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      "kind": "callout",
      "text": "Drugs withdrawn from market due to QT prolongation share similarities with pitolisant",
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      "text": "TdP, an uncommon polymorphic ventricular tachycardia, is characterized by a gradual change in the amplitude and twisting of the QRS complexes around the isoelectric line on an electrocardiogram. TdP is associated with QTc prolongation, which is the heart-rate-adjusted lengthening of the QT interval. QT prolongation is one of the most infamous adverse drug reactions taught in pharmacy curricula because it can lead to sudden cardiac death. Drug-induced prolonged repolarization of the heart is represented by a prolonged QT interval and can predispose a patient to develop this life-threatening arrhythmia. There is no threshold of QTc prolongation at which TdP is certain to occur. A QTc greater than 500 milliseconds (ms) has been associated with a twofold to threefold higher risk for TdP, and each 10-ms increase contributes to approximately a 5% to 7% exponential increase in risk. QT prolongation can increase hospital length of stay and all-cause mortality in patients. In addition, many drugs have the potential to cause QT prolongation and/or TdP, either alone or in a drug interaction situation.",
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      "text": "The literature on drug-induced hERG blockade and QT prolongation is extensive: “QT prolongation is one of the most infamous adverse drug reactions taught in pharmacy curricula because it can lead to sudden cardiac death.” Another paper indicates that “there is no threshold of QTc prolongation at which TdP [Torsades de Pointes] is certain to occur, and that each 10-ms increase in the QT interval contributes “to approximately 5% to 7% exponential increase in risk.”",
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