Comprehensive List of Drugs That Can Affect Long QT Heartbeats

Comprehensive List of Drugs That Can Affect Long QT Heartbeats

The prolonged QT interval is a condition that can lead to severe arrhythmias, including Torsades de Pointes (TdP), which may result in sudden cardiac death. Certain medications are known to prolong the QT interval, posing significant risks, especially for individuals with Long QT Syndrome (LQTS). Below is a comprehensive list of drugs that can affect long QT heartbeats:

Antipsychotics

• Chlorpromazine
• Haloperidol
• Droperidol
• Quetiapine
• Olanzapine
• Amisulpride
• Thioridazine
• Ziprasidone
• Clozapine
• Risperidone

Type IA Antiarrhythmics

• Quinidine
• Procainamide
• Disopyramide

Type IC Antiarrhythmics

• Flecainide
• Encainide

Class III Antiarrhythmics

• Sotalol
• Amiodarone
• Ibutilide
• Dofetilide

Tricyclic Antidepressants (TCAs)

• Amitriptyline
• Doxepin
• Imipramine
• Nortriptyline
• Desipramine

Other Antidepressants

• Mianserin
• Citalopram
• Escitalopram
• Venlafaxine
• Bupropion
• Moclobemide

Antihistamines

• Diphenhydramine
• Astemizole
• Loratidine
• Terfenadine

Antifungals

• Ketoconazole
• Itraconazole
• Voriconazole
• Fluconazole

Macrolides (Antibiotics)

• Erythromycin
• Clarithromycin
• Azithromycin

Other Medications

• Chloroquine
• Hydroxychloroquine
• Quinine
• Methadone
• Ondansetron
• Granisetron
• Domperidone
• Sildenafil
• Tetrabenazine
• Paliperidone
• Risperidone
• Sorafenib
• Apomorphine

Medications Predicted to Increase QT Prolongation Risk

• Domperidone
• Granisetron
• Mefloquine
• Ozanimod
• Pentamidine
• Siponimod
• Fingolimod
• Ivabradine
• Mizolastine
• Palonosetron
• Ponesimod

These drugs can cause QT prolongation through various mechanisms, such as blocking potassium channels, which delays repolarization of the heart muscles, leading to a longer QT interval. Some drugs can also interact with cytochrome P450 enzymes, altering the metabolism of other medications and increasing the risk of QT prolongation.

References

1. Comprehensive list of drugs and conditions causing QT prolongation, torsade de pointes (TdP) and long QT syndrome (LQTS) - ecgwaves.com
2. Drug-Induced QT Prolongation - U.S. Pharmacist
3. Drugs Causing QT Prolongation • LITFL • ECG Library Basics
4. Drugs that prolong the QT interval - North & East

By understanding and monitoring the use of these medications, healthcare providers can minimize the risk of QT prolongation and its associated complications in patients with Long QT Syndrome or other predispositions. Always consult with a healthcare professional before making any changes to your medication regimen.