QT Prolongation With Methadone, Donepezil, and Ibogaine
September 2, 2026 Scott R. Beach
When QT risk is a concern, consider buprenorphine over methadone. QT prolongation occurs in approximately 34% of methadone maintenance patients, and torsades in roughly 2%. Ibogaine carries a high risk of QT prolongation and torsades. Stanford developed a protocol to pre-dose patients with magnesium to reduce this risk. Evidence on donepezil's QT risk remains mixed. Case reports link it to QT...