Astemizole-induced torsades de pointes in a patient with vasospastic angina

Jpn Circ J. 1998 Mar;62(3):225-7. doi: 10.1253/jcj.62.225.


Astemizole (Hismanal), an antihistamine agent, has been reported to be associated with ventricular arrhythmias. In this paper we present a case of QT prolongation and torsades de pointes (TdP) in a 77-year-old woman who had been taking astemizole (10 mg/day) for 6 months because of allergic skin disease. At the time of admission, the serum concentration of astemizole and its metabolites was markedly elevated at 15.85 ng/ml, approximately 3 times the normal level. The patient was also taking cimetidine, a known inhibitor of cytochrome P-450 enzymatic activity, and during her admission was diagnosed as having vasospastic angina. To the best of our knowledge, this is the first report of astemizole-induced QT prolongation and TdP in Japan.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angina Pectoris, Variant / complications*
  • Angina Pectoris, Variant / physiopathology
  • Anti-Allergic Agents / adverse effects*
  • Anti-Allergic Agents / therapeutic use
  • Astemizole / adverse effects*
  • Astemizole / therapeutic use
  • Coronary Vasospasm / physiopathology
  • Female
  • Humans
  • Skin Diseases / complications
  • Skin Diseases / drug therapy*
  • Torsades de Pointes / chemically induced*
  • Torsades de Pointes / physiopathology


  • Anti-Allergic Agents
  • Astemizole