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Vonoprazan-associated long QT syndrome
Kimitoshi Kubo1, Toru Sakakibara2, Kazuya Yonezawa3
1Department of Gastroenterology National Hospital Organization Hakodate National Hospital Hakodate Hokkaido Japan.
Journal of General and Family Medicine
|January 10, 2022
Summary
This case study highlights vonoprazan-induced QT prolongation, a rare side effect that resolved after drug withdrawal. It emphasizes careful monitoring in patients with polypharmacy, especially those taking CYP3A4 substrates.
Area of Science:
- Pharmacology
- Clinical Cardiology
- Drug Safety
Background:
- Vonoprazan is a potassium-competitive acid blocker.
- QT prolongation is a known risk with some medications.
- Polypharmacy increases the risk of drug interactions.
Purpose of the Study:
- To report a novel case of vonoprazan-associated QT prolongation.
- To investigate the relationship between vonoprazan and QT interval changes.
- To emphasize the importance of drug monitoring in polypharmacy.
Main Methods:
- Case report of a single patient.
- Clinical observation of electrocardiogram (ECG) findings.
- Analysis of medication history and drug metabolism pathways (CYP3A4).
Main Results:
- Vonoprazan initiation was followed by newly occurring QT prolongation.
- Discontinuation of vonoprazan led to improvement in QT interval.
- The patient was on polypharmacy, including a CYP3A4-metabolized drug.
Conclusions:
- Vonoprazan can cause QT prolongation, even in the absence of other known risk factors.
- Discontinuation of vonoprazan is an effective management strategy.
- Clinicians should be vigilant for QT prolongation in patients receiving vonoprazan, particularly those on polypharmacy involving CYP3A4 substrates.
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