title: Analysis of an ECG record database reveals QT interval prolongation potential of famotidine in a large Korean population.
abstract: Some non-antiarrhythmic drugs have the undesirable property of delaying cardiac repolarization, an effect that can be measured empirically as a prolongation of the QT interval by surface electrocardiogram (ECG). The QT prolongation and proarrhythmia potential of famotidine are largely unknown, particularly in individuals that have cardiovascular risk factors such as abnormal electrolyte levels. Based on an analysis of QT/QTc intervals from a database of ECG recordings from a large Korean population (ECG-ViEW, 710,369 ECG recordings from 371,401 individuals), we observed that famotidine administration induced a prolonged QTc interval (above 480 ms, p < 0.05 compared to before-treatment, based on a McNemar test). Furthermore, famotidine induced QT prolongations in 10 out of 14 patients with hypocalcemia and 11 out of 13 patients with hypomagnesemia [difference of mean between before and after famotidine administration; 38.00 ms (95% confidence interval 2.72-73.28) and 67.08 ms (95% confidence interval 24.94-109.21), p < 0.05 and p < 0.01 by paired t test, respectively]. In vitro, the IC50 of famotidine for human-ether-a-go-go gene (hERG) channel inhibition was higher than 100 μM as determined by automated patch clamp hERG current assay, implying that hERG channel inhibition is not the underlying mechanism for QT prolongation. These results suggest that famotidine administration increases a proarrhythmic potential, especially in subjects with electrolytes imbalance.
authors.affiliation: Pharmaceutical Standardization Research and Testing Division, National Institute of Food and Drug Safety Evaluation (NIFDS), Ministry of Food and Drug Safety (MFDS), OHTAC 187, Osongsaengmyeong-2ro, Osong, Cheongju-si, Chungbuk, 363-700, Republic of Korea, actpotyjs@korea.kr.
authors.forename: Jaesuk
authors.initials: J
authors.lastname: Yun
authors.forename: Eun
authors.initials: E
authors.lastname: Hwangbo
authors.forename: Jongpill
authors.initials: J
authors.lastname: Lee
authors.forename: Chong-Run
authors.initials: CR
authors.lastname: Chon
authors.forename: Peol A
authors.initials: PA
authors.lastname: Kim
authors.forename: In-Hye
authors.initials: IH
authors.lastname: Jeong
authors.forename: Manyoung
authors.initials: M
authors.lastname: Park
authors.forename: Raewoong
authors.initials: R
authors.lastname: Park
authors.forename: Shin-Jung
authors.initials: SJ
authors.lastname: Kang
authors.forename: Donwoong
authors.initials: D
authors.lastname: Choi
mesh_terms: D000897:Anti-Ulcer Agents / Q000009:adverse effects; D016208:Databases, Factual / Q000639:trends; D004562:Electrocardiography / Q000187:drug effects* / Q000639:trends; D015738:Famotidine / Q000009:adverse effects*; D005260:Female; D057809:HEK293 Cells; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D011159:Population Surveillance; D056910:Republic of Korea / Q000453:epidemiology
chemical_list: D000897:Anti-Ulcer Agents; D015738:Famotidine