Do you prescribe hydroxychloroquine to patients who are on other medications that can prolong the QT interval?
If yes, do you do any sort of baseline or ongoing monitoring of EKG?
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When initiating hydroxychloroquine do you routinely obtain a baseline EKG?
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3 Answers
Mednet MemberInvited Expert
Rheumatology · Uniformed Services University of the Health Sciences (USUHS)
Answered on
- First, I'll remind everyone that before COVID-19, case reports of QT-prolongation-associated arrhythmias were rare. It wasn't until COVID that we all at once saw cases with the caveats that these were in patients treated with higher doses of HCQ, commonly loading doses of 800 mg daily, plus COVID-1...
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Mednet MemberInvited Expert
Rheumatology · Beth Israel Deaconess Medical Center
Answered on
I avoid hydroxychloroquine in high-risk patients, those on multiple QT-prolonging drugs, or with electrolyte abnormalities. If it has to be used, I would make sure there is a baseline EKG, and electrolytes and EKG are monitored periodically.
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Mednet MemberInvited Expert
Rheumatology · MUSC Health
Answered on
I will order an ECG, and if the QT is not prolonged, I will start hydroxychloroquine. After a few days, I will repeat the ECG to determine if a QT effect is occurring.
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