ArticleTherapeutic advances in psychopharmacology2017
Combinations of QTc-prolonging drugs: towards disentangling pharmacokinetic and pharmacodynamic effects in their potentially additive nature.
Article in Therapeutic advances in psychopharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Pharmacokinetics/Pharmacodynamics of Antiviral Agents Used to Treat SARS-CoV-2 and Their Potential Interaction with Drugs and Other Supportive Measures: A Comprehensive Review by the PK/PD of Anti-Infectives Study Group of the European Society of Antimicrobial Agents.Clinical pharmacokinetics · 2020Pooled it
- Effect of Clofazimine Concentration on QT Prolongation in Patients Treated for Tuberculosis.Antimicrobial agents and chemotherapy · 2021Trial
- Medication association analysis of antimicrobial-induced arrhythmias based on FP-growth frequent pattern mining.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Exposure-QTc modeling of bedaquiline, pretomanid, and clofazimine in adults with tuberculosis.Antimicrobial agents and chemotherapy · 2026Article
- Prescribed drugs and comorbidities as risk factors for Torsades de Pointes arrhythmia: a Swedish population-based cohort study.European journal of clinical pharmacology · 2026Article
- Exploratory prescribing risk profiles and drug drug interaction burden in older adults with depressive episodes.Frontiers in psychiatry · 2026Article
- PsychoPharm aggregated risk score (PARS): a multidimensional tool to flag high-risk pharmacotherapy in psychiatric patients.Frontiers in pharmacology · 2026Article
- Analysis of Adverse Drug Reactions of Clofazimine Reported in the FDA Adverse Event Reporting System from 2004 to 2025 Q1.Infectious diseases and therapy · 2025Article
- QT STAR: concomitant QTc-prolonging medication use among patients with HR+/HER2- metastatic breast cancer receiving a CDK4/6 inhibitor in first line.Cardio-oncology (London, England) · 2025Article
- Psychotropic Polypharmacy and QT Prolonging Medications in Hospitalized Patients.Pharmacology research & perspectives · 2025Observational
- Prevalence and clinical significance of potential drug-drug interactions among lung transplant patients.Frontiers in pharmacology · 2024Article
- Revisiting the QT Interval: An Old Marker for a New Disease?Arquivos brasileiros de cardiologia · 2023Article
- Molecular mechanisms of resistance and treatment efficacy of clofazimine and bedaquiline againstFrontiers in medicine · 2023Review
- Determinants of severe QTFrontiers in psychiatry · 2023Article
- Oxytocin exerts harmful cardiac repolarization prolonging effects in drug-induced LQTS.International journal of cardiology. Heart & vasculature · 2022Article
- Estimation of cardiac QTc intervals in people prescribed antipsychotics: a comparison of correction factors.Therapeutic advances in psychopharmacology · 2022Article
- 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
- Antipsychotics in routine treatment are minor contributors to QT prolongation compared to genetics and age.Journal of psychopharmacology (Oxford, England) · 2021Article
- Managing drug-induced QT prolongation in clinical practice.Postgraduate medical journal · 2021Review
- Concentration-QTc analysis of quizartinib in patients with relapsed/refractory acute myeloid leukemia.Cancer chemotherapy and pharmacology · 2021Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug-drug interactions.
methodsIn a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses.
resultsDrugs attributing a 'known' risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two
conclusionsThese observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure. Concurrently, it stresses the value of the AZCERT classification also for the risk prediction of combination therapies with QT-prolonging drugs.
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