Drug to be avoided in LQTcS

Drugs to be avoided for use in patients with diagnosed or suspected congenital long QT
syndrome. (Drugs on our category-of-risk lists are also included here.)
Generic Name Brand Name Class/Clinical Use Comments
Albuterol Ventolin Bronchodilator / Asthma
Albuterol Proventil Bronchodilator / Asthma
Alpha1-blocker / Benign
Alfuzosin Uroxatral
prostatic hyperplasia
Dopaminergic/Anti-viral /
Amantadine Symmetrel Anti-infective/ Parkinson's
Disease

Anti-arrhythmic / abnormal
Amiodarone Pacerone Females>Males,TdP risk regarded
heart rhythm
as low

Anti-arrhythmic / abnormal
Amiodarone Cordarone Females>Males,TdP risk regarded
heart rhythm
as low
Tricyclic Antidepressant /
Amitriptyline Elavil
depression
This includes dextroamphetamine
Amphetamine Dexedrine CNS stimulant / ADHD and amphetamine /
dextroamphetamine combinations.
This includes dextroamphetamine
Amphetamine Adderall CNS stimulant / ADHD and amphetamine /
dextroamphetamine combinations.
Arsenic trioxide Trisenox Anti-cancer / Leukemia
Antihistamine / Allergic
Astemizole Hismanal No Longer available in U.S.
rhinitis
Atazanavir Reyataz Protease inhibitor / HIV
norepinephrine reuptake
Atomoxetine Strattera
inhibitor / ADHD
Antibiotic / bacterial
Azithromycin Zithromax
infection
Bepridil Vascor Anti-anginal / heart pain Females>Males
Sedative / sedation/
Chloral hydrate Noctec
insomnia
Anti-malarial / malaria
Chloroquine Aralen
infection
Anti-psychotic/ Anti-emetic /
Chlorpromazine Thorazine
schizophrenia/ nausea
Antibiotic / bacterial
Ciprofloxacin Cipro
infection
Restricted availability;
Cisapride Propulsid GI stimulant / heartburn
Females>Males.
Citalopram Celexa Anti-depressant / depression
 Antibiotic / bacterial
Clarithromycin Biaxin
infection
Tricyclic Antidepressant /
Clomipramine Anafranil
depression
Anti-psychotic /
Clozapine Clozaril
schizophrenia
Cocaine Cocaine Local anesthetic /
Tricyclic Antidepressant /
Desipramine Pertofrane
depression
Dexmethylphenidate Focalin CNS stimulant / ADHD
Antihistamine / Allergic
Diphenhydramine Benadryl
rhinitis, insomnia
Antihistamine / Allergic
Diphenhydramine Nytol
rhinitis, insomnia
Anti-arrhythmic / abnormal
Disopyramide Norpace Females>Males
heart rhythm
Catecholamine / heart failure
Dobutamine Dobutrex
and shock
Anti-arrhythmic / abnormal
Dofetilide Tikosyn
heart rhythm
Anti-nausea / nausea,
Dolasetron Anzemet
vomiting
Domperidone Motilium Anti-nausea / nausea Not available in the U.S.
Inotropic agent / heart
Dopamine Intropine
failure; hypotension; shock
Tricyclic Antidepressant /
Doxepin Sinequan
depression
Sedative;Anti-nausea /
Droperidol Inapsine
anesthesia adjunct, nausea
Bronchodilator,
Ephedrine Broncholate decongestant / Allergies,
sinusitis, asthma
Bronchodilator,
Ephedrine Rynatuss decongestant / Allergies,
sinusitis, asthma
catecholamine,
vasoconstrictor /
Epinephrine Bronkaid
anaphylaxis, allergic
reactions
catecholamine,
vasoconstrictor /
Epinephrine Primatene
anaphylaxis, allergic
reactions
Antibiotic;GI stimulant /
