5-Hydroxytryptamine3 receptor antagonists and cardiac side effects. (October 2014)

• Record Type: Journal Article
• Authors: Brygger, Louise; Herrstedt, Jørn
• Is Part Of: Expert opinion on drug safety. Volume 13:Number 10(2014)
• Page Start: 1407
• Page End: 1422
• Publication Date: 2014-10
• Subjects: Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1517/14740338.2014.954546
• Languages: English
• ISSNs: 1474-0338

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold> <italic>Introduction:</italic> </bold> 5-Hydroxytryptamine<sub>3</sub>-receptor antagonists (5-HT<sub>3</sub>-RA) are the most widely used antiemetics in oncology, and although tolerability is high, QT<sub>C</sub> prolongation has been observed in some patients.</p> <p> <bold> <italic>Areas covered:</italic> </bold> The purpose of this article is to outline the risk of cardiac adverse events (AEs) from 5-HT<sub>3</sub>-RAs, with focus on the three most commonly used, ondansetron, granisetron and palonosetron.</p> <p> <bold> <italic>Expert opinion:</italic> </bold> Most of the studies analyze electrocardiogram (ECG) changes after 5-HT<sub>3</sub>-RA administrations in healthy, young adults, or in noncancer patients to treat postoperative nausea and vomiting (PONV). Only a few studies have addressed ECG changes in cancer patients treated for chemotherapy-induced nausea and vomiting (CINV). Investigations in cancer patients are essential, because these patients are older and have a higher incidence of comorbidity, than those usually included in clinical trials. Furthermore, polypharmacy is frequent and drug–drug interactions between chemotherapy and other QTc-prolonging drugs may influence the pharmacokinetics and pharmacodynamics of the 5-HT<sub>3</sub>-RAs. During the next 10 – 15 years a huge increase in the number of cancer patients is expected, primarily in the group of 65-plus-year old. Therefore it will be crucial to address the incidence of cardiac AEs in cancer patients with known heart disease receiving chemotherapy and a 5-HT<sub>3</sub> RA for the prophylaxis of CINV.</p> </abstract>