supplement supplemental table 1supplement supplemental table 1: clinical parameters of...

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Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW), human plasma protein binding (PPB) percentage, and unbound effective therapeutic plasma concentration (ETPC free ). Many of these drugs are viewed as safe, not regulated by the United States Food and Drug Administration (FDA), and are available over the counter (OTC). Where necessary, ETPC free was calculated from reported maximum plasma concentrations using MW and PPB. Where multiple reports of PPB were available, the minimum value was used in calculations. Compound Indication FDA Approval Status MW PPB ETPC free Range [M] References Acetaminophen analgesic and antipyretic OTC 151.2 77.5 1.5E-05 7.4E-05 (1-3) Ascorbic Acid antioxidant OTC 176.1 0.0 2.3E-05 1.0E-04 (4; 5) Aspirin analgesic and antipyretic OTC 180.2 55.0 3.7E-04 7.5E-04 (6; 7) Caffeine stimulant and diuretic OTC 194.2 17.0 2.1E-05 1.7E-04 (8) Ceftriaxone antibiotic 1984 554.6 83.3 1.5E-07 9.0E-05 (6; 9) Cilostazol phosphodiesterase inhibitor 1999 369.5 95.0 1.1E-07 1.8E-07 (10-12) Ciprofloxacin antibiotic 2004 311.3 20.0 5.1E-06 1.3E-05 (13-15) Clozapine antipsychotic 1989 326.8 94.5 3.8E-09 4.6E-08 (16-19) Desvenlafaxine antidepressant 2008 263.4 30.0 4.3E-07 6.2E-07 (20; 21) Diltiazem vasodilator (calcium channel blocker) 1982 414.5 80.0 3.5E-08 7.3E-08 (22-24) Duloxetine Oxalate antidepressant 2004 297.4 95.0 5.9E-09 1.5E-08 (25-27) Eltrombopag hematopoietic 2008 564.7 99.0 3.0E-09 1.9E-08 (28) Famotidine antihistamine 1998 337.4 15.0 1.5E-07 4.5E-07 (29-32) Fluconazole antifungal 1990 306.3 11.0 7.6E-06 4.1E-05 (16; 33) Fluoxetine antidepressant 1987 309.3 94.5 2.3E-09 1.3E-08 (25; 34-36) Fluvoxamine antipsychotic 1994 434.4 80.0 4.1E-08 2.5E-07 (37) Lamivudine antiviral 1995 229.3 36.0 2.8E-06 1.4E-05 (38-40) Lamotrigine antiepileptic 1994 256.1 55.0 9.5E-07 3.0E-06 (41-43) Linezolid antibacterial 2000 337.4 31.0 6.3E-06 4.3E-05 (44) Lopinavir antiretroviral 2000 628.8 98.0 3.1E-07 3.8E-07 (45) Loratadine antihistamine 1993 382.9 97.0 3.7E-10 2.3E-09 (25; 46; 47) Metronidazole antibacterial 1981 171.2 11.0 3.1E-05 2.1E-04 (22; 25; 48) Mexiletine antiarrhythmic (class IB) 1998 215.7 70.0 4.7E-07 1.1E-06 (22; 49) Mibefradil antihypertensive (calcium antagonist) Approved 1997 Withdrawn 1998* 568.6 99.6 1.9E-07 1.1E-05 (50) Mitoxantrone antineoplastic 1996 517.4 78.0 2.8E-08 6.8E-08 (51; 52) Nebivolol antihypertensive (beta-blocker) 2007 441.9 98.0 6.7E-11 8.6E-10 (53-56) Nelfinavir antiretroviral 1997 567.8 98.0 1.1E-07 1.7E-07 (57) Nifedipine antihypertensive (calcium channel block) 1989 346.3 97.0 2.3E-09 1.0E-08 (22; 58; 59) Nitrendipine antihypertensive (calcium channel block) - 360.4 99.0 1.8E-10 1.2E-09 (22; 60-63) Olanzapine antipsychotic 1996 312.4 93.0 1.3E-09 4.4E-09 (17; 64; 65) Paroxetine antidepressant 1992 374.8 93.0 1.2E-09 1.2E-08 (66; 67) Phenytoin antiepileptic 1956 252.3 84.4 4.0E-06 1.1E-05 (3; 68; 69) Piperacillin antibacterial 1993 517.6 30.0 1.8E-07 4.0E-07 (25; 70) Propranolol antihypertensive (beta-blocker) 2003 295.8 86.6 1.2E-08 7.3E-08 (16; 71) Quetiapine antipsychotic 1997 883.1 83.0 9.5E-08 2.1E-07 (72-74) Raltegravir antiretroviral 2007 482.5 83.0 1.4E-08 4.0E-08 (75) Ribavirin antiviral 1998 482.5 83.0 1.4E-08 4.0E-08 (25; 76) Ritonavir antiretroviral 1996 721.0 98.0 4.5E-07 7.4E-07 (77; 78) Sildenafil phosphodiesterase inhibitor 1998 666.7 88.5 2.2E-08 2.0E-07 (16; 79; 80) Silodosin alpha-blocker 2008 495.5 97.0 1.4E-09 5.7E-09 (81-83) Sitagliptin peptidase inhibitor 2006 523.3 38.0 2.1E-07 1.1E-06 (84-86) Tadalafil phosphodiesterase inhibitor 2003 389.4 94.0 1.5E-08 5.0E-08 (87; 88) Telbivudine antiviral 2006 242.2 3.3 8.0E-07 2.2E-05 (89; 90) Vardenafil phosphodiesterase inhibitor 2003 579.1 95.0 6.9E-07 1.8E-06 (91-93) Verapamil antihypertensive (calcium channel block) 1998 491.1 90.0 2.5E-08 8.1E-08 (6; 94) Voriconazole antifungal 2004 349.3 58.0 3.0E-06 4.6E-06 (95) *Mebefradil was withdrawn for potentially fatal interactions with more than 25 other compounds. The danger apparently arises from the reduction of activity of liver enzymes (96), which may increase plasma concentrations of concomitantly administered drugs to dangerous levels.