Erythromycin Erythrocin bacterial infection; increase Females>Males
GI motility
Antibiotic;GI stimulant /
Erythromycin E.E.S. bacterial infection; increase Females>Males
GI motility
Felbamate Felbatrol Anti-convulsant / seizure
Appetite suppressant /
Fenfluramine Pondimin
dieting, weight loss
Anti-arrhythmic / abnormal
Flecainide Tambocor
heart rhythm
 Fluconazole Diflucan Anti-fungal / fungal infection
Fluoxetine Prozac Anti-depressant / depression
Fluoxetine Sarafem Anti-depressant / depression
Foscarnet Foscavir Anti-viral / HIV infection
Fosphenytoin Cerebyx Anti-convulsant / seizure
Cholinesterase inhibitor /
Galantamine Reminyl
Dementia, Alzheimer's
Antibiotic / bacterial
Gatifloxacin Tequin
infection
Antibiotic / bacterial
Gemifloxacin Factive
infection
Anti-nausea / nausea and
Granisetron Kytril
vomiting
Anti-malarial / malaria
Halofantrine Halfan Females>Males
infection
When given intravenously or at
higher-than- recommended doses,
Anti-psychotic /
Haloperidol Haldol risk of sudden death, QT
schizophrenia, agitation
prolongation and torsades
increases.
Anti-arrhythmic / abnormal
Ibutilide Corvert Females>Males
heart rhythm
Tricyclic Antidepressant /
Imipramine Norfranil
depression
Diuretic / stimulate urine &
Indapamide Lozol
salt loss
Catecholamine / allergic
Isoproterenol Medihaler-Iso
reaction
Catecholamine / allergic
Isoproterenol Isupres
reaction
Anti-hypertensive / high
Isradipine Dynacirc
blood pressure
Itraconazole Sporanox Anti-fungal / fungal infection
Ketoconazole Nizoral Anti-fungal / fungal infection
Anti-cancer / breast cancer,
Lapatinib Tykerb
metastatic
Anti-cancer / breast cancer,
Lapatinib Tyverb
metastatic
Levalbuterol Xopenex Bronchodilator / asthma
Antibiotic / bacterial
Levofloxacin Levaquin
infection
Opiate agonist / pain
Levomethadyl Orlaam
control, narcotic dependence
Lisdexamfetamine Vyvanse CNS stimulant / ADHD
Lithium Lithobid Anti-mania / bipolar disorder
Lithium Eskalith Anti-mania / bipolar disorder
Anti-psychotic /
Mesoridazine Serentil
schizophrenia
Metaproterenol Metaprel Bronchodilator / asthma
Metaproterenol Alupent Bronchodilator / asthma
Opiate agonist / pain
Methadone Methadose Females>Males
control, narcotic dependence
 Opiate agonist / pain
Methadone Dolophine Females>Males
control, narcotic dependence
Methylphenidate Ritalin CNS stimulant / ADHD
Methylphenidate Concerta CNS stimulant / ADHD
Anti-arrhythmic / Abnormal
Mexiletine Mexitil
heart rhythm
Vasoconstrictor / low blood
Midodrine ProAmatine
pressure, fainting
Anti-hypertensive / high
Moexipril/HCTZ Uniretic
blood pressure
Antibiotic / bacterial
Moxifloxacin Avelox
infection
Anti-hypertensive / high
Nicardipine Cardene
blood pressure
Nilotinib Tasigna Anti-cancer / Leukemia
Vasconstrictor, Inotrope /
Norepinephrine Levophed
shock, low blood pressure
Tricyclic Antidepressant /
Nortriptyline Pamelor
depression
Endocrine / acromegaly,
Octreotide Sandostatin
carcinoid diarrhea
Antibiotic / bacterial
Ofloxacin Floxin
infection
Anti-emetic / nausea and
Ondansetron Zofran
vomiting
Oxytocin Pitocin Oxytocic / Labor stimulation
