Do Oral Contraceptives Have an Effect on QT Prolongation?

Researchers looking at whether oral contraceptives have an effect on drug-induced corrected QT prolongation (a surrogate for drug-induced torsade de pointes) looked at a cohort of 498 nonmenopausal women receiving 80 mg of sotalol. Participants took either no contraception or oral contraceptives with various types of progestin (levonorgestrel, desogestrel, or drospirenone) and electrocardiographic changes after 3 hours following sotalol administration were assessed. The results showed that QT prolongation was higher in women taking drospirenone vs those taking no contraceptives (P=0.05) or those taking levonorgestrel (P=0.05). The researchers concluded that “contraceptive pills are associated with variable drug-induced alterations of ventricular repolarization in health nonmenopausal women […] more data are required on whether antiandrogenic oral contraceptives lead to clinical significant adverse events in patients taking QTc-prolonging drugs.”

Salem JE, Dureau P, Bachelot A, et al. JAMA Cardiology. 2018;doi:10.1001/jamacardio.2018.2251