Ventricular Tachycardia Triggered by Loperamide and Famotidine Abuse

A 32-year-old male developed recurrent ventricular tachycardia after taking mega doses of loperamide and famotidine in order to experience an opiate-like euphoric effect. He was taking up to 200 mg of loperamide and multiple doses of famotidine each day. He developed palpitations and syncope. Electr...

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Bibliographic Details
Published in:Drug safety - case reports 2018-02, Vol.5 (1), p.1-4, Article 11
Main Authors: Larsen, Timothy R., McMunn, Jedediah, Ahmad, Hala, AlMahameed, Soufian T.
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
Case Report
Case reports
Drug Safety and Pharmacovigilance
Electrocardiography
Medicine
Medicine & Public Health
Patient safety
Pharmaceuticals
Pharmacology/Toxicology
Side effects
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Summary:A 32-year-old male developed recurrent ventricular tachycardia after taking mega doses of loperamide and famotidine in order to experience an opiate-like euphoric effect. He was taking up to 200 mg of loperamide and multiple doses of famotidine each day. He developed palpitations and syncope. Electrocardiography demonstrated ventricular tachycardia and QT interval prolongation (corrected QT interval was 597 ms). He was diagnosed with loperamide-induced QT prolongation resulting in incessant ventricular tachycardia. Loperamide was discontinued, and he was treated with electrolyte replacement, supportive care, and monitoring. After 5 days, his electrocardiogram (ECG) normalized and he had no more ventricular tachycardia. A Naranjo assessment score of 8 was obtained, indicating a probable relationship between QT prolongation and his use of loperamide. Large doses of loperamide can cause QT interval prolongation and life-threatening arrhythmias. These effects may be accentuated when histamine-2 receptor blockers are also abused.
ISSN:2199-1162
2198-977X
DOI:10.1007/s40800-018-0077-0