Antipsychotic, atypical /
Paliperidone Invega
Schizophrenia
Paroxeti ne Paxil Anti-depressant / depression
Anti-infective / pneumocystis
Pentamidine NebuPent Females>Males
pneumonia
Anti-infective / pneumocystis
Pentamidine Pentam Females>Males
pneumonia
Perflutren lipid Imaging contrast agent /
Definity
microspheres Echocardiography
Appetite suppressant /
Phentermine Fastin
dieting, weight loss
Appetite suppressant /
Phentermine Adipex
dieting, weight loss
Vasoconstrictor,
decongestant / low blood
Phenylephrine Neosynephrine
pressure, allergies, sinusitis,
asthma
Decongestant / allergies,
Phenylpropanolamine Dexatrim
sinusitis, asthma
Decongestant / allergies,
Phenylpropanolamine Acutrim
sinusitis, asthma
Anti-psychotic / Tourette's
Pimozide Orap Females>Males
tics
Antilipemic /
Probucol Lorelco No longer available in U.S.
Hypercholesterolemia
Anti-arrhythmic / abnormal
Procainamide Pronestyl
heart rhythm
 Anti-arrhythmic / abnormal
Procainamide Procan
heart rhythm
Tricyclic Antidepressant /
Protriptyline Vivactil
depression
Decongestant / allergies,
Pseudoephedrine PediaCare
sinusitis, asthma
Decongestant / allergies,
Pseudoephedrine Sudafed
sinusitis, asthma
Anti-psychotic /
Quetiapine Seroquel
schizophrenia
Anti-arrhythmic / abnormal
Quinidine Quinaglute Females>Males
heart rhythm
Anti-arrhythmic / abnormal
Quinidine Cardioquin Females>Males
heart rhythm
Ranolazine Ranexa Anti-anginal / chronic angina
Anti-psychotic /
Risperidone Risperdal
schizophrenia
Uterine relaxant / prevent
Ritodrine Yutopar
premature labor
Antibiotic / bacterial
Roxithromycin* Rulide *not available in the United States
infection
Sympathomimetic / asthma,
Salmeterol Serevent
COPD
Antipsychotic, atypical /
Sertindole Serdolect
Anxiety, Schizophrenia
Antipsychotic, atypical /
Sertindole Serlect
Anxiety, Schizophrenia
Sertraline Zoloft Anti-depressant / depression
Appetitie suppressant /
Sibutramine Meridia
dieting, weight loss
muscarinic receptor
Solifenacin VESIcare anatagonist / treatment of
overactive bladder
Anti-arrhythmic / abnormal
Sotalol Betapace Females>Males
heart rhythm
Antibiotic / bacterial
Sparfloxacin Zagam
infection
Sunitinib Sutent Anti-cancer / RCC, GIST
Immunosuppressant /
Tacrolimus Prograf
Immune suppression
Tamoxifen Nolvadex Anti-cancer / breast cancer
Antibiotic / bacterial
Telithromycin Ketek
infection
Terbutaline Brethine Bronchodilator / asthma
Antihistamine / Allergic
Terfenadine Seldane No longer available in U.S.
rhinitis
Anti-psychotic /
Thioridazine Mellaril
schizophrenia
Tizanidine Zanaflex Muscle relaxant /
Tolterodine Detrol Bladder Antispasmodic /
Tolterodine Detrol LA Bladder Antispasmodic /
Trimethoprim-Sulfa Bactrim Antibiotic / bacterial
 infection
Antibiotic / bacterial
Trimethoprim-Sulfa Sulfa
infection
Tricyclic Antidepressant /
Trimipramine Surmontil
depression
phosphodiesterase inhibitor /
Vardenafil Levitra
vasodilator
Venlafaxine Effexor Anti-depressant / depression
Voriconazole VFend Anti-fungal / anti-fungal
Anti-psychotic /
Ziprasidone Geodon
schizophrenia

