Skip to main content
PMC home page
Journal of Medical Toxicology logoLink to Journal of Medical Toxicology
. 2007 Dec;3(4):190–194. doi: 10.1007/BF03160939

Case files of the Drexel University medical toxicology fellowship: Methadone-induced QTc prolongation

Stella C Wong 1,✉, James R Roberts 1,2
PMCID: PMC3550015  PMID: 18072176

Full Text

The Full Text of this article is available as a PDF (104.5 KB).

Footnotes

There was no outside funding of any kind used for this study.

References

  • 1.Al-Khatib SM, LaPointe NM, Kramer JM, Califf RM. What clinicians should know about the QT interval. JAMA. 2003;289:2120–2127. doi: 10.1001/jama.289.16.2120. [DOI] [PubMed] [Google Scholar]
  • 2.Kornick CA, Kilborn MJ, Santiago-Palma J, Schulman G, Thaler HT, Keefe DL, Katchman AN, Pezzullo JC, Ebert SN, Woosley RL, Payne R, Manfredi PL. QTc interval prolongation associated with intravenous methadone. Pain. 2003;105:499–506. doi: 10.1016/S0304-3959(03)00205-7. [DOI] [PubMed] [Google Scholar]
  • 3.Martell BA, Arnsten JH, Krantz MJ, Gourevitch MN. Impact of methadone treatment on cardiac repolarization and conduction in opioid users. Am J Cardiol. 2005;95:915–918. doi: 10.1016/j.amjcard.2004.11.055. [DOI] [PubMed] [Google Scholar]
  • 4.Arizona CERT (Center for Education and Research on Therapeutics) [webpage on the Internet]. Drugs That Prolong the QT Interval and/or Induce Torsades de Pointes. [updated 2006 Mar 1, cited2007 May 1]. Available from: http://www.qtdrugs.org/medical-pros/drug-lists/pubMed-drug-list.cfm
  • 5.Dolophine® Hydrochloride CII (Methadone Hydrochloride Tablets, USP). Roxane Laboratories, INC. Columbus, OH 43216.
  • 6.Drug Abuse Warning Network [webpage on the Internet]. Drug Abuse Warning Network, 2005: National Estimates of Drug-Related Emergency Department Visits. [updated 2007 Mar, cited2007 June 4]. Available from: http://dawninfo.samhsa.gov/ files/DAWN-ED-2005-Web.pdf
  • 7.Lai MW, Klein-Schwartz W, Rodgers GC, Abrams JY, Haber DA, Bronstein AC, et al. Annual Report of the American Association of Poison Control Centers’ National Poisoning and Exposure Database. Clinical Toxicology. 2005;44(6):803–932. doi: 10.1080/15563650600907165. [DOI] [PubMed] [Google Scholar]
  • 8.Katchman AN, McGroary KA, Kilborn MJ, Kornick CA, Manfredi PL, Woosley RL, Ebert SN. Influence of opioid agonists on cardiac human ether-a-go-go-related gene K+ currents. J Pharmacol Exp Ther. 2002;303:688–694. doi: 10.1124/jpet.102.038240. [DOI] [PubMed] [Google Scholar]
  • 9.Nelson LS. Toxicologic myocardial sensitization. Journal of Toxicology: Clinical Toxicology. 2002;40:867–879. doi: 10.1081/CLT-120016958. [DOI] [PubMed] [Google Scholar]
  • 10.Lipski J, Stimmel B, Donoso E. The effect of heroin and multiple drug abuse on the electrocardiogram. American Heart Journal. 1973;86(5):663–668. doi: 10.1016/0002-8703(73)90344-X. [DOI] [PubMed] [Google Scholar]
  • 11.Krantz MJ, Lewkowiez L, Hays H, Woodroffe MA, Robertson AD, Mehler PS. Torsade de pointes associated with very-high-dose methadone. Ann Intern Med. 2002;137:501–504. doi: 10.7326/0003-4819-137-6-200209170-00010. [DOI] [PubMed] [Google Scholar]
  • 12.Krantz MJ, Mehler PS. QTc prolongation: methadone’s efficacy-safety paradox. The Lancet. 2006;368:556–557. doi: 10.1016/S0140-6736(06)69173-3. [DOI] [PubMed] [Google Scholar]
  • 13.Ehret GB, Voide C, Gex-Fabry M, Chabert J, Shah D, Broers B, Piguet V, Musset T, Gaspoz JM, Perrier A, Dayer P, Desmeules JA. Drug-induced long QT syndrome in Injection drug users receiving methadone. Arch Intern Med. 2006;166:1280–1287. doi: 10.1001/archinte.166.12.1280. [DOI] [PubMed] [Google Scholar]
