Guiding principle in the use of antihistamines for patients with long QT syndrome (LQTs) has not been sufficiently discussed, although suspected adverse drug reactions (ADR) relating to drug-induced LQTs were reported in some antihistamines. To clarify the causality between ADR and each drug, we exhaustively assessed the electropharmacological properties of 11 antihistamines with ADR reports by using anesthetized guinea-pig model under the monitoring of ECG parameters and monophasic action potential duration (MAP 90 ) of the right ventricle. Cetirizine, clemastine, diphenhydramine, ebastine, epinastine, fexofenadine, hydroxyzine, levocetirizine, loratadine, mequitazine, and promethazine were administered intravenously. Diphenhydramine and hydroxyzine at therapeutic dose and clemastine at 10 times higher therapeutic dose prolonged the QT interval and MAP 90 . On the other hand, other 8 antihistamines did not prolong the QT interval nor MAP 90 even though they were administered at 10 times higher therapeutic dose. These data indicated that diphenhydramine, hydroxyzine, and clemastine essentially have a potential to be a causative drug of drug-induced LQTs, whereas the cases using other 8 antihistamines should be reinvestigated on the case information such as the presence of cardiovascular diseases and concomitant medications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.