Close Window Print

Revised: 07/24/2009
Printed: 10/22/2009

Source: www.QTdrugs.org

Drugs on the QT Drug Lists are reviewed on an ongoing basis to assure the evidence is still appropriate for
their placement on their respective list.

KEY
Drugs to be Avoided Drugs to be avoided for use in patients with diagnosed or suspected
congenital long QT syndrome. (Drugs on our category- of-risk lists are also
included here, as are some additional drugs.)
Females > Males: Substantial evidence indicates a greater risk (usually > two-fold) of TdP in
women.

Arizona Center for Education and Research on Therapeutics

The Critical Path Institute
Tucson, Arizona and Rockville, Maryland

Funded in part by Agency for Healthcare Research and Quality grant 1 U18 HS10385

Disclaimer and Waiver

The information presented is intended solely for the purpose of providing general information about health
related matters. It is not intended for any other purpose, including, but not limited to, medical or
pharmaceutical advice and/or treatment, nor is it intended to substitute for the users' relationships with
their own health care/pharmaceutical providers. To that extent, by continued use of this program, the
user affirms the understanding of the purpose and releases The Critical Path Institute, The University of
Arizona, State of Arizona and Arizona Board of Regents from any claims arising out of his/her use of the
website.

DRUGS with Conditional Risk

Drugs that, in some reports, have been weakly associated with torsades de pointes and/or QT
prolongation but that are unlikely to be a risk for torsades de pointes when used in usual recommended
dosages and in patients without other risk factors (e.g., concomitant QT prolonging drugs, bradycardia,
electrolyte disturbances, congenital long QT syndrome, concomitant drugs that inhibit metabolism).
Brand
Generic Name Class/Clinical Use Comments
Name
Tricyclic Antidepressant /
Amitriptyline Elavil
depression
Ciprofloxacin Cipro Antibiotic / bacterial infection
Citalopram Celexa Anti-depressant / depression
Tricyclic Antidepressant /
Clomipramine Anafranil
depression
Tricyclic Antidepressant /
Desipramine Pertofrane
depression
Antihistamine / Allergic rhinitis,
Diphenhydramine Benadryl
insomnia
Antihistamine / Allergic rhinitis,
Diphenhydramine Nytol
insomnia
Tricyclic Antidepressant /
Doxepin Sinequan
depression
Fluconazole Diflucan Anti-fungal / fungal infection
Fluoxetine Sarafem Anti-depressant / depression
Fluoxetine Prozac Anti-depressant / depression
Cholinesterase inhibitor /
Galantamine Reminyl
Dementia, Alzheimer's
Tricyclic Antidepressant /
Imipramine Norfranil
depression
Itraconazole Sporanox Anti-fungal / fungal infection
Ketoconazole Nizoral Anti-fungal / fungal infection
Anti-arrhythmic / Abnormal heart
Mexiletine Mexitil
rhythm
Tricyclic Antidepressant /
Nortriptyline Pamelor
depression
Paroxetine Paxil Anti-depressant / depression
Tricyclic Antidepressant /
Protriptyline Vivactil
depression
Sertraline Zoloft Anti-depressant / depression
muscarinic receptor anatagonist /
Solifenacin VESIcare
treatment of overactive bladder
Trimethoprim-Sulfa Sulfa Antibiotic / bacterial infection
Trimethoprim-Sulfa Bactrim Antibiotic / bacterial infection
Tricyclic Antidepressant /
Trimipramine Surmontil
depression

Close Window Print

Revised: 07/24/2009
Printed: 10/22/2009

Source: www.QTdrugs.org

Drugs on the QT Drug Lists are reviewed on an ongoing basis to assure the evidence is still appropriate for
their placement on their respective list.
Arizona Center for Education and Research on Therapeutics
The Critical Path Institute
Tucson, Arizona and Rockville, Maryland

Funded in part by Agency for Healthcare Research and Quality grant 1 U18 HS10385

Disclaimer and Waiver

The information presented is intended solely for the purpose of providing general information about health
related matters. It is not intended for any other purpose, including, but not limited to, medical or
pharmaceutical advice and/or treatment, nor is it intended to substitute for the users' relationships with
their own health care/pharmaceutical providers. To that extent, by continued use of this program, the
user affirms the understanding of the purpose and releases The Critical Path Institute, The University of
Arizona, State of Arizona and Arizona Board of Regents from any claims arising out of his/her use of the
website.

