Hello everyone,

I just wanted to share this resource for anyone who has not already seen
it. There is a website, AZCert.com, that maintains and updates a list of
the known drugs that prolong the QT interval of the heart. This is the
cardiac risk that people are concerned about with use of domperidone. I
find this list of drugs very useful when talking to a mother about whether
she is a candidate for domperidone (she shouldn't take it if she is already
taking another drug that lengthens the QT interval).

A few things about this issue are really interesting in regards to our work:
1) While domperidone has gotten a lot of attention for it, this risk is in
fact common to many drugs - it's not a special side effect of domperidone.
2) Although many physicians in the US seem to be much more comfortable
prescribing Reglan (despite its neurologic effects and its risk for
triggering postpartum depression) than domperidone, in part because of the
cardiac concerns, Reglan itself also carries the QT interval risk. (Thank
you to Frank Nice for pointing this out at GOLD this year.)
3) Some of these drugs are so common that moms may not think to mention
their use to us, including antidepressants like Celexa and Lexapro. I have
seen conflicting information about whether Paxil, Zoloft and Prozac
lengthen QT or not.

The AZCert.com list was created for people who have a congenital tendency
toward long QT, but it seems like it could be just as useful for our
conversations with clients. The website allows you to register and receive
alerts by email when this list is revised.

I hope this is of use to some of you.

April
--

"There isn't anyone you couldn't love once you've heard their story."
- Mary Lou Kownacki

April Rosenblum, IBCLC

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---------- Forwarded message ----------
From: Raymond Woosley | AZCERT, Inc. <[log in to unmask]>
Date: Wed, Nov 19, 2014 at 2:20 AM
Subject: Update: Changes to QTdrugs Lists at CredibleMeds.org
To: [log in to unmask]




Re: Change to CredibleMeds® lists

November 18, 2014

Dear Registrant:

You requested that we inform you when we make changes to the CredibleMeds®
lists of medications that prolong the QT interval and/or cause torsades de
pointes (TdP). Based upon our analysis of emerging evidence, the following
change has been made to the lists:

*Hydroxyzine (Atarax*®*, Vistaril*® *and many other brand names) *is an
antihistamine that is used to treat allergies, anxiety and other
conditions.  It has been added to the list of drugs with* Conditional Risk
of TdP *because it is associated with TdP in patients with conditions such
as low serum potassium or magnesium, extremely slow heart rate
or concomitant use of drugs known to cause TdP and/or prolong the QT
interval.

*Metoclopramide (Reglan*® *and many other brand names) *is an anti-emetic
that is used to treat nausea, vomiting and other conditions.  It has been
added to the list of drugs with* Conditional Risk of TdP *because it is
associated with TdP in patients with conditions such as concomitant use of
drugs known to cause TdP and/or prolong the QT interval.

Hydroxyzine and metoclopramide have also been added to the list of Drugs to
be Avoided by Patients with Congenital Long QT Syndrome
<http://lotosnile.com/mail/l/1Rvu5zX4OytEhJer6bHzTg/ZF1yUWpQY0eGlXGlpVp9oQ/fVfvNpWc4EC24ITOnfhqXw>
(CLQTS) if at all possible.

CredibleMeds® relies on charitable contributions and grants to maintain the
QTdrugs list. Please click here
<http://lotosnile.com/mail/l/1Rvu5zX4OytEhJer6bHzTg/vCuGnCMC763sB3XSdipMFo892g/fVfvNpWc4EC24ITOnfhqXw>
and become a supporter with your donation.

Thank you for your interest in www.CredibleMeds.org
<http://lotosnile.com/mail/l/1Rvu5zX4OytEhJer6bHzTg/V9Y9KRVAlZG9STYwDj199A/fVfvNpWc4EC24ITOnfhqXw>
.

Best regards,

Raymond L. Woosley, MD, PhD



President, AZCERT, Inc.

<http://lotosnile.com/mail/l/1Rvu5zX4OytEhJer6bHzTg/08hqg6HdxLDS2eGoe5GB8g/fVfvNpWc4EC24ITOnfhqXw>
<http://lotosnile.com/mail/l/1Rvu5zX4OytEhJer6bHzTg/SyFjOso9QUkYY2GWbPf8Ow/fVfvNpWc4EC24ITOnfhqXw>

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