Crizotinib is a multitarget tyrosine kinase inhibitor used in treating non-small cell lung cancer (NSCLC) with anaplastic lymphoma kinase (ALK) gene mutation. Common and well-known adverse effects include gastrointestinal disturbance, dizziness, fatigue, liver enzyme elevation and visual disturbance. We describe here a patient with NSCLC who presented with symptomatic bradycardia due to crizotinib.
The patient was a 69-year-old Chinese male with stage IV epidermal growth factor receptor-negative, ALK-rearranged NSCLC. He presented to the emergency department complaining of breathlessness, swollen legs and hiccups. He had type 2 diabetes mellitus but no previous cardiovascular disease. He was taking crizotinib 250 mg twice daily, vildagliptin 50 mg twice daily and gliclazide 160 mg every morning and 80 mg every evening. His heart rate on admission was 36 beats per minute (bpm), with a blood pressure of 128/72 mm Hg and an oxygen saturation of 99% in room air. Cardiac examination revealed symmetrical and regular pulses, normal jugular venous...
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