Drugs with Possible Risk

Drugs that in some reports have been associated with torsades de pointes and/or QT
prolongation but at this time lack substantial evidence for causing torsades de pointes.
Brand
Generic Name Class/Clinical Use Comments
Name
Alpha1-blocker / Benign prostatic
Alfuzosin Uroxatral
hyperplasia
Dopaminergic/Anti-viral / Anti-
Amantadine Symmetrel
infective/ Parkinson's Disease
Atazanavir Reyataz Protease inhibitor / HIV
Azithromycin Zithromax Antibiotic / bacterial infection
Chloral hydrate Noctec Sedative / sedation/ insomnia
Clozapine Clozaril Anti-psychotic / schizophrenia
Dolasetron Anzemet Anti-nausea / nausea, vomiting
Felbamate Felbatrol Anti-convulsant / seizure
Anti-arrhythmic / abnormal heart
Flecainide Tambocor
rhythm
Foscarnet Foscavir Anti-viral / HIV infection
Fosphenytoin Cerebyx Anti-convulsant / seizure
Gatifloxacin Tequin Antibiotic / bacterial infection
Gemifloxacin Factive Antibiotic / bacterial infection
Granisetron Kytril Anti-nausea / nausea and vomiting
Diuretic / stimulate urine & salt
Indapamide Lozol
loss
Anti-hypertensive / high blood
Isradipine Dynacirc
pressure
Anti-cancer / breast cancer,
Lapatinib Tykerb
metastatic
 Anti-cancer / breast cancer,
Lapatinib Tyverb
metastatic
Levofloxacin Levaquin Antibiotic / bacterial infection
Lithium Lithobid Anti-mania / bipolar disorder
Lithium Eskalith Anti-mania / bipolar disorder
Anti-hypertensive / high blood
Moexipril/HCTZ Uniretic
pressure
Moxifloxacin Avelox Antibiotic / bacterial infection
Anti-hypertensive / high blood
Nicardipine Cardene
pressure
Nilotinib Tasigna Anti-cancer / Leukemia
Endocrine / acromegaly, carcinoid
Octreotide Sandostatin
diarrhea
Ofloxacin Floxin Antibiotic / bacterial infection
Ondansetron Zofran Anti-emetic / nausea and vomiting
Oxytocin Pitocin Oxytocic / Labor stimulation
Antipsychotic, atypical /
Paliperidone Invega
Schizophrenia
Perflutren lipid Imaging contrast agent /
Definity
microspheres Echocardiography
Quetiapine Seroquel Anti-psychotic / schizophrenia
Ranolazine Ranexa Anti-anginal / chronic angina
Risperidone Risperdal Anti-psychotic / schizophrenia
*not available in the United
Roxithromycin* Rulide Antibiotic / bacterial infection
States
Antipsychotic, atypical / Anxiety,
Sertindole Serlect
Schizophrenia

Drug with Risk

Drugs that are generally accepted by the QTdrugs.org Advisory Board of the Arizona
CERT to have a risk of causing torsades de pointes.
Brand
Generic Name Class/Clinical Use Comments
Name

