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
Albuterol
Proventil®;Ventolin® ß2-receptor agonist / Asthma
Alfuzosin
Uroxatral®
Alpha1-blocker / Benign
prostatic hyperplasia
Amantadine
Symmetrel®
Dopaminergic/Anti-viral /
Anti-infective/ Parkinson's
Disease
Amiodarone
Cordarone®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males,TdP risk regarded as
low
Amiodarone
Pacerone®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males,TdP risk regarded as
low
Amitriptyline
Elavil®
Tricyclic Antidepressant /
depression
Risk of TdP with overdosage
Amphetamine
Dexedrine®
CNS stimulant / ADHD
This includes dextroamphetamine
and amphetamine /
dextroamphetamine combinations.
Amphetamine
Adderall®
CNS stimulant / ADHD
This includes dextroamphetamine
and amphetamine /
dextroamphetamine combinations.
Arsenic trioxide
Trisenox®
Anti-cancer / Leukemia
Astemizole
Hismanal®
Antihistamine / Allergic
rhinitis
Atazanavir
Reyataz®
Protease inhibitor / HIV
Atomoxetine
Strattera®
norepinephrine reuptake
inhibitor / ADHD
Azithromycin
Zithromax®
Antibiotic / bacterial infection Rare reports
Bepridil
Vascor®
Anti-anginal / heart pain
Chloral hydrate
Noctec®
Sedative / sedation/ insomnia
Chloroquine
Aralen®
Anti-malarial / malaria
infection
Chlorpromazine
Thorazine®
Anti-psychotic/ Anti-emetic /
schizophrenia/ nausea
Ciprofloxacin
Cipro®
Antibiotic / bacterial infection
Cisapride
Propulsid®
GI stimulant / heartburn
Citalopram
Celexa®
Anti-depressant / depression
Clarithromycin
Biaxin®
Antibiotic / bacterial infection
Comments
No Longer available in U.S.
Females>Males
Drug metabolism inhibitor- Risk for
drug interactions
No longer available in the U.S.;
available in Mexico
Clomipramine
Anafranil®
Tricyclic Antidepressant /
depression
Clozapine
Clozaril®
Anti-psychotic /
schizophrenia
Cocaine
Cocaine
Local anesthetic /
Cardiac stimulant
Desipramine
Pertofrane®
Tricyclic Antidepressant /
depression
Risk of TdP with overdosage
Dexmethylphenidate
Focalin®
CNS stimulant / ADHD
Diphenhydramine
Benadryl®
Antihistamine / Allergic
rhinitis, insomnia
Risk of QT increase/TdP in
overdosages
Diphenhydramine
Nytol®
Antihistamine / Allergic
rhinitis, insomnia
Risk of QT increase/TdP in
overdosages
Disopyramide
Norpace®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males
Dobutamine
Dobutrex®
Catecholamine / heart failure
and shock
Dofetilide
Tikosyn®
Anti-arrhythmic / abnormal
heart rhythm
Dolasetron
Anzemet®
Anti-nausea / nausea,
vomiting
Domperidone
Motilium®
Anti-nausea / nausea
Dopamine
Intropine®
Inotropic agent / heart failure;
hypotension; shock
Doxepin
Sinequan®
Tricyclic Antidepressant /
depression
Dronedarone
Multaq®
Anti-arrhythmic / Atrial
Fibrillation
Droperidol
Inapsine®
Sedative;Anti-nausea /
anesthesia adjunct, nausea
Ephedrine
Broncholate®
Bronchodilator, decongestant
/ Allergies, sinusitis, asthma
Ephedrine
Rynatuss®
Bronchodilator, decongestant
/ Allergies, sinusitis, asthma
Epinephrine
Bronkaid®
catecholamine,
vasoconstrictor / anaphylaxis, Cardiac stimulant
allergic reactions
Epinephrine
Primatene®
catecholamine,
vasoconstrictor / anaphylaxis, Cardiac stimulant
allergic reactions
Eribulin
Halaven®
Anti-cancer / metastatic
breast neoplasias
Erythromycin
E.E.S.®
Antibiotic;GI stimulant /
bacterial infection; increase
GI motility
Females>Males
Erythromycin
Erythrocin®
Antibiotic;GI stimulant /
bacterial infection; increase
Females>Males
Not available in the U.S.
