The Successful Use of Parenteral Methadone in a Patient with a Prolonged QTc Interval

Overview

Journal J Pain Symptom Manage

Publisher Elsevier

Specialties Critical Care
Pharmacology
Psychiatry

Date 2007 Jul 10

PMID 17616330

Citations 5

Authors

Ryuichi Sekine

Eugenie A M T Obbens

Nessa Coyle

Charles E Inturrisi

Affiliations

Soon will be listed here.

Abstract

Recent case reports have raised concerns about the potential for methadone to prolong the QTc interval (QT corrected for heart rate) and predispose patients to torsade de pointes (TdP), a life-threatening arrhythmia. We present a case report that describes the successful use of parenteral and oral methadone in a patient with uncontrolled cancer pain and a history of QTc prolongation. We describe an approach to the use of methadone in this patient and review both case reports and recent prospective studies that have evaluated the risk of TdP and the long-term outcome with respect to the development of TdP in patients receiving methadone for chronic pain or addiction.

Citing Articles

Intravenous Methadone for Severe Cancer Pain: A Presentation of 10 Cases.

Lossignol D, Libert I, Michel B, Rousseau C, Obiols-Portis M ISRN Pain. 2016; 2013:452957.

PMID: 27335869 PMC: 4893405. DOI: 10.1155/2013/452957.

Methadone prolongs cardiac conduction in young patients with cancer-related pain.

Anghelescu D, Patel R, Mahoney D, Trujillo L, Faughnan L, Steen B J Opioid Manag. 2016; 12(2):131-8.

PMID: 27194198 PMC: 5073866. DOI: 10.5055/jom.2016.0325.

A systematic review of the cardiotoxicity of methadone.

Alinejad S, Kazemi T, Zamani N, Hoffman R, Mehrpour O EXCLI J. 2016; 14:577-600.

PMID: 26869865 PMC: 4747000. DOI: 10.17179/excli2015-553.

Methadone, QTc interval prolongation and torsade de pointes: Case reports offer the best understanding of this problem.

Vieweg W, Hasnain M, Howland R, Clausen T, Koneru J, Kogut C Ther Adv Psychopharmacol. 2013; 3(4):219-32.

PMID: 24167694 PMC: 3805428. DOI: 10.1177/2045125312469982.

Current awareness: pharmacoepidemiology and drug safety.

Pharmacoepidemiol Drug Saf. 2008; 17(6):i-xvi.

PMID: 18533281 PMC: 7167700.

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