin associated toxicity have been reported. Experiment using animal models and clinical experience showed that Ciprofloxacin induced cardiotoxicity is marked by increase QT and
QTC interval and prolonged action potential duration. This increases the risk of
arrhythmia (tosarde de pointes). Ciprofloxacin induced cardiotoxic effect could
be associated with blocking cardiac voltage—gated
potassium channels particularly the rapid component (IKr) of the delayed
rectifier potassium current. Drug interaction with inhibitors of Cytochrome
P450 (CYP) mediated metabolism could be one of the
underlying mechanisms. Several cases of Ciprofloxacin induced hepatoxicity have
been also reported. These were characterized by extensive
hepatocellular necrosis, mixed inflammatory infiltrate and abundant esinophils in the liver. Elevated liver enzymes
which include serum aspartate aminotransferase, alanine aminotransferase,
alkaline phosphatase, and gramma-glutamyltranferase and prolong prothrobin time
were reported. The hepatotoxic effect of Ciprofloxacin as reported could be due
to oxidative stress induced in the liver by Ciprofloxacin through the
generation of oxidative radicals leading to depletion of protein content in hepatocytes as a consequence of nucleic
acids diminution and DNA damage. This may lead to significant decrease in the number and degeneration in
mitochondria which is responsible for energy supply. Conclusion: Ciprofloxacin induced cardiotoxicity and hepatotoxicity
is relatively low in humans but patients’ liver and cardiac function may be considered
before Ciprofloxacin use.