GI motility
Escitalopram
Cipralex®
Anti-depressant / Major
depression/ Anxiety disorders
Escitalopram
Lexapro®
Anti-depressant / Major
depression/ Anxiety disorders
Famotidine
Pepcid®
H2-receptor antagonist /
Peptic ulcer/ GERD
Felbamate
Felbatrol®
Anti-convulsant / seizure
Fenfluramine
Pondimin®
Appetite suppressant / dieting,
weight loss
Fingolimod
Gilenya®
Immunosuppressant /
Multiple Sclerosis
Flecainide
Tambocor®
Anti-arrhythmic / abnormal
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
Galantamine
Reminyl®
Cholinesterase inhibitor /
Dementia, Alzheimer's
Gatifloxacin
Tequin®
Antibiotic / bacterial infection
Gemifloxacin
Factive®
Antibiotic / bacterial infection
Granisetron
Kytril®
Anti-nausea / nausea and
vomiting
Halofantrine
Halfan®
Anti-malarial / malaria
infection
Females>Males
Haloperidol
Haldol®
Anti-psychotic /
schizophrenia, agitation
When given intravenously or at
higher-than- recommended doses,
risk of sudden death, QT
prolongation and torsades increases.
Ibutilide
Corvert®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males
Imipramine
Norfranil®
Tricyclic Antidepressant /
depression
Risk of TdP in overdosage
Indapamide
Lozol®
Diuretic / stimulate urine &
salt loss
Isoproterenol
Isupres®
Catecholamine / allergic
reaction
Isoproterenol
Medihaler-Iso®
Catecholamine / allergic
reaction
Isradipine
Dynacirc®
Anti-hypertensive / high
blood pressure
Itraconazole
Sporanox®
Anti-fungal / fungal infection Drug metabolism inhibitor- Risk for
Drug metabolism inhibitor- Risk for
drug interactions
drug interactions
Ketoconazole
Nizoral®
Anti-fungal / fungal infection Drug metabolism inhibitor
Lapatinib
Tykerb®
Anti-cancer / breast cancer,
metastatic
Lapatinib
Tyverb®
Anti-cancer / breast cancer,
metastatic
Levalbuterol
Xopenex®
Bronchodilator / asthma
Levofloxacin
Levaquin®
Antibiotic / bacterial infection
Levomethadyl
Orlaam®
Opiate agonist / pain control,
narcotic dependence
Lisdexamfetamine
Vyvanse®
CNS stimulant / ADHD
Lithium
Eskalith®
Anti-mania / bipolar disorder
Lithium
Lithobid®
Anti-mania / bipolar disorder
Mesoridazine
Serentil®
Anti-psychotic /
schizophrenia
Metaproterenol
Alupent®
Bronchodilator / asthma
Metaproterenol
Metaprel®
Bronchodilator / asthma
Methadone
Dolophine®
Opiate agonist / pain control,
narcotic dependence
Females>Males
Methadone
Methadose®
Opiate agonist / pain control,
narcotic dependence
Females>Males
Methylphenidate
Ritalin®
CNS stimulant / ADHD
Methylphenidate
Concerta®
CNS stimulant / ADHD
Midodrine
ProAmatine®
Vasoconstrictor / low blood
pressure, fainting
Moexipril/HCTZ
Uniretic®
Anti-hypertensive / high
blood pressure
Moxifloxacin
Avelox®
Antibiotic / bacterial infection
Nicardipine
Cardene®
Anti-hypertensive / high
blood pressure
Nilotinib
Tasigna®
Anti-cancer / Leukemia
Norepinephrine
Levophed®
Vasconstrictor, Inotrope /
shock, low blood pressure
Nortriptyline
Pamelor®
Tricyclic Antidepressant /
depression
Octreotide
Sandostatin®
Endocrine / acromegaly,
carcinoid diarrhea
Ofloxacin
Floxin®
Antibiotic / bacterial infection
Ondansetron
Zofran®
Anti-emetic / nausea and
vomiting
Oxytocin
Pitocin®
Oxytocic / Labor stimulation
Paliperidone
Invega®
Antipsychotic, atypical /
Schizophrenia
Not available in the U.S.
Paroxetine
Paxil®
Anti-depressant / depression
Pentamidine
NebuPent®
Anti-infective / pneumocystis
Females>Males
pneumonia
Pentamidine
Pentam®
Anti-infective / pneumocystis
Females>Males
pneumonia
Perflutren lipid
microspheres
Definity®
Imaging contrast agent /
Echocardiography
Phentermine
Fastin®
Appetite suppressant / dieting,
weight loss
Phentermine
Adipex®
Appetite suppressant / dieting,
weight loss
Phenylephrine
Neosynephrine®
Vasoconstrictor, decongestant
/ low blood pressure,
allergies, sinusitis, asthma
Phenylpropanolamine
Acutrim®
Decongestant / allergies,
sinusitis, asthma
No longer available in the U.S.
