Successful transition to buprenorphine in a patient with methadone-induced torsades de pointes.
A 56-year-old-man presented with syncope and torsades de pointes secondary to methadone-induced QT prolongation. After transition from methadone to buprenorphine, a partial mu-opiate-receptor agonist and a kappa-opiate-receptor antagonist, the QT normalized and ventricular arrhythmias resolved. Buprenorphine should be used for opiate dependence and chronic pain in patients with methadone-induced QT prolongation and as first line therapy in patients with risk factors for torsades de pointes.
Esses
Jason Levi
JL
Department of Cardiology, Beth Israel Medical Center, 1st Ave. at 16th Street, Baird Hall, 5th Floor, New York, NY, 10003, USA.
Rosman
Jonathan
J
Do
Lien Thanh
LT
Schweitzer
Paul
P
Hanon
Sam
S
D002047:Buprenorphine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000503:physiopathology
D009292:Narcotic Antagonists; D002047:Buprenorphine; D008691:Methadone