Home Cardiology Methadone Linked to Initial QTc Prolongation in Chronic Pain

Methadone Linked to Initial QTc Prolongation in Chronic Pain

Nonsignificant increase in QTc in first month after initiating methadone, which does not persist

FRIDAY, June 26, 2015 (HealthDay News) — For patients with chronic pain, methadone is associated with a small, but nonsignificant, initial increase in QTc, which does not persist, according to a study published in the June issue of Pain Medicine.

Samuel Grodofsky, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a prospective cohort study in a chronic pain clinic involving 82 patients receiving methadone and 102 receiving non-methadone opioid therapy. Automated QTc calculations from 12-lead electrocardiograms were analyzed at baseline and during the subsequent six months.

The researchers found that there was no overall higher frequency of QTc >470 milliseconds in the methadone group (6 percent for methadone group versus 5 percent for controls; P = 0.722). Furthermore, the methadone group had no increase in the incidence of QTc >60 milliseconds from baseline (4 and 4 percent, respectively; P = 0.94). Patients in the methadone group exhibited an increase in QTc compared with controls in the first month after initiating methadone (5 versus 0 percent; P = 0.073), but the difference did not persist at three and six months.

“We believe larger scale studies to further characterize the safety profile of low-dose methadone are warranted,” the authors write.

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