Abstract
Anamorelin is prescribed for cancer cachexia treatment. Anamorelin is a ghrelin receptor
antagonist and exerts a sodium channel blockade effect, possibly inducing disorders
of the cardiac conduction system. We herein report two cases of wide QRS complex tachycardia
caused by anamorelin. In both cases, the patients had liver dysfunction. Anamorelin
is mainly metabolized in the liver; hence, sodium channel blockade by anamorelin during
liver dysfunction can cause serious side effects, including wide QRS complex tachycardia,
similar to flecainide toxicity. The differential diagnosis of wide QRS tachycardia
caused by anamorelin can be challenging because conventional electrocardiogram criteria
cannot be applicable in patients with drug intoxication. It can worsen the situation
for the use of antiarrhythmic drugs for wide QRS tachycardia. The appropriate treatment
is supportive care until anamorelin is metabolized. To our best knowledge, this is
the first study to report the life-threatening adverse effects of anamorelin.
Learning objective
Anamorelin is prescribed for cancer cachexia treatment. Anamorelin can cause wide
QRS complex tachycardia. Our findings in the two cases we encountered indicate that
we should be aware of wide QRS complex tachycardia in patients taking anamorelin,
especially if they have liver dysfunction. We should suspect the condition to be the
adverse effect of anamorelin and monitor the electrocardiogram and blood test findings
regularly to prevent this fatal side effect.
Keywords
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References
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Article info
Publication history
Published online: June 01, 2022
Accepted:
April 25,
2022
Received in revised form:
April 15,
2022
Received:
March 1,
2022
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
