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Q. Does prolong use of Klonopin increase the risk of QT prolongation or other heart problems?

Answered by
Dr. Vivek Pillai
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 07, 2020

Hello doctor,

I have been suffering from panic attacks and anxiety for several years, and on top of that essential tremor affects my everyday life. A couple of weeks ago, my doctor prescribed Klonopin (Clonazepam) for me, but there are some things I am worried about after googling a bit. Does Klonopin increase the risk of QT prolongation or other serious heart problems? I just do not want to take any risk, because I have been suffering form PVCs every day for over a year. Sometimes I have also bradycardia and every now and then short burst of an accelerated heartbeat with fluttering sensation. They are still under investigation. I have had lots of ECGs, and at one my QT, QTc was 412, 447 at a heart rate of 71 bpm. And I would not like to make my QT any longer.

I have also used Oxazepam. Is it a safer option when it comes to the risk of QT prolongation or can I continue taking Klonopin?

#

Hello,

Welcome to icliniq.com.

Long term Clonazepam, as well as high dose clonazepam, puts you at a risk for developing acquired long QT, having said that a QTC of 447 msec is within the prescribed i.e < 460 msec limit for women.

Oxazepam is safer but if you combine either of these with another QT prolonging drug, the QT may become dangerously prolonged, also avoid a low potassium blood level and diuretics (medications which promote urination).

Your description of PVCs leads me to suggest a Holter and ECG just to rule out any pause dependent arrhythmia. Do get an echo done to rule out structural heart disease.


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