QT prolongation and torsade de pointes associated with solifenacin in an 81-year-old woman

摘要

Solifenacin, an antimuscarinic drug, has been widely used for the treatment of overactive bladder (OAB), but severe cardiac adverse effects have not been reported. An 81-year-old woman was prescribed solifenacin 5 mg day~(-1) for OAB. Two weeks later she developed the first syncope. Nine days after the first syncope she developed recurrent syncope, and electrocardiogram monitoring showed marked QT prolongation and torsade de pointes (TdP). Concomitant drugs remained unchanged. Serum electrolytes and hepatic function were normal. Calculated creati-nine clearance was mildly decreased. We considered that the loss of consciousness was associated with solifenacin. Although intravenous magnesium sulphate could not terminate the recurrence of TdP, increasing the pacing rate prevented further attacks of TdP. Solifenacin might be a possible cause of QT prolongation and TdP.Solifenacin is a newer bladder-selective antimuscarinic drug for the treatment of OAB. Although terodiline, an older antimuscarinic drug forOAB, has been reported to predispose to QT prolongation and TdP and was withdrawn from the market in the early 1990s, solifenacin has not been reported to have severe cardiac adverse effects.