Phenylpropanolamine
Dexatrim®
Decongestant / allergies,
sinusitis, asthma
No longer available in the U.S.
Pimozide
Orap®
Anti-psychotic / Tourette's
tics
Females>Males
Probucol
Lorelco®
Antilipemic /
Hypercholesterolemia
No longer available in U.S.
Procainamide
Pronestyl®
Anti-arrhythmic / abnormal
heart rhythm
Procainamide
Procan®
Anti-arrhythmic / abnormal
heart rhythm
Protriptyline
Vivactil®
Tricyclic Antidepressant /
depression
Pseudoephedrine
PediaCare®
Decongestant / allergies,
sinusitis, asthma
Pseudoephedrine
Sudafed®
Decongestant / allergies,
sinusitis, asthma
Quetiapine
Seroquel®
Anti-psychotic /
schizophrenia
Quinidine
Quinaglute®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males
Quinidine
Cardioquin®
Anti-arrhythmic / abnormal
heart rhythm
Females>Males
Ranolazine
Ranexa®
Anti-anginal / chronic angina
Risperidone
Risperdal®
Anti-psychotic /
schizophrenia
Ritodrine
Yutopar®
Uterine relaxant / prevent
premature labor
Ritonavir
Norvir®
Protease inhibitor / HIV
Roxithromycin*
Rulide®
Antibiotic / bacterial infection *not available in the United States
Salmeterol
Serevent®
Sympathomimetic / asthma,
COPD
Sertindole
Serdolect®
Antipsychotic, atypical /
Anxiety, Schizophrenia
Sertindole
Serlect®
Antipsychotic, atypical /
Anxiety, Schizophrenia
Sertraline
Zoloft®
Anti-depressant / depression
Sibutramine
Meridia®
Appetitie suppressant /
dieting, weight loss
Solifenacin
VESIcare®
muscarinic receptor
anatagonist / treatment of
overactive bladder
Sotalol
Betapace®
Anti-arrhythmic / abnormal
heart rhythm
Sparfloxacin
Zagam®
Antibiotic / bacterial infection
Sunitinib
Sutent®
Anti-cancer / RCC, GIST
Tacrolimus
Prograf®
Immunosuppressant / Immune
suppression
Tamoxifen
Nolvadex®
Anti-cancer / breast cancer
Telithromycin
Ketek®
Antibiotic / bacterial infection
Terbutaline
Brethine®
Bronchodilator / asthma
Terfenadine
Seldane®
Antihistamine / Allergic
rhinitis
Thioridazine
Mellaril®
Anti-psychotic /
schizophrenia
Tizanidine
Zanaflex®
Muscle relaxant /
Tolterodine
Detrol®
Bladder Antispasmodic /
Tolterodine
Detrol LA®
Bladder Antispasmodic /
Trazodone
Desyrel®
Anti-depressant / Depression,
insomnia
Trimethoprim-Sulfa
Bactrim®
Antibiotic / bacterial infection
Trimethoprim-Sulfa
Sulfa®
Antibiotic / bacterial infection
Trimipramine
Surmontil®
Tricyclic Antidepressant /
depression
Vandetanib
Caprelsa®
Anti-cancer / Thyroid cancer
Vardenafil
Levitra®
phosphodiesterase inhibitor /
vasodilator
Venlafaxine
Effexor®
Anti-depressant / depression
Voriconazole
VFend®
Anti-fungal / anti-fungal
Ziprasidone
Geodon®
Anti-psychotic /
schizophrenia
Revised: 03/02/2012
Females>Males
No longer available in U.S.
Substantial evidence supports the conclusion that these drugs prolong the QT interval and have a risk
of TdP when used as directed in labeling.
Generic Name
Brand Name
Class/Clinical Use
Comments
Amiodarone
Cordarone®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males,TdP risk regarded
as low
Amiodarone
Pacerone®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males,TdP risk 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
Chlorpromazine
Thorazine®
Anti-psychotic/ Anti-emetic /
schizophrenia/ nausea
No longer available in the U.S.;
available in Mexico
Cisapride
Propulsid®
GI stimulant / heartburn
Citalopram
Celexa®
Anti-depressant / depression
Clarithromycin
Biaxin®
Antibiotic / bacterial infection
Disopyramide
Norpace®
Anti-arrhythmic / abnormal heart
rhythm
Dofetilide
Tikosyn®
Anti-arrhythmic / abnormal heart
rhythm
Domperidone
Motilium®
Anti-nausea / nausea
Droperidol
Inapsine®
Sedative;Anti-nausea / anesthesia
adjunct, nausea
Erythromycin
E.E.S.®
Antibiotic;GI stimulant / bacterial
infection; increase GI motility
Females>Males
Erythromycin
Erythrocin®
Antibiotic;GI stimulant / bacterial
infection; increase GI motility
Females>Males
Flecainide
Tambocor®
Anti-arrhythmic / abnormal heart
rhythm
Halofantrine
Halfan®
Anti-malarial / malaria infection
Females>Males
Haloperidol
Haldol®
Anti-psychotic / schizophrenia,
agitation
When given intravenously or at
higher-than- recommended doses,
risk of sudden death, QT
prolongation and torsades increases.