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Page 1: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW), human plasma protein binding (PPB) percentage, and unbound effective therapeutic plasma concentration (ETPCfree). Many of these drugs are viewed as safe, not regulated by the United States Food and Drug Administration (FDA), and are available over the counter (OTC). Where necessary, ETPCfree was calculated from reported maximum plasma concentrations using MW and PPB. Where multiple reports of PPB were available, the minimum value was used in calculations.

Compound Indication FDA Approval

Status MW PPB ETPCfree

Range [M] References

Acetaminophen analgesic and antipyretic OTC 151.2 77.5 1.5E-05 7.4E-05 (1-3)

Ascorbic Acid antioxidant OTC 176.1 0.0 2.3E-05 1.0E-04 (4; 5)

Aspirin analgesic and antipyretic OTC 180.2 55.0 3.7E-04 7.5E-04 (6; 7)

Caffeine stimulant and diuretic OTC 194.2 17.0 2.1E-05 1.7E-04 (8)

Ceftriaxone antibiotic 1984 554.6 83.3 1.5E-07 9.0E-05 (6; 9)

Cilostazol phosphodiesterase inhibitor 1999 369.5 95.0 1.1E-07 1.8E-07 (10-12)

Ciprofloxacin antibiotic 2004 311.3 20.0 5.1E-06 1.3E-05 (13-15)

Clozapine antipsychotic 1989 326.8 94.5 3.8E-09 4.6E-08 (16-19)

Desvenlafaxine antidepressant 2008 263.4 30.0 4.3E-07 6.2E-07 (20; 21)

Diltiazem vasodilator (calcium channel blocker) 1982 414.5 80.0 3.5E-08 7.3E-08 (22-24)

Duloxetine Oxalate antidepressant 2004 297.4 95.0 5.9E-09 1.5E-08 (25-27)

Eltrombopag hematopoietic 2008 564.7 99.0 3.0E-09 1.9E-08 (28)

Famotidine antihistamine 1998 337.4 15.0 1.5E-07 4.5E-07 (29-32)

Fluconazole antifungal 1990 306.3 11.0 7.6E-06 4.1E-05 (16; 33)

