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Terfenadine (Seldane) is a commonly prescribed antihistamine that can cause cardiotoxicity in overdoses. This case report describes a 39-year-old woman who developed torsade de pointes, a polymorphic form of ventricular tachycardia, while using the recommended dose of terfenadine. The arrhythmia seems to have resulted from a drug interaction.
The patient was taking terfenadine (60 mg twice daily) and an antibiotic for sinusitis; after 8 days, she began taking oral ketoconazole (Nizoral) for early symptoms of vaginal candidiasis. About 3 days later, she began having episodes of lightheadedness and syncope that were found to be caused by torsade de pointes. Her electrocardiogram on hospital admission was notable for a prolonged corrected QT in…