Dolasetron-induced torsades de pointes

Early Drug Discovery Prediction of Proarrhythmia Potential and Its Covariates

“…In 2010, after 13 years of a presence on market, the US FDA issued a safety announcement regarding Anzemet (dolasetron mesylate—an antiemetic 5-HT 3 receptor inhibitor) use, informing patients and health professionals that the injectable form of Anzemet should no longer be used to prevent nausea and vomiting associated with cancer chemotherapy (CINV) in pediatric and adult patients ( 59 , 60 ). Such a decision was undertaken after review of dolasetron-induced TdP cases ( 61 ). The drug can still be used in postoperative nausea and vomiting prophylaxis and treatment because lower doses are used for these indications.…”

Reappraisal of the role of dolasetron in prevention and treatment of nausea and vomiting associated with surgery or chemotherapy

“…38 Turner et al have also described an episode of acute QTc prolongation with progression to torsades de pointes and ultimately ventricular fibrillation one hour after dolasetron administration. 39 Clearly, prolongation of QTc has been clearly associated with the development of torsades de pointes and potentially fatal arrhythmia, though only in 1% of these patients overall. [40][41][42] Though these are profound examples of the cardiovascular effects of dolasetron, multiple studies consistently support cardiac conduction changes caused by dolasetron, though the clinical relevance of these changes is controversial.…”

Aspects of interest related to antiemesis in haematological patients

“…[19][20][21] However, potentially fatal cardiac arrhythmias, including Torsade de pointes (TdP), have been reported in relation to QTc prolongation. [19][20][21][22][23] The FDA has warned about potentially fatal cardiac arrhythmias related to QT prolongation in subjects treated with ondansetron. 24 QT prolongation appears to be a dose dependent effect and, particularly, an intravenous single dose of 32mg would be enough to trigger this adverse event.…”