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Prolonged QT Interval due to Medication

Aka: Prolonged QT Interval due to Medication, Drug-Induced Torsades de Pointes

See Also
1. Prolonged QT
2. Torsades de Pointes
Risk Factors: Medication-Induced Torsades de Pointes
1. Female gender
2. Hypokalemia
3. Severe Hypomagnesemia
4. Bradycardia
5. Atrial Fibrillation Cardioversion recently
6. Congestive Heart Failure
7. Concurrent Digoxin use
8. Baseline QT Prolongation or subclinical long QT
Causes: Medications causing Torsades de Pointes
1. General
  1. Higher doses of predisposing drug raise risk
  2. Rapid drug administration raises risk
2. Overall associated medication classes causing Prolonged QT interval
  1. Amphetamines
  2. Anticholinergics
  3. Antihistamines
  4. Decongestants
  5. Diuretics
  6. Fluoroquinolones
  7. Macrolides
  8. Phenothiazines
  9. Protease Inhibitors
  10. Selective Serotonin Reuptake Inhibitors
  11. Sympathomimetics
  12. Tricyclic Antidepressants
  13. Vasodilators
3. Medications that more commonly cause Torsades
  1. Bepridil
  2. Disopyramide
  3. Dofetilide
  4. Ibutilide
  5. Procainamide
  6. Quinidine
  7. Sotalol
4. Medications that less frequently cause Torsades
  1. Amiodarone
  2. Arsenic trioxide
  3. Chlorpromazine
  4. Cisapride
  5. Clarithromycin
  6. Domperidone
  7. Droperidol
  8. Erythromycin
  9. Halofantrine
  10. Haloperidol
  11. Lidoflazine
  12. Mesoridazine
  13. Methadone
  14. Pentamidine
  15. Pimozide
  16. Sparfloxacin
  17. Thioridazine
References
1. Roden (2004) N Engl J Med 350:1013-22
2. Wexler (2011) Am Fam Physician 84(1): 63-9

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 9/30/2011 and last published on 2/5/2012.

This is one of 5663 pages in the Family Practice Notebook