drug-induced prolongation of the QT interval
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Etiology
- analeptics
- agents for ADHD
- appetite suppressants
- antiarrhythmic agents
- class IA agents
- class 1B
- class 1C
- class III agents
- sotalol*
- ibutilide
- amiodarone#
- dronedarone (Multaq)
- antidepressants
- tricyclic antidepressants (TCA)
- maprotiline
- amitriptyline (Elavil)[3]
- increasing doses associated with QT prolongation[10]
- doxepin
- imipramine
- desipramine
- clomipramine (Anafranil)
- nortriptyline
- protriptyline
- Trimipramine
- SSRI
- sertraline
- sertraline is not associated with increased risk of QT prolongation (NEJM)[17]
- fluoxetine
- paroxetine
- sibutramine (Meridia)
- citalopram (Celexa) & escitalopram (Lexapro)
- increasing doses associated with QT prolongation[10]
- sertraline
- venlaxafine & desvenlafaxine (Pristiq)
- mirtazapine (Remeron)
- trazodone
- tricyclic antidepressants (TCA)
- antiemetics
- antihistamines
- astemizole
- terfenadine
- diphenydramine
- hydroxyzine
- antihypertensive agents
- antineoplastic agents
- antibiotics:
- atazanavir (Reyataz)
- bronchodilators
- cardiac agents
- decongestants
- psychotropic agents
- phenothiazines
- haloperidol
- sertindole
- risperidone (Risperdal)[3]
- ziprasidone (Geodon)
- pimozide (Orap)
- clozapine (Clozaril)
- quetiapine (Seroquel)
- aripiprazole (Abilify)
- paliperidone (Invega)
- asenapine (Saphris)
- iloperidone (Fanapt)
- loxapine
- molindone
- olanzapine[8]
- risk least for haloperidol, risperidone, olanzapine[9]
- triptans
- sumitriptan[8]
- zolmitriptan[8]
- chemotherapy
- urogenital agents
- other
- amantadine
- apomorphine (Apokyn)
- arsenic
- chloral hydrate
- chloroquine & hydroxychloroquine[14]
- cisapride
- cocaine
- domperidone
- donepezil
- encainide
- felbamate
- FK506
- foscarnet
- fosphenytoin
- galantamine
- halofantrine (Halfan)
- indapamide (Lozol)
- ketanserin
- levomethadyl (Orlaam) - off market
- lithium carbonate
- Metoclopramide (Reglan)
- methadone
- midodrine
- nefazodone
- octreotide (Sandostatin)
- orphenadrine (Norflex)
- oxytocin (Pitocin)
- pentamidine
- probucol (off US market)
- quinine
- ritodrine
- salmeterol (Serevent)
- tacrolimus
- terodiline
- tizanidine (Zanaflex)
* most common agents implicated in torsades de pointes
# amiodarone is rarely associated with torsades de pointes
More general terms
Additional terms
References
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 151
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 3.0 3.1 3.2 3.3 3.4 Prescriber's Letter 8(4):19 2001
- ↑ Prescriber's Letter 11(11): 2004 Drugs That Prolong the QT Interval and/or Induce Torsades de Pointes Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=201115&pb=PRL Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=201111&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 5.0 5.1 Prescriber's Letter 17(4): 2010 Drug-induced Long QT Interval CHART: Drug-induced Long QT Interval COMMENTARY: QT Prolongation, Torsades de Pointes, & Medication Safety Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260421&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Prescriber's Letter 18(9): 2011 CHART: Drug-induced Long QT Interval COMMENTARY: QT Prolongation, Torsades de Pointes, & Medication Safety Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=270905&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ Prescriber's Letter 19(1): 2012 Drug-Induced Long QT Interval Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280111&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 8.0 8.1 8.2 8.3 8.4 8.5 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ 9.0 9.1 Campbell N, Boustani MA, Ayub A, et al. Pharmacological management of delirium in hospitalized adults- a systematic evidence review. J Gen Intern Med 2009; 24:848-853 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19424763
- ↑ 10.0 10.1 10.2 Castro VM et al. QT interval and antidepressant use: A cross sectional study of electronic health records. BMJ 2013 Jan 29; 346:f288. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23360890
- ↑ Isbister GK, Page CB. Drug induced QT prolongation: the measurement and assessment of the QT interval in clinical practice. Br J Clin Pharmacol. 2013 Jul;76(1):48-57 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23167578
- ↑ Wenzel-Seifert K, Wittmann M, Haen E. QTc prolongation by psychotropic drugs and the risk of Torsade de Pointes. Dtsch Arztebl Int. 2011 Oct;108(41):687-93. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22114630 Free PMC Article
- ↑ CredibleMeds (MKSAP suggested reference) https://crediblemeds.org
- ↑ 14.0 14.1 Lou N Heart Groups: Clear Risks With HCQ for COVID-19 - AHA/ACC/HRS caution on malaria drug plus antibiotic. MedPage Today April 9, 2020 https://www.medpagetoday.com/infectiousdisease/covid19/85870
Roden DM, Harrington RA, Poppas A, Russo AM. Considerations for drug interactions on QTc in exploratory COVID-19 (coronarvirus disease 2019) treatment. Circulation 2020. April 8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32267732 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.047521 - ↑ Yap YG, Camm AJ. Drug induced QT prolongation and torsades de pointes Heart. 2003 Nov;89(11):1363-72 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14594906 PMCID: PMC1767957 Free PMC article
- ↑ Roden DM Drug-Induced Prolongation of the QT Interval N Engl J Med 2004;350:1013-22 PMID: https://www.ncbi.nlm.nih.gov/pubmed/14999113 https://www.nejm.org/doi/pdf/10.1056/NEJMra032426
- ↑ 17.0 17.1 NEJM Knowledge+ Psychiatry