Korean J Pain.  2018 Jan;31(1):3-9. 10.3344/kjp.2018.31.1.3.

Pain medication and long QT syndrome

• Klivinyi C
• Bornemann-Cimenti H

• KMID: 2400902
• DOI: http://doi.org/10.3344/kjp.2018.31.1.3

Abstract

Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation. Other substances, not used in the treatment of pain, such as proton pump inhibitors, antiemetics, and diuretics are also associated with long QT syndrome. When the possible benefits of therapy outweigh the associated risks, slow dose titration and electrocardiography monitoring are recommended.

Keyword

Adverse effects; Analgesics; Anticonvulsants; Cannabinoids; Central muscle relaxants; Electrocardiography; Long QT syndrome; Narcotics; Non-steroidal anti-inflammatory drugs; Torsade de pointes

MeSH Terms

Analgesics
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Anticonvulsants
Antidepressive Agents
Antiemetics
Cannabinoids
Chronic Pain
Diuretics
Electrocardiography
Long QT Syndrome*
Muscle Relaxants, Central
Narcotics
Proton Pump Inhibitors
Torsades de Pointes
Analgesics
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Anticonvulsants
Antidepressive Agents
Antiemetics
Cannabinoids
Diuretics
Muscle Relaxants, Central
Narcotics
Proton Pump Inhibitors

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