Ibutilide
Corvert®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males
Levomethadyl
Orlaam®
Opiate agonist / pain control, narcotic
Not available in the U.S.
Females>Males
Not available in the U.S.
dependence
Mesoridazine
Serentil®
Anti-psychotic / schizophrenia
Methadone
Dolophine®
Opiate agonist / pain control, narcotic
dependence
Females>Males
Methadone
Methadose®
Opiate agonist / pain control, narcotic
dependence
Females>Males
Moxifloxacin
Avelox®
Antibiotic / bacterial infection
Pentamidine
NebuPent®
Anti-infective / pneumocystis
pneumonia
Females>Males
Pentamidine
Pentam®
Anti-infective / pneumocystis
pneumonia
Females>Males
Pimozide
Orap®
Anti-psychotic / Tourette's tics
Females>Males
Probucol
Lorelco®
Antilipemic / Hypercholesterolemia
No longer available in U.S.
Procainamide
Pronestyl®
Anti-arrhythmic / abnormal heart
rhythm
Procainamide
Procan®
Anti-arrhythmic / abnormal heart
rhythm
Quinidine
Quinaglute®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males
Quinidine
Cardioquin®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males
Sotalol
Betapace®
Anti-arrhythmic / abnormal heart
rhythm
Females>Males
Sparfloxacin
Zagam®
Antibiotic / bacterial infection
Terfenadine
Seldane®
Antihistamine / Allergic rhinitis
Thioridazine
Mellaril®
Anti-psychotic / schizophrenia
Vandetanib
Caprelsa®
Anti-cancer / Thyroid cancer
No longer available in U.S.
Revised: 6/6/2011
Substantial evidence supports the conclusion that these drugs cause QT prolongation but there is
insufficient evidence that they, when used as directed in labeling, have a risk of causing TdP.
Generic Name
Brand Name
Class/Clinical Use
Alfuzosin
Uroxatral®
Alpha1-blocker / Benign prostatic
hyperplasia
Amantadine
Symmetrel®
Dopaminergic/Anti-viral / Antiinfective/ Parkinson's Disease
Atazanavir
Reyataz®
Protease inhibitor / HIV
Azithromycin
Zithromax®
Antibiotic / bacterial infection
Comments
Rare reports
Chloral hydrate
Noctec®
Sedative / sedation/ insomnia
Clozapine
Clozaril®
Anti-psychotic / schizophrenia
Dolasetron
Anzemet®
Anti-nausea / nausea, vomiting
Dronedarone
Multaq®
Anti-arrhythmic / Atrial Fibrillation
Eribulin
Halaven®
Anti-cancer / metastatic breast
neoplasias
Escitalopram
Cipralex®
Anti-depressant / Major depression/
Anxiety disorders
Escitalopram
Lexapro®
Anti-depressant / Major depression/
Anxiety disorders
Famotidine
Pepcid®
H2-receptor antagonist / Peptic ulcer/
GERD
Felbamate
Felbatrol®
Anti-convulsant / seizure
Fingolimod
Gilenya®
Immunosuppressant / Multiple
Sclerosis
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
Indapamide
Lozol®
Diuretic / stimulate urine & salt loss
Isradipine
Dynacirc®
Anti-hypertensive / high blood pressure
Lapatinib
Tykerb®
Anti-cancer / breast cancer, metastatic
Lapatinib
Tyverb®
Anti-cancer / breast cancer, metastatic
Levofloxacin
Levaquin®
Antibiotic / bacterial infection
Lithium
Lithobid®
Anti-mania / bipolar disorder
Lithium
Eskalith®
Anti-mania / bipolar disorder
Moexipril/HCTZ
Uniretic®
Anti-hypertensive / high blood pressure
Nicardipine
Cardene®
Anti-hypertensive / high blood pressure
Nilotinib
Tasigna®
Anti-cancer / Leukemia
Octreotide
Sandostatin®
Endocrine / acromegaly, carcinoid
diarrhea
Ofloxacin
Floxin®
Antibiotic / bacterial infection
Ondansetron
Zofran®
Anti-emetic / nausea and vomiting
Oxytocin
Pitocin®
Oxytocic / Labor stimulation
Paliperidone
Invega®
Antipsychotic, atypical / Schizophrenia
Perflutren lipid
microspheres
Definity®
Imaging contrast agent /
Echocardiography
