Loratedine and ventricular tachycardia

Good, Arnold P.; Rockwood, Robert; Schad, P

doi:10.1016/0002-9149(94)90108-2

Cited by 23 publications

(9 citation statements)

References 3 publications

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“…Thus the use of sertindole was suspended in Europe in 1998 because of its association with sudden death and serious arrhythmia (16). The suspension of sertindole occurred when much attention was being paid to the arrhythmogenic effects of some nonsedating antihistamines (17)(18)(19)(20)(21). These coinciding events likely contributed to the medical community's hyperawareness of the risks of QTc prolongation, torsades de pointes, and sudden death.…”

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confidence: 99%

Corrected QT Intervals in Newly Admitted Geriatric Psychiatric Patients: An Examination of Risk Factors

et al. 2006

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Objectives:The primary objective of this study was to determine the incidence of prolonged corrected QT (QTc) intervals in a population of geriatric psychiatry inpatients. Our secondary objective was to examine the associations between prolonged QTc intervals and risk factors identified as determinants in prolonging the QTc interval. Methods:We identified all geriatric patients (aged 60 years and older) who were admitted to the geriatric program of our facility between May 1, 2003, and December 31, 2003. Those patients with a heart rate QTc interval calculated on the electrocardiogram (ECG) were eligible for the study. We used Bazett's formula to calculate the QTc interval. We defined a priori that a prolonged QTc interval would be 450 ms and 460 ms for men and women, respectively. We collected data on demographic variables such as weight, sex, age, and Axis I and III diagnoses, as well as on recognized risk factors for prolonged QTc interval. We used Student's t tests to conduct parametric analysis on continuous variables, and chi-square to test categorical variables for independence.Results: During the study period, 88 patients were admitted to the geriatric division of Riverview Hospital. Of these patients, 34 men and 42 women had calculated QTc intervals on their ECG and therefore made up the study population. Our data show that 29.4% of men and 21.4% of women had prolonged QTc intervals. However, neither diagnostic nor medicinal risk factors were found to be associated with an increased incidence of prolonged QTc interval in this patient population. Conclusion:The preliminary findings of this study suggest that in this patient population the QTc interval may not be influenced by recognized risk factors to the same extent as observed in the adult population. These results warrant confirmation by a larger, prospectively designed study. Clinical Implications · Known risk factors may not influence the QTc intervals of geriatric psychiatric patients to the same extent as they influence the QTc intervals of the adult population. · Sex differences in QTc interval are less apparent in the geriatric population, possibly owing to declining hormonal influences. · Cardiac risk factors tended to influence the QTc interval.Limitations · This was a cross-sectional study and the results need to be verified with a prospectively designed study. · The relatively small sample size may have prevented the identification of the influence of some risk factors on QTc. · The QTc interval itself is only a surrogate marker for the prediction of a serious cardiac event.

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confidence: 99%

Corrected QT Intervals in Newly Admitted Geriatric Psychiatric Patients: An Examination of Risk Factors

et al. 2006

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“…In addition to atrial arrhythmias, loratadine use has also been associated with ventricular arrhythmias. One case report associates loratadine use with QT prolongation and ventricular arrhythmias in a patient with a history of both atrial and ventricular arrhythmias ( Good et al ., 1994 ).…”

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confidence: 99%

Rate‐dependent blockade of a potassium current in human atrium by the antihistamine loratadine

Crumb

1999

British J Pharmacology

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The antihistamine loratadine is widely prescribed for the treatment of symptoms associated with allergies. Although generally believed to be free of adverse cardiac effects, there are a number of recent reports suggesting that loratadine use may be associated with arrhythmias, in particular atrial arrhythmias. Nothing is known regarding the potassium channel blocking properties of loratadine in human cardiac cells. Using the whole‐cell patch clamp technique, the effects of loratadine on the transient outward K current (Ito), sustained current (Isus), and current measured at −100 mV (IK1 and Ins), the major inward and outward potassium currents present in human atrial myocytes, were examined in order to provide a possible molecular mechanism for the observed atrial arrhythmias reported with loratadine use. Loratadine rate‐dependently inhibited Ito at therapeutic concentrations with 10 nM loratadine reducing Ito amplitude at a pacing rate of 2 Hz by 34.9±6.0%. In contrast, loratadine had no effect on either Isus or current measured at −100 mV. These results may provide a possible mechanism for the incidences of supraventricular arrhythmias reported with the use of loratadine. British Journal of Pharmacology (1999) 126, 575–580; doi:

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“…Concomitant use of erythromycin, ketoconazole or cimetidine may raise the blood levels of loratadine, which is metabolized predominantly in the cytochrome P450 system, however this situation does not cause significant effect on QT intervals. It may be speculated that loratadine does not affect ion channels in the cardiac conduction system, even at higher concentrations than encountered clinically [20,55,58].…”

Section: Loratadinementioning

confidence: 97%

“…Furthermore, there is a single case report describing a ventricular tachycardia, likely to have been torsade de pointes with ingestion of a single tablet of loratadine [42,55]. A search of the World Health Organization database reveals an adverse cardiac event profile for loratadine, which includes ventricular arrythmias, similar to that of terfenadine [56].…”

Section: Loratadinementioning

confidence: 99%

Adverse Systemic Reactions of Antihistamines: Highlights in Sedating Effects, Cardiotoxicity and Drug Interactions

Kus¹

2005

CMCAIAA

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Antihistamines are already among the most frequently used pharmaceutical compounds and with the predictable increase of the prevalence of atopic disease, even more patients are expected to use them in future. Though the common belief on their safety has existed since some decades, they, including the over the counter ones, might potentially bear serious side effects. Thus , the following article focuses on the adverse effects of antihistamines by summarizing the current data mainly on central nervous system and cardiovascular side effects. Meanwhile, less common side effects, and important issues like their use in pregnancy and lactation are also included. Updated information is provided on drug interactions and overdose situations along with their management. As a finalstep, pitfalls in choosing suitable antihistamine/s in special circumstances to avoid adverse effects are also covered.

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Loratedine and ventricular tachycardia

Cited by 23 publications

References 3 publications

Corrected QT Intervals in Newly Admitted Geriatric Psychiatric Patients: An Examination of Risk Factors

Corrected QT Intervals in Newly Admitted Geriatric Psychiatric Patients: An Examination of Risk Factors

Rate‐dependent blockade of a potassium current in human atrium by the antihistamine loratadine

Adverse Systemic Reactions of Antihistamines: Highlights in Sedating Effects, Cardiotoxicity and Drug Interactions

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