hERG blocker

hERG potassium channel blocker

Delayed cardiac repolarization → QT prolongation
Greater block → greater torsades risk
Risk rises with high exposure and hypokalemia

Class III antiarrhythmics
Psychiatric medications that prolong QT interval do so by blocking Kv11.1 (hERG)
➔ many antidepressants and antipsychotics
➔ TCAs prolong QT, but overdose danger is driven primarily by Na⁺ channel blockade → QRS widening & malignant arrhythmias

Other causes of QT prolongation

The hERG pore is the usual route, not the only one

hERG blocker — mechanism peg — hERG blocker

hERG trafficking inhibition — pentamidine, arsenic trioxide (no hERG peg)
Ion-channel gene expression — the HDAC inhibitors
Androgen deprivation — leuprolide, bicalutamide, apalutamide
Bradycardia — ivabradine, fingolimod, cholinesterase inhibitors
Coronary vasospasm — fluorouracil, capecitabine
QRS widening measured as QT — flecainide, propafenone, tricyclic overdose
Amplifiers — low K⁺/Mg²⁺, CYP3A4 inhibitors, a second QT drug

Open the QT prolongation presentation →

Drugs with this mechanism (146)

8-OH-Amoxapine Loxapine inhaled Ajmaline Amiodarone Amisulpride Amitriptyline Amoxapine Apomorphine Aripiprazole lauroxil LAI Aripiprazole lauroxil LAI Aripiprazole monohydrate LAI Aripiprazole monohydrate LAI Azithromycin Bedaquiline Ceritinib Chloroquine Chlorpromazine Chlorpromazine injection Cibenzoline Cilostazol Ciprofloxacin Cisapride Citalopram Clarithromycin Clomipramine Clozapine Crizotinib Dasatinib Dehydroaripiprazole Desipramine Desmethylclomipramine (Desmethyl-) mirtazapine Desmethylsertraline Disopyramide Dofetilide Dolasetron Domperidone Donepezil Doxepin Dronedarone Droperidol Efavirenz Erythromycin Escitalopram Ezogabine Clozapine ODT Fluconazole Fluphenazine Fluphenazine decanoate LAI Gemifloxacin Gepirone Gepotidacin Granisetron Haloperidol Haloperidol decanoate LAI Haloperidol injection Hydroquinidine Hydroxychloroquine Hydroxynefazodone Hydroxyzine HCl Hydroxyzine IM Hydroxyzine pamoate Ibogaine Ibutilide Iloperidone Imipramine Isoflurane Ketoconazole Lapatinib Levofloxacin Lofexidine Loperamide Loxapine Maprotiline Methadone Mianserin Mifepristone Milsaperidone Mirtazapine Mitragynine Moxifloxacin NAPA Nemonoxacin Nilotinib Norclozapine Nordoxepin Norquetiapine Ofloxacin Olanzapine Olanzapine IM Olanzapine pamoate LAI Olanzapine SubQ LAI Oliceridine Ondansetron Osimertinib Pacritinib Paliperidone Panobinostat Pentamidine Perphenazine Pimavanserin Pimozide Pitolisant Posaconazole Procainamide Prochlorperazine Promethazine Promethazine injection Protriptyline Quetiapine Quinidine Quizartinib R-Methadone Ranolazine Remimazolam Ribociclib Risperidone Rucaparib S-Methadone Saquinavir Quetiapine XR Sevoflurane Doxepin low-dose (insomnia) Sorafenib Sotalol Sparfloxacin Sulpiride Tacrolimus Telithromycin Tetrabenazine Thioridazine Thiothixene Tolterodine Toremifene Trazodone Trifluoperazine Trimipramine Valbenazine Vandetanib Vemurafenib Vepdegestrant Clozapine oral suspension Voclosporin Voriconazole Ziprasidone Ziprasidone IM

All mechanisms · Open hERG blocker in the interactive console ↗