Key result
Simultaneous treatment with methadone, haloperidol, and fluoxetine in a patient with advanced cancer resulted in reversible drug-induced QT prolongation presenting with chest pain and bradycardia.
Why the study?
Multiple drugs used in advanced cancer can prolong the QT interval and increase the risk of Torsade de Pointes and sudden cardiac death, especially in patients with predisposing factors.
Case Report (n=1)
Simultaneous use of multiple QT-prolonging medications like methadone, haloperidol, and fluoxetine in cancer patients requires careful medication review to prevent arrhythmias.
Alerts to QT-prolonging risk with anti-tumor agents; leaves open need for prospective monitoring studies.
QT prolongation is related to the development of ventricular arrhythmias such as Torsade de Pointes (TdP) that can lead to sudden cardiac death. Several drugs used in the treatment of patients with advanced cancer may induce QT prolongation due to their interference with cardiac ion channels. Some patients may be at higher risk if predisposing factors are present. Herein we present the case of a patient with advanced cancer under anti-tumor treatment with radical intention that developed a reversible drug-induced QT prolongation when simultaneously treated with methadone, haloperidol and fluoxetine that presented with chest pain and bradycardia. An approach to cancer patients at risk for drug-induced QT prolongation is discussed highlighting the need of a thorough medication review with a special focus in the patient with polypharmacy.
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Cerdà et al. (2024) conducted a case report in Advanced cancer with drug-induced QT prolongation (n=1). Polypharmacy (methadone, haloperidol, and fluoxetine) was evaluated on Reversible drug-induced QT prolongation presenting with chest pain and bradycardia. Simultaneous treatment with methadone, haloperidol, and fluoxetine in a patient with advanced cancer resulted in reversible drug-induced QT prolongation presenting with chest pain and bradycardia.
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