Fluoxetine antidepressant 1987 309.3 94.5 2.3E-09 1.3E-08 (25; 34-36)

Fluvoxamine antipsychotic 1994 434.4 80.0 4.1E-08 2.5E-07 (37)

Lamivudine antiviral 1995 229.3 36.0 2.8E-06 1.4E-05 (38-40)

Lamotrigine antiepileptic 1994 256.1 55.0 9.5E-07 3.0E-06 (41-43)

Linezolid antibacterial 2000 337.4 31.0 6.3E-06 4.3E-05 (44)

Lopinavir antiretroviral 2000 628.8 98.0 3.1E-07 3.8E-07 (45)

Loratadine antihistamine 1993 382.9 97.0 3.7E-10 2.3E-09 (25; 46; 47)

Metronidazole antibacterial 1981 171.2 11.0 3.1E-05 2.1E-04 (22; 25; 48)

Mexiletine antiarrhythmic (class IB) 1998 215.7 70.0 4.7E-07 1.1E-06 (22; 49)

Mibefradil antihypertensive (calcium antagonist) Approved 1997

Withdrawn 1998* 568.6 99.6 1.9E-07 1.1E-05 (50)

Mitoxantrone antineoplastic 1996 517.4 78.0 2.8E-08 6.8E-08 (51; 52)

Nebivolol antihypertensive (beta-blocker) 2007 441.9 98.0 6.7E-11 8.6E-10 (53-56)

Nelfinavir antiretroviral 1997 567.8 98.0 1.1E-07 1.7E-07 (57)

Nifedipine antihypertensive (calcium channel block) 1989 346.3 97.0 2.3E-09 1.0E-08 (22; 58; 59)

Nitrendipine antihypertensive (calcium channel block) - 360.4 99.0 1.8E-10 1.2E-09 (22; 60-63)

Olanzapine antipsychotic 1996 312.4 93.0 1.3E-09 4.4E-09 (17; 64; 65)

Paroxetine antidepressant 1992 374.8 93.0 1.2E-09 1.2E-08 (66; 67)

Phenytoin antiepileptic 1956 252.3 84.4 4.0E-06 1.1E-05 (3; 68; 69)

Piperacillin antibacterial 1993 517.6 30.0 1.8E-07 4.0E-07 (25; 70)

Propranolol antihypertensive (beta-blocker) 2003 295.8 86.6 1.2E-08 7.3E-08 (16; 71)

Quetiapine antipsychotic 1997 883.1 83.0 9.5E-08 2.1E-07 (72-74)

Raltegravir antiretroviral 2007 482.5 83.0 1.4E-08 4.0E-08 (75)

Ribavirin antiviral 1998 482.5 83.0 1.4E-08 4.0E-08 (25; 76)

Ritonavir antiretroviral 1996 721.0 98.0 4.5E-07 7.4E-07 (77; 78)

Sildenafil phosphodiesterase inhibitor 1998 666.7 88.5 2.2E-08 2.0E-07 (16; 79; 80)

Silodosin alpha-blocker 2008 495.5 97.0 1.4E-09 5.7E-09 (81-83)

Sitagliptin peptidase inhibitor 2006 523.3 38.0 2.1E-07 1.1E-06 (84-86)

Tadalafil phosphodiesterase inhibitor 2003 389.4 94.0 1.5E-08 5.0E-08 (87; 88)

Telbivudine antiviral 2006 242.2 3.3 8.0E-07 2.2E-05 (89; 90)

Vardenafil phosphodiesterase inhibitor 2003 579.1 95.0 6.9E-07 1.8E-06 (91-93)

Verapamil antihypertensive (calcium channel block) 1998 491.1 90.0 2.5E-08 8.1E-08 (6; 94)

Voriconazole antifungal 2004 349.3 58.0 3.0E-06 4.6E-06 (95)

*Mebefradil was withdrawn for potentially fatal interactions with more than 25 other compounds. The danger apparently arises from the reduction of activity of liver enzymes (96), which may increase plasma concentrations of concomitantly administered drugs to dangerous levels.

