Risk of torsades de pointes with non-cardiac drugs

doi:10.1136/bmj.322.7277.46/a

BMJ 2001;322:46 ( 6 January )

Letters

Risk of torsades de pointes with non-cardiac drugs

Prolongation of QT interval is probably a class effect of fluoroquinolones

Grapefruit juice is source of potentially life threatening adverse drug reactions

Prolongation of QT interval is probably a class effect of fluoroquinolones

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EDITOR $---$ Yap and Camm emphasise the risk of torsades de pointes associated with non-cardiac drugs that prolong the QT interval.¹They comment on the fluoroquinolone antimicrobial agents grepafloxacinand sparfloxacin causing QT prolongation but also the apparentlack of this effect with levofloxacin. We recently cared for apatient who developed torsades de pointes while taking levofloxacin,which prompted us to examine retrospectively paired electrocardiogramsin other patients to compare QTc intervals before and after theystarted treatment with thisdrug.

Twenty three patients who received a standard dose of 500 mg levofloxacin daily had cardiograms that could be compared forQTc prolongation. Prolongation of >30 ms was found in four patientsand of >60 ms in two patients. Absolute QT interval prolongationof >500 ms was present in four, one of whom developed torsadesde pointes. This patient was also receiving amiodarone, whichis known to prolong the QTc . . . [Full text of this article]

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Risk of torsades de pointes with non-cardiac drugs: Yee Guan Yap and John Camm
BMJ 2000 320: 1158-1159. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Nykamp, D. L, Blackmon, C. L, Schmidt, P. E, Roberson, A. G (2005). QTc Prolongation Associated with Combination Therapy of Levofloxacin, Imipramine, and Fluoxetine. The Annals of Pharmacotherapy 39: 543-546 [Abstract] [Full text]