Anti-arrhythmic / abnormal heart

Amiodarone Cordarone Females>Males,TdP risk
rhythm
regarded as low

Anti-arrhythmic / abnormal heart

Amiodarone Pacerone Females>Males,TdP risk
rhythm
regarded as low
Arsenic trioxide Trisenox Anti-cancer / Leukemia
Astemizole Hismanal Antihistamine / Allergic rhinitis No Longer available in U.S.
 Bepridil Vascor Anti-anginal / heart pain Females>Males
Chloroquine Aralen Anti-malarial / malaria infection
Anti-psychotic/ Anti-emetic /
Chlorpromazine Thorazine
schizophrenia/ nausea
Restricted availability;
Cisapride Propulsid GI stimulant / heartburn
Females>Males.
Clarithromycin Biaxin Antibiotic / bacterial infection
Anti-arrhythmic / abnormal heart
Disopyramide Norpace Females>Males
rhythm
Anti-arrhythmic / abnormal heart
Dofetilide Tikosyn
rhythm
Domperidone Motilium Anti-nausea / nausea Not available in the U.S.
Sedative;Anti-nausea / anesthesia
Droperidol Inapsine
adjunct, nausea
Antibiotic;GI stimulant / bacterial
Erythromycin Erythrocin Females>Males
infection; increase GI motility
Antibiotic;GI stimulant / bacterial
Erythromycin E.E.S. Females>Males
infection; increase GI motility
Halofantrine Halfan Anti-malarial / malaria infection Females>Males
When given intravenously or at
higher-than- recommended
Anti-psychotic / schizophrenia,
Haloperidol Haldol doses, risk of sudden death, QT
agitation
prolongation and torsades
increases.
Anti-arrhythmic / abnormal heart
Ibutilide Corvert Females>Males
rhythm
Opiate agonist / pain control,
Levomethadyl Orlaam
narcotic dependence
Mesoridazine Serentil Anti-psychotic / schizophrenia
Opiate agonist / pain control,
Methadone Dolophine Females>Males
narcotic dependence
Opiate agonist / pain control,
Methadone Methadose Females>Males
narcotic dependence
Anti-infective / pneumocystis
Pentamidine Pentam Females>Males
pneumonia
Anti-infective / pneumocystis
Pentamidine NebuPent Females>Males
pneumonia
Pimozide Orap Anti-psychotic / Tourette's tics Females>Males
Probucol Lorelco Antilipemic / Hypercholesterolemia No longer available in U.S.
Anti-arrhythmic / abnormal heart
Procainamide Pronestyl
rhythm
Anti-arrhythmic / abnormal heart
Procainamide Procan
rhythm
Anti-arrhythmic / abnormal heart
Quinidine Cardioquin Females>Males
rhythm
Anti-arrhythmic / abnormal heart
Quinidine Quinaglute Females>Males
rhythm
Anti-arrhythmic / abnormal heart
Sotalol Betapace Females>Males
rhythm
Sparfloxacin Zagam Antibiotic / bacterial infection
Terfenadine Seldane Antihistamine / Allergic rhinitis No longer available in U.S.
Thioridazine Mellaril Anti-psychotic / schizophrenia
 Close Window Print

Revised: 03/25/2008
Printed: 10/22/2009

Source: www.QTdrugs.org

Drugs on the QT Drug Lists are reviewed on an ongoing basis to assure the evidence is still appropriate for
their placement on their respective list.

KEY
Females > Males: Substantial evidence indicates a greater risk (usually > two-fold) of TdP in
women

Arizona Center for Education and Research on Therapeutics

The Critical Path Institute
Tucson, Arizona and Rockville, Maryland

Funded in part by Agency for Healthcare Research and Quality grant 1 U18 HS10385

Disclaimer and Waiver

The information presented is intended solely for the purpose of providing general information about health
related matters. It is not intended for any other purpose, including, but not limited to, medical or
pharmaceutical advice and/or treatment, nor is it intended to substitute for the users' relationships with
their own health care/pharmaceutical providers. To that extent, by continued use of this program, the
user affirms the understanding of the purpose and releases The Critical Path Institute, The University of
Arizona, State of Arizona and Arizona Board of Regents from any claims arising out of his/her use of the
website.