Page 2: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplemental Table 2: Clinical parameters of QT-prolonging drugs, including mode of action, United States Food and Drug Administration (FDA) approval status, molecular weight (MW), human plasma protein binding (PPB) percentage, and unbound effective therapeutic plasma concentration (ETPCfree). Where necessary, ETPCfree was calculated from reported maximum plasma concentrations using MW and PPB. Where multiple reports of PPB were available, the minimum value was used in calculations.

Compound Indication FDA Approval

Status MW PPB ETPCfree

Range [M] References

Alfuzosin prostatic hyperplasia 2003 425.9 82 5.7E-09 5.9E-09 (97; 98)

Amiodarone antiarrhythmic (class III) 1985 681.0 96 1.0E-10 3.7E-06 (99-103)

Amitriptyline antidepressant (tricyclic) 1976 277.4 91.4 4.6E-09 7.9E-07 (16; 99; 104-

107)

Arsenic Trioxide oncology 2000 125.9 5.5 1.5E-07 5.2E-07 (108; 109)

Astemizole antihistamine (2nd generation) Approved 1988 Withdrawn 1999 458.6 96.7 5.3E-11 7.8E-09 (99; 110; 111)

Bepridil antiarrhythmic (class I and IV) Approved 1990 Withdrawn 2004 384.5 95.4 1.0E-08 3.3E-06 (16; 99; 112)

Chlorpromazine antipsychotic 1954 355.3 91 3.0E-09 9.8E-07 (99; 113-116)

Cibenzoline antiarrhythmic (class Ia, 3, 4) - 262.4 50 1.1E-07 1.6E-06 (99; 117-120)

Cisapride gastrointestinal

Approved 1993

Withdrawn 2000 465.9 97.5 2.0E-09 1.3E-07 (99; 121-124)

Clemastine antihistamine (1st generation) 1977 344.0 98 3.4E-11 4.7E-09 (99; 125-127)

Dasatinib oncology 2006 488.0 96 1.4E-09 9.2E-09 (128; 129)

Desipramine antidepressant (tricyclic) 1964 266.3 80 1.1E-08 6.0E-07 (99; 116; 130;

131)

Diphenhydramine antihistamine (1st generation) 1946 291.8 74 2.2E-08 2.2E-07 (99; 132-134)

Disopyramide antiarrhythmic (class Ia) 1977 339.5 51 2.5E-07 1.2E-05 (99; 135; 136)

Dofetilide antiarrhythmic (class III) 1999 441.6 60 4.0E-10 9.1E-09 (99; 137; 138)

Donepezil Alzheimer's (cholinesterase inhibitor) 1996 379.5 60 3.4E-09 6.4E-08 (139; 140)

Droperidol antiemetic and antipsychotic Approved 1970 Withdrawn 2001 379.4 75 6.6E-08 1.6E-07 (99; 141-143)

Erythromycin antibiotic 1981 733.9 64.5 1.0E-07 3.4E-05 (99; 144-149)

Flecainide antiarryhthmic (class Ic) 1985 414.4 61 3.0E-07 1.9E-06 (99; 116; 150)

Grepafloxacin antibiotic Approved 1997 Withdrawn 1999 359.4 50 6.3E-07 4.4E-06 (99; 151-153)

Halofantrine antimalarial 1992 536.9 83 2.7E-07 1.0E-06 (99; 154-157)

Haloperidol antiemetic and antipsychotic 1967 375.9 92 1.2E-09 4.5E-08 (99; 158; 159)

Ibutilide antiarryhthmic (class III) 1996 384.6 40 4.7E-10 2.3E-07 (99; 160-164)

Imipramine antidepressant (tricyclic) 1959 949.2 82 5.5E-09 3.2E-07 (16; 116; 165-

167)

Lapatinib oncology (tyrosine kinase inhibitor) 2007 943.5 99 1.1E-08 3.9E-08 (168-173)

Maraviroc antiretroviral 2007 513.7 76 4.7E-08 5.1E-07 (174-177)

Moxifloxacin antibiotic 1999 437.9 70 2.0E-07 4.8E-06 (152; 178-180)

Nilotinib oncology (tyrosine kinase inhibitor) 2007 584.0 98 2.1E-08 1.2E-07 (169; 181-185)

