Torsades de Pointes from Terfenadine and Sotalol Given in Combination

A patient receiving sotalol developed recurrent torsades de pointes following the addition of terfenadine (Seldane) to her medical regimen. A 71-year-old woman with a history of atrial fibrillation successfully suppressed with sotalol, 80 mg bid, was started on terfenadine, 60 mg bid. Eight days later, she developed repeated self-terminating episodes of torsades de pointes. Sotalol and terfenadine were discontinued, and no further arrhythmia was observed after 72 hours of temporary pacing was discontinued.