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Review Article

. 2013; 4(4): 229-235


Methadone, QTc prolongation and torsades de pointes: Current concepts, management and a hidden twist in the tale?

Sobia Mujtaba, Jorge Romero, Cynthia C. Taub.

Abstract
Methadone is a drug that has found widespread utility in the management of opioid addiction and pain.
Along with its popularity, methadone has also earned an infamous reputation for causing prolongation of
the QT interval and an increased risk of torsades de pointes.
In this article we will give a brief overview of the long QT syndromes, followed by an in-depth look at
the current pathophysiologic mechanisms of methadone induced QT prolongation, a review of the
existing literature and the current concepts regarding the prevention and management of methadone
induced torsades de pointes. In addition, we explore the idea and implications of a genetic link between
methadone induced prolongation of the QT interval and torsades de pointes.

Key words: Methadone Pharmacogenetics QT-prolongation Torsades de pointes



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