Paliperidone antipsychotic 2006 426.5 74 2.4E-09 6.9E-08 (159; 186-188)

Pentamidine antiprotozoal 1984 592.7 60 8.0E-09 1.0E-06 (99; 189; 190)

Pimozide antipsychotic 1984 461.6 99 8.7E-11 4.3E-10 (99; 159; 191-

194)

Procainamide antiarrhythmic (class Ia) 1950 235.3 14 7.3E-06 6.4E-05 (99; 116; 195-

198)

Quinidine antiarrhythmic (class Ia) 1950 324.4 87 2.9E-07 2.2E-05 (99; 116; 199;

200)

Ranolazine antianginal 2006 427.5 61 6.2E-07 5.2E-06 (201-204)

Risperidone antipsychotic 1993 410.5 88 2.9E-10 1.8E-08 (99; 159)

Sematilide antiarrhythmic (class III) - 312.2 4 2.0E-06 8.3E-06 (99; 205; 206)

Sertindole antipsychotic - 440.9 99 2.0E-11 3.2E-07 (99; 159)

Sotalol (d,l-) antiarrhythmic (class II, III), beta blocker 1992 308.8 0.0 1.3E-06 1.5E-05 (99; 207-210)

Sparfloxacin antibiotic Approved 1996 Withdrawn 2001 392.4 45 2.0E-07 3.4E-06

(99; 151; 152; 211)

Sunitinib oncology (tyrosine kinase inhibitor) 2006 532.6 95 1.9E-09 1.9E-08 (169; 212-215)

Terfenadine antihistamine (2nd generation) Approved 1985 Withdrawn 1998 471.7 97 9.8E-11 9.5E-09 (99; 216-218)

Thioridazine antipsychotic 1962 370.6 45 2.1E-08 1.8E-06 (99; 219-221)

Tolterodine antimuscarinic (urology) 1998 475.6 96.3 8.6E-11 2.2E-09 (222-224)

Ziprasidone antipsychotic 2001 467.4 99.9 2.6E-11 6.8E-10 (225-227)

Page 3: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplemental Table 3: Table of patient unbound drug levels linked to electrophysiological effect by clinical trial. Unbound concentrations are calculated using MW and PPB values in Supplemental Table 2.

Unbound plasma concentrations (PC) are the range of the smallest Cmax (peak concentration) linked to QTc prolongation greater than 10 ms in controlled clinical study cohorts, and the lowest levels linked with increased arrhythmia incidence. Reports are classified according to whether the defined proarrhythmic effect is reported together with PC, or if the effect is reported without documentation of PC.

Compound Clinical QTc Prolongation >10ms

Concentration Range [M] Arrhythmia (min) [M] References With PC

Effect Without PC Report

Long QT Arrhythmia

Alfuzosin (228)

Amiodarone

(229-231) (229; 232-234)

Amitriptyline

(99; 230; 235-237) (236; 238)

Arsenic Trioxide 5.2E-07 5.2E-07

(109) (239; 240) (239-242)

Astemizole

9.9E-10 (234) (99) (243; 244)

Bepridil 7.2E-08 7.2E-08

(245) (99; 246; 247) (233)

Chlorpromazine

(230; 248)

Cibenzoline 1.0E-06 1.2E-06

(99; 118) (249) (233)

Cisapride 6.3E-09 8.3E-09

(124) (230; 250) (250)

Clemastine

(251)

Dasatinib

(252; 253)

Desipramine 5.4E-08 1.3E-07

(254) (99; 230; 255) (238)

Diphenhydramine

(234; 256) (99)

Disopyramide

(99; 230; 249) (233)

Dofetilide 1.0E-09 9.1E-09

(99; 138)

Donepezil

(257) (257; 258)

Droperidol 9.4E-08 9.4E-08

(259) (99; 260-263) (262)

Erythromycin

(99; 230; 264-266) (233; 267)

Flecainide 5.9E-07 7.2E-07

(268; 269) (230; 270-274) (233; 274)

Grepafloxacin

(275) (276)

Halofantrine 2.0E-07 6.8E-07

(99; 277) (155; 278; 279) (280)

Haloperidol 1.6E-09 3.8E-09

(226; 281) (230; 260; 282) (233; 260; 283)

