ArticlePharmacology research & perspectives2017
Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: re-evaluation of an established drug.
Article in Pharmacology research & perspectives, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Article
- Sedation Methods in Paediatric Auditory Electrophysiologic Testing: A Narrative Review.Audiology research · 2025Review
- Variation in Management of CKD-Associated Pruritus: Results From a Multinational Survey of Kidney Units.Kidney medicine · 2025Article
- Decreasing Preoperative Anxiety in Patients with Newly Available Multimodal Approaches-A Narrative Review.Journal of clinical medicine · 2025Review
- Pharmacotherapeutic actions related to drug interaction alerts - a questionnaire study among Swedish hospital interns and residents in family medicine.European journal of clinical pharmacology · 2025Article
- Preventive Effect of Hydroxyzine on Postoperative Nausea and Vomiting: A Single-Center, Retrospective, Observational Cohort Study.Journal of clinical medicine · 2024Article
- The Potential Mechanisms behind Loperamide-Induced Cardiac Arrhythmias Associated with Human Abuse and Extreme Overdose.Biomolecules · 2023Article
- Association between First-Generation Antihistamine Use in Children and Cardiac Arrhythmia and Ischemic Heart Disease: A Case-Crossover Study.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Article
- Revisiting the QT Interval: An Old Marker for a New Disease?Arquivos brasileiros de cardiologia · 2023Article
- Safety of hydroxyzine in the sedation of pediatric dental patients.Journal of dental anesthesia and pain medicine · 2022Review
- Hydroxyzine-induced Torsade de Pointes in a Patient with Complete Atrioventricular Block.Internal medicine (Tokyo, Japan) · 2021Article
- Oral sedation in dentistry: evaluation of professional practice of oral hydroxyzine in the University Hospital of Rennes, France.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2021Article
- Torsade de pointes associated with chloroquine, hydroxychloroquine, and azithromycin: a retrospective analysis of individual case safety reports from VigiBase.European journal of clinical pharmacology · 2021Article
- A New Era in Pharmacovigilance: Toward Real-World Data and Digital Monitoring.Clinical pharmacology and therapeutics · 2021Review
- Acquired long QT syndrome in chronic kidney disease patients.Renal failure · 2020Review
- Potential drug-drug interactions associated with drugs currently proposed for COVID-19 treatment in patients receiving other treatments.Fundamental & clinical pharmacology · 2020Review
- Spontaneous Reports of Serious Adverse Drug Reactions Resulting From Drug-Drug Interactions: An Analysis From the French Pharmacovigilance Database.Frontiers in pharmacology · 2020Article
- Towards definitive management of allergic rhinitis: best use of new and established therapies.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2020Review
- CSACI position statement: Newer generation HAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2019Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Several noncardiac drugs have been linked to cardiac safety concerns, highlighting the importance of post-marketing surveillance and continued evaluation of the benefit-risk of long-established drugs. Here, we examine the risk of QT prolongation and/or torsade de pointes (TdP) associated with the use of hydroxyzine, a first generation sedating antihistamine. We have used a combined methodological approach to re-evaluate the cardiac safety profile of hydroxyzine, including: (1) a full review of the sponsor pharmacovigilance safety database to examine real-world data on the risk of QT prolongation and/or TdP associated with hydroxyzine use and (2) nonclinical electrophysiological studies to examine concentration-dependent effects of hydroxyzine on a range of human cardiac ion channels. Based on a review of pharmacovigilance data between 14th December 1955 and 1st August 2016, we identified 59 reports of QT prolongation and/or TdP potentially linked to hydroxyzine use. Aside from intentional overdose, all cases involved underlying medical conditions or concomitant medications that constituted at least 1 additional risk factor for such events. The combination of cardiovascular disorders plus concomitant treatment of drugs known to induce arrhythmia was identified as the greatest combined risk factor. Parallel patch-clamp studies demonstrated hydroxyzine concentration-dependent inhibition of several human cardiac ion channels, including the ether-a-go-go-related gene (hERG) potassium ion channels. Results from this analysis support the listing of hydroxyzine as a drug with "conditional risk of TdP" and are in line with recommendations to limit hydroxyzine use in patients with known underlying risk factors for QT prolongation and/or TdP.
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