  • 14.Piguet V, Desmeules J, Ehret G, Stoller R, Dayer P. QT interval prolongation in patients on methadone with concomitant drugs. Journal of Clinical Psychopharmacology. 2004;24(4):446–8. doi: 10.1097/01.jcp.0000132347.81455.57. [DOI] [PubMed] [Google Scholar]
  • 15.Decerf JA, Gressens B, Brohet C, Liolios A, Hantson P. Can methadone prolong the QT interval? Intensive Care Med. 2004;30:1690–1691. doi: 10.1007/s00134-004-2335-0. [DOI] [PubMed] [Google Scholar]
  • 16.Reddy S, Fisch M, Bruera E. Oral methadone for cancer pain: no indication of Q-T interval prolongation or torsades de pointes. Journal of Pain and Symptom Management. 2004;28(4):301–303. doi: 10.1016/j.jpainsymman.2004.07.001. [DOI] [PubMed] [Google Scholar]
  • 17.Fredheim OM, Borchgrevink PC, Hegrenaes L, Kaasa S, Dale O, Klepstad P. Opioid switching from morphine to methadone causes a minor but not clinically significant increase in QTc time: a prospective 9-month follow-up study. J Pain Symptom Manage. 2006;32:180–185. doi: 10.1016/j.jpainsymman.2006.02.010. [DOI] [PubMed] [Google Scholar]
  • 18.Sticherling C, Schaer BA, Ammann P, Maeder M, Osswald S. Methadone-induced torsade de pointes tachycardias. Swiss Med Wkly. 2005;135:282–285. doi: 10.4414/smw.2005.10939. [DOI] [PubMed] [Google Scholar]
  • 19.Lamont P, Hunt SC. A twist on torsade: a prolonged QT interval on methadone. J Gen Intern Med. 2006;21:C9–C12. doi: 10.1111/j.1525-1497.2006.00588.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Arizona CERT (Center for Education and Research on Therapeutics) [webpage on the Internet]. Drugs with Risk of Torsades de Pointes. [updated 2006 Mar 1, cited2007 June 4]. Available from: http://www.torsades.org/medical-pros/ drug-lists/list-01.cfm.
  • 21.Arizona CERT (Center for Education and Research on Therapeutics) [webpage on the Internet]. Drugs with Risk of Torsades de Pointes. [updated 2006 Mar 1, cited2007 June 4]. Available from: http://www.torsades.org/medical-pros/drug-lists/list-02.cfm.
  • 22.Ferreira S, Crumb WJ, Carlton CG, Clarkson CW. Effects of cocaine and its major Metabolites on the HERG-encoded potassium channel. J Pharmacol Exp Ther. 2001;299:220–226. [PubMed] [Google Scholar]
  • 23.Magnano AR, Talathoti NB, Hallur R, Jurus DT, Dizon J, Holleran S, Bloomfield DM, Collins E, Garan H. Effect of acute cocaine administration on the QTc interval of habitual users. Am J Cardiol. 2006;97:1244–1246. doi: 10.1016/j.amjcard.2005.11.046. [DOI] [PubMed] [Google Scholar]
  • 24.Gamouras GA, Monir G, Plunkitt K, Gursoy S, Dreifus L. Cocaine abuse: repolarization abnormalities and ventricular arrhythmias. Am J Med Sci. 2000;320(1):9–12. doi: 10.1097/00000441-200007000-00002. [DOI] [PubMed] [Google Scholar]
  • 25.Ashwath ML, Ajjan M, Culclasure T. Methadone-induced bradycardia. The Journal Emergency Medicine. 2005;29(1):73–5. doi: 10.1016/j.jemermed.2004.10.022. [DOI] [PubMed] [Google Scholar]
  • 26.Wheeler AD, Tobias JD. Bradycardia during methadone therapy in an infant. Pediatr Crit Care Med. 2006;7(1):83–85. doi: 10.1097/01.PCC.0000192337.00842.1E. [DOI] [PubMed] [Google Scholar]
  • 27.Seyler DE, Borowitz JL, Maickel RP. Calcium channel blockade by certain opioids. Fundam Appl Toxicol. 1983;3:536–542. doi: 10.1016/S0272-0590(83)80101-8. [DOI] [PubMed] [Google Scholar]
  • 28.U.S. Food and Drug Adminstration [webpage on the internet]. Methadone Use of Pain Control May Result in Death and Life-Threatening Changes in Breathing and Heart Beat. [created2006 Nov 27]. Available from: http://www.fda.gov/cder/drug/ advisory/methadone.htm.

Articles from Journal of Medical Toxicology are provided here courtesy of Springer

RESOURCES