Ibutilide 1.6E-08 1.6E-08 1.6E-08 (160) (164; 284) (233)

Imipramine

(230) (238)

Lapatinib 2.5E-08 2.5E-08

(172) (202; 285)

Maraviroc

(175)

Moxifloxacin 2.1E-06 4.1E-06

(202; 286-288) (178; 215; 230;

289; 290)

Nilotinib 5.7E-08 5.7E-08

(182) (230; 291; 292)

Paliperidone 6.9E-08 6.9E-08

(186) (293) (186)

Pentamidine

(294-296) (294)

Pimozide 9.5E-11 9.5E-11

(194) (230; 260)

Procainamide 1.8E-05 1.8E-05

(99) (230) (233)

Quinidine 6.4E-08 2.3E-06

(99; 199; 200; 297; 298) (200; 230; 299) (233)

Ranolazine 3.5E-06 9.1E-06

(202; 300) (301)

Risperidone

(230; 260; 302) (283; 303)

Sematilide 2.0E-06 6.1E-06 2.5E-06 (99; 205; 304) (305) (205)

Sertindole

(260; 306; 307)

Sotalol (d,l-) 1.3E-06 1.4E-05

(210; 308; 309) (209; 230) (160; 209; 233)

Sparfloxacin 6.2E-07 3.0E-06

(99; 310) (211; 311; 312)

Sunitinib 1.2E-08 1.9E-08

(215) (212) (212)

Terfenadine 2.0E-10 1.3E-09 3.0E-09 (99; 217; 313; 314) (230) (233; 244; 251)

Thioridazine 1.5E-07 1.1E-06

(219; 221; 315; 316) (230; 260) (233; 283)

Tolterodine

(230; 317)

Ziprasidone 3.6E-10 6.8E-10

(226; 315; 318; 319) (220; 230; 260) (319)

Page 4: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplemental Table 4: Table of drug electrophysiological effects observed in in vivo and ex vivo animal studies. Studies included were performed on non-rodent, large animal species such as monkey, rabbit, guinea pig, cat and dog. Peak unbound plasma concentration associated with in vivo QTc prolongation of greater than 10 ms (range of study minimums), or increased arrhythmia incidence (minimum of studies), by whole-animal, close-chested methods such as telemetery or Holter monitor. Unbound concentrations are calculated using MW and PPB values in Supplemental Table 2. Ex vivo preparations include open-

chest and Langendorff studies of the heart, wedge preparations, isolated primary ventricular cardiomyocytes, and Purkinje fibers.

Compound In Vivo QTc

Prolong. >10ms [M] Arrhythmia In Vivo [M]

In Vivo References

Ex Vivo QTc/APD Prolong. >10ms [M]

Arrhythmia Ex Vivo [M]

Ex Vivo References

Alfuzosin

3.0E-08 1.0E-05

(228; 320)

Amiodarone 3.0E-10 2.9E-09 2.9E-09 (99; 321) 1.0E-07 5.9E-05

(99; 322)

Amitriptyline 3.8E-07 3.8E-07 2.1E-06 (323; 324) 1.0E-06 1.0E-05

(99)

Arsenic Trioxide

1.0E-05 3.5E-04 1.0E-05 (239; 325)

Astemizole 7.2E-10 1.0E-05 7.2E-10 (99; 110; 234;

326; 327) 3.0E-10 9.5E-07

(99; 322; 328)

Bepridil 2.6E-08 6.7E-08

(110; 327) 1.0E-07 2.6E-05

(99; 322; 329)

Chlorpromazine

1.0E-05 1.3E-05

(99; 330)

Cibenzoline

Cisapride 2.0E-10 1.3E-07 2.3E-08 (99; 110; 124;

327; 331) 6.0E-09 3.0E-06 1.0E-07 (99; 217; 320; 322;

332)

Clemastine

1.0E-07 1.0E-05 1.0E-07 (99; 322; 330; 333)

Dasatinib

3.0E-05 3.0E-05

(129)

Desipramine Diphenhydramine

2.0E-06 1.0E-05

(99; 234; 330)

Disopyramide

5.0E-06 4.0E-05

(99)