Quetiapine
Seroquel®
Anti-psychotic / schizophrenia
Ranolazine
Ranexa®
Anti-anginal / chronic angina
Risperidone
Risperdal®
Anti-psychotic / schizophrenia
Roxithromycin*
Rulide®
Antibiotic / bacterial infection
Sertindole
Serlect®
Antipsychotic, atypical / Anxiety,
Schizophrenia
Sertindole
Serdolect®
Antipsychotic, atypical / Anxiety,
Schizophrenia
Sunitinib
Sutent®
Anti-cancer / RCC, GIST
Tacrolimus
Prograf®
Immunosuppressant / Immune
suppression
Tamoxifen
Nolvadex®
Anti-cancer / breast cancer
Telithromycin
Ketek®
Antibiotic / bacterial infection
Tizanidine
Zanaflex®
Muscle relaxant /
Vardenafil
Levitra®
phosphodiesterase inhibitor /
vasodilator
Venlafaxine
Effexor®
Anti-depressant / depression
Voriconazole
VFend®
Anti-fungal / anti-fungal
Ziprasidone
Geodon®
Anti-psychotic / schizophrenia
*not available in the United States
Revised: 03/02/2012
Substantial evidence supports the conclusion that these drugs prolong QT and have a risk of TdP but
only under certain known conditions (e.g. excessive dose, drug interaction, etc.).
Generic Name
Brand Name
Class/Clinical Use
Comments
Amitriptyline
Elavil®
Tricyclic Antidepressant / depression
Risk of TdP with overdosage
Ciprofloxacin
Cipro®
Antibiotic / bacterial infection
Drug metabolism inhibitor- Risk for
drug interactions
Clomipramine
Anafranil®
Tricyclic Antidepressant / depression
Desipramine
Pertofrane®
Tricyclic Antidepressant / depression
Risk of TdP with overdosage
Diphenhydramine
Benadryl®
Antihistamine / Allergic rhinitis,
insomnia
Risk of QT increase/TdP in
overdosages
Diphenhydramine
Nytol®
Antihistamine / Allergic rhinitis,
insomnia
Risk of QT increase/TdP in
overdosages
Doxepin
Sinequan®
Tricyclic Antidepressant / depression
Fluconazole
Diflucan®
Anti-fungal / fungal infection
Fluoxetine
Sarafem®
Anti-depressant / depression
Fluoxetine
Prozac®
Anti-depressant / depression
Galantamine
Reminyl®
Cholinesterase inhibitor / Dementia,
Alzheimer's
Drug metabolism inhibitor- Risk for
drug interactions
Imipramine
Norfranil®
Tricyclic Antidepressant / depression
Risk of TdP in overdosage
Itraconazole
Sporanox®
Anti-fungal / fungal infection
Drug metabolism inhibitor- Risk for
drug interactions
Ketoconazole
Nizoral®
Anti-fungal / fungal infection
Drug metabolism inhibitor
Nortriptyline
Pamelor®
Tricyclic Antidepressant / depression
Paroxetine
Paxil®
Anti-depressant / depression
Protriptyline
Vivactil®
Tricyclic Antidepressant / depression
Ritonavir
Norvir®
Protease inhibitor / HIV
Sertraline
Zoloft®
Anti-depressant / depression
Solifenacin
VESIcare®
muscarinic receptor anatagonist /
treatment of overactive bladder
Trazodone
Desyrel®
Anti-depressant / Depression, insomnia
Trimethoprim-Sulfa
Sulfa®
Antibiotic / bacterial infection
Trimethoprim-Sulfa
Bactrim®
Antibiotic / bacterial infection
Trimipramine
Surmontil®
Tricyclic Antidepressant / depression
Revised: 03/30/2010
Source: www.QTdrugs.org
Drugs on the QT Drug Lists are reviewed on an ongoing basis to assure that the available evidence supports their
continued placement on their respective list.
KEY
Drugs to be Avoided Drugs to be avoided, if possible, by patients with Congenital Long QT Syndrome (All
drugs on the three category- of-risk lists are also included here, as are some additional
adrenergic drugs.)
Females > Males: Substantial evidence indicates a greater risk (usually > two-fold) of TdP in women.
Critical Path Institute
Tucson, Arizona and Rockville, Maryland
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