Greater Glasgow and Clyde Medicines

Galantamine and QTc prolongation

The Summary of Product Characteristics for galantamine was updated in March 2021 to include the following caution:

‘There have been reports of QTc prolongation in patients using therapeutic doses of galantamine and of torsade de pointes in association with overdoses. Galantamine should therefore be used with caution in patients with prolongation of the QTc interval, in patients treated with drugs affecting the QTc interval, or in patients with relevant pre-existing cardiac disease or electrolyte disturbances.’

For new initiations

  • Consider cardiac status during workup (refer to Medicines Update Extra bulletin for risk factors associated with QTc prolongation)
  • If cardiac risk identified obtain U&Es and ECG at baseline and once stable therapeutic dose is established
  • Further ECG should be carried out when clinically appropriate, for example if cardiac symptoms emerge or a patient is started on medication known to cause QTc prolongation

For existing patients

  • Review patients established on treatment at next routine appointment
  • Check clinical portal for ECG within the last 6 months
  • Assess cardiac risk and identify if prescribed other medication known to prolong QTc interval
  • If clinically appropriate refer for ECG
  • If QTc is found to be prolonged, galantamine should be reviewed and an alternative considered.

Further information on medicines known to affect QTc interval can be found at CredibleMeds or NHSGGC Medicines Update Extra Bulletin: Drug induced QTc prolongation.


Published 01/06/21. Medicines Update blogs are correct at the time of publication.