Sibutramine-Associated QT Interval Prolongation and Cardiac Arrest

Abstract

Clinicians prescribing sibutramine should monitor their patients for ECG abnormalities and be cautious in coprescribing drugs known to prolong the QT interval.

Sibutramine on Cardiovascular Outcome

“…Further studies are required, but sibutramine should be avoided in patients with long QT syndrome and in patients taking other medicines that may prolong the QT interval (35). Another article (36) reported on a probable association between sibutramine and QT interval prolongation leading to ventricular fibrillation and cardiac arrest in a 51-year-old woman with obesity but no other relevant past medical history or cardiac risk factors. Therefore sibutramine should be avoided by patients with high susceptibility for cardiac arrhythmia.…”

Cardiovascular Risk-Benefit Profile of Sibutramine

“…[89] Another paper reported on a probable association between sibutramine and QT interval prolongation leading to ventricular fibrillation and cardiac arrest in a 51-year-old woman with obesity but no other relevant past medical history or cardiac risk factors. [90] In vitro studies demonstrated that sibutramine preferentially inhibits the hERG potassium channel, in a concentration-dependent manner, an effect that may contribute to prolong the cardiac action potential duration associated with long QT syndrome. [91] Therefore sibutramine should be avoided by patients with high susceptibility for cardiac arrhythmia.…”

Cardiac arrest caused by sibutramine obtained over the Internet: a case of a young woman without pre‐existing cardiovascular disease successfully resuscitated using extracorporeal membrane oxygenation

“…There are two previously published reports of sibutramine‐induced cardiac arrest, but in both cases, sibutramine was prescribed for 1–4 months to treat obesity before the cardiac arrest 4, 5. In the reported cases4, 5 and also the present patient, the QT interval was significantly prolonged at admission and was normalized after discontinuation of sibutramine. The significant impact of this agent on ventricular repolarization, that is, significant increase in QT dispersion, was shown in 65 consecutive patients 6.…”