Biomaterial Database

[Risk of QTc prolongation due to combination of ziprasidone and quetiapine]. 2004

Christo Minov

Bezirkskrankenhaus Augsburg.

BACKGROUND Ziprasidone, a novel antipsychotic agent for the treatment of schizophrenia, undergoes partial metabolism by cytochrome P450 3A4. It is associated with moderate prolongation of QT interval, but no increased risk for ventricular tachyarrhythmia or sudden death was demonstrated. METHODS A 70-year-old male was initiated on quetiapine therapy for an acute exacerbation of chronic schizophrenia. The baseline electrocardiogram (ECG) showed a normal QT interval (QTc: 417 ms). In combination therapy of quetiapine and ziprasidone the patient developed suddenly cardiac arrhythmia with extrasystoles and the ECG revealed a prolonged QTc interval of 482 ms. After breaking off treatment with quetiapine and reduction of ziprasidone a normalized QT interval (QTc: 428 ms) was measured. CONCLUSIONS We suppose a potential of pharmacokinetic interaction between quetiapine and ziprasidone because of the same metabolic pathway by CYP3A4. Combining treatment of quetiapine and ziprasidone is therefore contraindicated. In addition we suggest caution using ziprasidone with any potential 3A4 substrate or inhibitor.

UI	MeSH Term	Description	Entries
D008133	Long QT Syndrome	A condition that is characterized by episodes of fainting (SYNCOPE) and varying degree of ventricular arrhythmia as indicated by the prolonged QT interval. The inherited forms are caused by mutation of genes encoding cardiac ion channel proteins. The two major forms are ROMANO-WARD SYNDROME and JERVELL-LANGE NIELSEN SYNDROME.	Electrocardiogram QT Prolonged
D008297	Male		Males
D010879	Piperazines	Compounds that are derived from PIPERAZINE.
D003987	Dibenzothiazepines
D004347	Drug Interactions	The action of a drug that may affect the activity, metabolism, or toxicity of another drug.	Drug Interaction,Interaction, Drug,Interactions, Drug
D004359	Drug Therapy, Combination	Therapy with two or more separate preparations given for a combined effect.	Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D004562	Electrocardiography	Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.	12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006212	Hallucinations	Subjectively experienced sensations in the absence of an appropriate stimulus, but which are regarded by the individual as real. They may be of organic origin or associated with MENTAL DISORDERS.	Hallucination of Body Sensation,Hallucinations, Auditory,Hallucinations, Dissociative,Hallucinations, Elementary,Hallucinations, Formed, of People,Hallucinations, Gustatory,Hallucinations, Hypnagogic,Hallucinations, Hypnapompic,Hallucinations, Internal Body Sensation,Hallucinations, Kinesthetic,Hallucinations, Mood Congruent,Hallucinations, Mood Incongruent,Hallucinations, Olfactory,Hallucinations, Organic,Hallucinations, Reflex,Hallucinations, Sensory,Hallucinations, Somatic,Hallucinations, Tactile,Hallucinations, Verbal Auditory,Hallucinations, Visual,Hallucinations, Visual, Formed,Hallucinations, Visual, Unformed,Auditory Hallucination,Auditory Hallucination, Verbal,Auditory Hallucinations,Auditory Hallucinations, Verbal,Body Sensation Hallucination,Body Sensation Hallucinations,Dissociative Hallucination,Dissociative Hallucinations,Elementary Hallucination,Elementary Hallucinations,Gustatory Hallucination,Gustatory Hallucinations,Hallucination,Hallucination, Auditory,Hallucination, Dissociative,Hallucination, Elementary,Hallucination, Gustatory,Hallucination, Hypnagogic,Hallucination, Hypnapompic,Hallucination, Kinesthetic,Hallucination, Mood Congruent,Hallucination, Mood Incongruent,Hallucination, Olfactory,Hallucination, Organic,Hallucination, Reflex,Hallucination, Sensory,Hallucination, Somatic,Hallucination, Tactile,Hallucination, Verbal Auditory,Hallucination, Visual,Hypnagogic Hallucination,Hypnagogic Hallucinations,Hypnapompic Hallucination,Hypnapompic Hallucinations,Kinesthetic Hallucination,Kinesthetic Hallucinations,Mood Congruent Hallucination,Mood Congruent Hallucinations,Mood Incongruent Hallucination,Mood Incongruent Hallucinations,Olfactory Hallucination,Olfactory Hallucinations,Organic Hallucination,Organic Hallucinations,Reflex Hallucination,Reflex Hallucinations,Sensory Hallucination,Sensory Hallucinations,Somatic Hallucination,Somatic Hallucinations,Tactile Hallucination,Tactile Hallucinations,Verbal Auditory Hallucination,Verbal Auditory Hallucinations,Visual Hallucination,Visual Hallucinations
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069348	Quetiapine Fumarate	A dibenzothiazepine and ANTIPSYCHOTIC AGENT that targets the SEROTONIN 5-HT2 RECEPTOR; HISTAMINE H1 RECEPTOR, adrenergic alpha1 and alpha2 receptors, as well as the DOPAMINE D1 RECEPTOR and DOPAMINE D2 RECEPTOR. It is used in the treatment of SCHIZOPHRENIA; BIPOLAR DISORDER and DEPRESSIVE DISORDER.	2-(2-(4-dibenzo(b,f)(1,4)thiazepine-11-yl-1-piperazinyl)ethoxy)ethanol,Ethanol, 2-(2-(4-dibenzo(b,f)(1,4)thiazepin-11-yl-1-piperazinyl)ethoxy)-, (E)-2-butenedioate (2:1) (salt),ICI 204,636,ICI 204636,ICI-204636,Quetiapine,Seroquel,ICI204636