Opioid Switching from Morphine to Methadone Causes a Minor But Not Clinically Significant Increase in QTc Time: A Prospective 9-Month Follow-Up Study

Case reports and retrospective studies suggest that methadone causes an increase in QTc (QT time corrected for heart rate) time and risk of torsades de pointes arrhythmia. No prospective studies in pain patients have been conducted, and data on whether a methadone-induced increase in QTc time persis...

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Bibliographic Details
Published in:Journal of pain and symptom management 2006-08, Vol.32 (2), p.180-185
Main Authors: Fredheim, Olav Magnus S., Borchgrevink, Petter C., Hegrenæs, Lars, Kaasa, Stein, Dale, Ola, Klepstad, Pål
Format: Article
Language:English
Subjects:
Aged
Analgesics, Opioid - administration & dosage
arrhythmia
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
chronic pain
Drug Administration Schedule
Electrocardiography
Female
Follow-Up Studies
Heart
Heart Rate - drug effects
Humans
Long QT Syndrome - chemically induced
Long QT Syndrome - diagnosis
Male
Medical sciences
Methadone
Methadone - administration & dosage
Methadone - adverse effects
Middle Aged
Morphine - administration & dosage
opioid switch
Pharmacology. Drug treatments
Prospective Studies
QT time
Risk Assessment - methods
Risk Factors
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Summary:Case reports and retrospective studies suggest that methadone causes an increase in QTc (QT time corrected for heart rate) time and risk of torsades de pointes arrhythmia. No prospective studies in pain patients have been conducted, and data on whether a methadone-induced increase in QTc time persists during long-term treatment have not been reported. Eight chronic nonmalignant pain patients experiencing insufficient pain control or intolerable side effects during treatment with oral morphine switched to oral methadone and were included in this study. Electrocardiograms were obtained at baseline and at follow-up 2 weeks, and 3 and 9 months after the opioid switch. Start of methadone caused a minor but statistically significant increase in QTc time, while fluctuations in QTc during treatment with stable doses of methadone were neither clinically nor statistically significant. We observed no episodes of arrhythmias.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2006.02.010