Barw Barw Medical Journal 2960-1959 2026 06 20 Torsades de Pointes Following Ondansetron Administration: A Case Report with literature review 60 64 10.58742/bmj.v4i1.232 eng Swara H. Abdullah Department of Medicine, Shar Hospital, Malik Mahmud Ring Road, Sulaymaniyah, Iraq. swara.abdullah@gmail.com Shaho F. Ahmed Department of Endocrinology, Shar Hospital, Malik Mahmud Ring Road, Sulaymaniyah, Iraq|Department of Endocrinology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. Shaho.Ahmed@gmail.com Soran H. Tahir Department of Clinical Sciences, College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. Soran.Tahir@gmail.com Dana HB. Mohammed Saeed Department of Cardiology, Suleimani Centre for Heart Disease, Zanko Street, Sulaymaniyah, Iraq | Department of Cardiology, Suleimani Centre for Heart Disease, Zanko Street, Sulaymaniyah, Iraq. Dana.HamaBaqi@gmail.com Farman J. Ahmed Department of Cardiology, Suleimani Centre for Heart Disease, Zanko Street, Sulaymaniyah, Iraq. Farman.Ahmed@gmail.com Aso N. Qadir Department of Endocrinology, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. Aso.Qadir@gmail.com Karokh F. HamaHussein Department of Gastroenterology and Hepatology, Gastroenterology and Hepatology Teaching Hospital, Zanko Street, Sulaymaniyah, Iraq. Karokh.Fazil@gmail.com Las Hussain Department of Scientific Affairs, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. hlasslatif2@gmail.com Omar N. Mohammed Department of Cardiology, Suleimani Centre for Heart Disease, Zanko Street, Sulaymaniyah, Iraq. Omar.Mohammed@gmail.com Payam K. Abdulrahman Department of Clinical Pharmacy, Hiwa Cancer Hospital, Kani Ba Street, Sulaymaniyah, Iraq. Payam.Abdulrahman@gmail.com 2026 04 20 Introduction Ondansetron blocks human ether-à-go-go-related gene (hERG) potassium channels, causing QT prolongation and risk of torsades de pointes (TdP). Despite its widespread use, TdP following a standard intravenous dose is rarely reported. This report presents a case of a 40-year-old female who developed TdP after receiving an 8 mg intravenous dose of ondansetron. Case Presentation A 40-year-old female with no significant past medical history presented with vomiting and diarrhea. Approximately 30 minutes after receiving 8 mg of intravenous ondansetron, she developed TdP requiring cardioversion. Laboratory results revealed mild hypokalemia (3.12 mmol/L). Post-event troponin elevation and Grade I diastolic dysfunction suggested transient myocardial involvement. She was stabilized with potassium replacement and supportive care, with full recovery. Literature Review Five cases of ondansetron-induced TdP were reviewed. Patient ages ranged from 41 to 60 years, one case (20%) involved oral administration and four cases (80%) involved intravenous administration. Doses ranged from standard 4 mg to cumulative 36 mg infusions, with QTc intervals reaching up to 653 ms. Presenting events included TdP, ventricular tachycardia, and cardiac arrest. Symptom resolution and recovery were achieved in all cases following medical intervention and electrolyte correction. Conclusion This case highlights that standard-dose ondansetron can precipitate TdP in physiologically unstable patients.