Methadone-induced Torsade de pointes tachycardias

Publication

Methadone-induced Torsade de pointes tachycardias

Journal Paper/Review - May 14, 2005

Sticherling Christian, Schaer Beat A, Ammann Peter, Maeder Micha, Osswald Stefan

Citation

Sticherling C, Schaer B, Ammann P, Maeder M, Osswald S. Methadone-induced Torsade de pointes tachycardias. Swiss medical weekly : official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology 2005; 135:282-5.

Type

Journal Paper/Review (English)

Journal

Swiss medical weekly : official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology 2005; 135

Publication Date

May 14, 2005

Issn Print

1424-7860

Pages

282-5

Brief description/objective

Methadone is a synthetic opioid frequently used in drug maintenance programs for heroin addicts. It prolongs the QT-interval and is mainly metabolized by the isoenzyme CYP3A4 of the hepatic cytochrome-P450-system, which is used by numerous other QT-prolonging agents. Its most severe side effect is the development of life-threatening Torsade de pointes ventricular tachycardia in the setting of a prolonged QT-interval. Since drug addicts are prone to concomitant medical conditions requiring additional medication as well as to continued abuse of cocaine, they are at higher risk for developing this major complication of methadone therapy. Before subjecting patients on methadone to other drugs, the QT-interval should be determined and it should be ascertained whether the new agent has the property to prolong the QT-interval or is metabolised by the cytochrome-P450 system.