Dofetilide 3.0E-08 3.0E-08

(99) 1.0E-09 1.0E-06 3.0E-09 (99; 320; 322; 332;

334; 335)

Donepezil Droperidol 1.2E-07 1.2E-07

(336) 1.0E-08 1.0E-06 3.0E-08 (99; 336-340)

Erythromycin

1.4E-05 3.0E-04 1.0E-04 (99; 152; 267; 322;

334; 341; 342)

Flecainide 2.7E-06 2.7E-06

(343) 2.4E-06 2.4E-05

(99)

Grepafloxacin

1.4E-05 2.6E-05

(99; 151)

Halofantrine 8.0E-08 8.0E-08

(344) 2.0E-06 2.0E-06

(280)

Haloperidol 2.8E-09 3.5E-08

(110; 327) 2.6E-08 1.0E-07 3.0E-07 (322; 345)

Ibutilide 1.6E-09 1.6E-09

(346) 1.0E-08 1.0E-06

(99; 347)

Imipramine Lapatinib

5.0E-06 5.0E-06

(170; 348)

Maraviroc 4.3E-07 1.2E-06

(174) 3.0E-06 3.0E-06

(174)

Moxifloxacin

3.0E-06 3.0E-05 9.0E-05 (151; 152; 332)

Nilotinib

1.0E-06 1.0E-06

(349)

Paliperidone

1.0E-07 1.0E-06 1.0E-06 (350; 351)

Pentamidine

1.0E-05 3.0E-04

(352-354)

Pimozide 2.2E-10 2.2E-10

(110) 7.5E-08 1.0E-07 3.0E-07 (322; 355)

Procainamide

1.0E-04 1.0E-04

(99)

Quinidine 3.0E-07 2.6E-06 1.4E-07 (99; 110; 326;

327) 2.4E-07 1.0E-06 1.0E-05 (99; 322; 356)

Ranolazine

5.0E-05 1.0E-04

(357)

Risperidone 6.0E-08 6.0E-08

(345) 1.0E-07 1.0E-06 3.0E-07 (121; 329; 332; 345;

358-360)

Sematilide 3.1E-06 1.1E-05 3.1E-06 (99; 321) 1.0E-07 1.0E-05

(99; 347)

Sertindole 1.0E-09 2.0E-07

(99; 260) 3.0E-07 1.0E-06 1.0E-06 (99; 334; 345)

Sotalol (d,l-) 1.3E-06 2.3E-05

(99; 336) 5.0E-07 1.0E-04 1.0E-04

(99; 121; 320; 322; 345; 347; 356; 361-

363)

Sparfloxacin 6.3E-06 9.8E-05

(99; 364) 6.6E-06 1.0E-04 3.0E-05 (99; 151; 152; 322; 332; 334; 364; 365)

Sunitinib 2.7E-08 3.1E-08

(215) 1.0E-06 1.0E-06

(215)

Terfenadine 1.5E-10 3.0E-07

(99; 110; 234; 327) 1.0E-08 1.0E-06 1.0E-08

(99; 217; 322; 328; 330; 356; 366-368)

Thioridazine 2.4E-07 9.1E-07

(110; 327) 3.0E-07 1.0E-05

(99; 322; 340; 367)

Tolterodine

3.2E-08 3.2E-08

(369)

Ziprasidone

1.0E-07 1.0E-06 6.0E-06 (370; 371)

Page 5: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplemental Table 5: Calcium transient prolongation by clinically QT-prolonging drugs in the 90 compound training set, measured by kinetic image cytometry of human iPSC-derived cardiomyocytes. Molar concentrations corresponding to >140% effect size on CTD75, EC20 and EC50 when a fit was possible, cessation of calcium transients are recorded, along with the maximum effect size observed, and other response and protocol notes.

Compound CTD75

>140% [M] CTD75

EC20 [M] CTD75

EC50 [M] CT Stopped

[M] Notes

Alfuzosin 5.0E-06 4.8E-06 6.8E-06 5.0E-04 Prolonged CTD75 to 286% of control

Amiodarone 1.0E-05 9.2E-07 1.6E-06 1.0E-04 Prolonged CTD75 to 141% of control

Amitriptyline

8.69E-10 8.69E-10 1.0E-05 Prolonged CTD75 to 115% of control

Arsenic Trioxide

1.75E-01 2.45E+01 With 48 hour exposure, CTD75 prolonged to 126% of control.

