Donepezil – QT prolongation and torsades de pointes
Editor – I read with interest, the ‘Lesson of the month 1: Prolonged QT syndrome due to donepezil: a reversible cause of falls?’ by Emily G Jackson and Sarah Stowe.1 Being a higher specialist trainee in geriatric medicine, I have seen a few cases of cardiac conduction disorders arising from the use of cholinesterase inhibitors such as donepezil, galantamine and rivastigmine in patients with cognitive decline.2 I will like to bring your readers’ attention to the fact that although British National Formulary (BNF) does not specifically mention QT prolongation and torsades de pointes as listed side effect of donepezil, it does state that ‘cardiac conduction disorders’ are a rare or very rare side effect of donepezil, so care and caution should be exercised in interpreting this fact.3 I also wanted to highlight some facts regarding CredibleMeds.org, published on their own website. It is a federally funded, university-based centre for education and research on therapeutics founded in 1999. It is used as a resource by some individual healthcare professionals registered with their website, a few hospitals including the Mayo Clinic in Rochester, Minnesota and New Zealand’s federal Medicines Safety Authority for the safety of anti-depressants.4 But I am yet to find a source that confirms its recognition by the National Institute for Health and Care Excellence, the BNF or any of the UK based NHS trusts, therefore information offered by this website should be interpreted with caution by the healthcare professionals in the United Kingdom.
- © Royal College of Physicians 2019. All rights reserved.
References
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- Jackson EG
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- British National Formulary
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