Cytotoxicity noted at 100 µM

Astemizole 1.0E-09 4.0E-10 1.1E-09 1.0E-07 Prolonged CTD75 to 345% of control

Bepridil 1.0E-06 7.2E-08 1.5E-07 1.0E-05 Prolonged CTD75 to 178% of control

Chlorpromazine

1.0E-05 Prolonged CTD75 to 124% of control

Cibenzoline 1.0E-05 7.5E-07 1.7E-06 Prolonged CTD75 to 141% of control

Cisapride 1.0E-07 1.0E-07 1.6E-07 Prolonged CTD75 to 337% of control

Clemastine 1.0E-07 2.6E-08 9.8E-08 1.0E-05 Prolonged CTD75 to 445% of control

Dasatinib 1.0E-06 5.1E-07 5.8E-07 With 4 hour exposure, CTD75 prolonged to 162% of control

Desipramine

9.23E-10 1.11E-09 1.0E-05 Prolonged CTD75 to 111% of control

Diphenhydramine 1.0E-05 8.5E-07 1.5E-06 Prolonged CTD75 to 175% of control

Disopyramide 1.0E-05 1.0E-05 1.6E-05 Prolonged CTD75 to 343% of control

Dofetilide 1.0E-08 2.5E-10 3.0E-09 Prolonged CTD75 to 452% of control

Donepezil 1.0E-05

1.0E-04 Prolonged CTD75 to 477% of control

Droperidol 5.0E-08 1.2E-07 1.7E-07 1.0E-06 Prolonged CTD75 to 472% of control

Erythromycin 5.0E-04

Prolonged CTD75 to 219% of control DMSO 0.5% in all doses and controls

Flecainide 1.0E-05

1.0E-04 Prolonged CTD75 to 175% of control

Grepafloxacin

Prolonged CTD75 to 112% of control

Halofantrine 1.0E-06

Prolonged CTD75 to 236% of control

Haloperidol 5.0E-08 1.5E-07 5.7E-07 Prolonged CTD75 to 384% of control

Ibutilide 1.0E-09 Prolonged CTD75 to 322% of control

Imipramine

5.27E-09 2.20E-08 1.0E-06 Prolonged CTD75 to 113% of control

Lapatinib

6.81E-06 8.53E-06 Prolonged CTD75 to 133% of control.

Cytotoxicity noted.

Maraviroc 1.0E-04

Prolonged CTD75 to 332% of control

Moxifloxacin 1.0E-04

Prolonged CTD75 to 154% of control

Nilotinib

1.0E-04 With 48 hour exposure, CTD75 prolonged to 105% of control.

Cytotoxicity noted.

Paliperidone 1.0E-06

Prolonged CTD75 to 448% of control

Pentamidine 1.0E-05

1.0E-04 With 48 hour exposure, CTD75 prolonged to 476% of control

Cytotoxicity noted at 10 µM

Pimozide 1.0E-09 8.8E-11 1.5E-10 1.0E-07 Prolonged CTD75 to 227% of control

Procainamide 1.0E-04 5.8E-05 9.9E-05 Prolonged CTD75 to 183% of control

Quinidine 5.0E-06 9.9E-07 2.9E-06 5.0E-04 Prolonged CTD75 to 329% of control DMSO 0.5% in all doses and controls

Ranolazine 2.0E-05 1.8E-06 5.4E-06 1.0E-04 Prolonged CTD75 to 156% of control

Risperidone 5.0E-07 5.8E-07 8.3E-07 Prolonged CTD75 to 427% of control

Sematilide 1.0E-05 7.7E-06 4.1E-05 Prolonged CTD75 to 292% of control

Sertindole 1.0E-07 9.1E-08 1.7E-07 1.0E-05 Prolonged CTD75 to 357% of control

Sotalol (d,l-) 3.1E-05 3.5E-05 5.5E-05 Prolonged CTD75 to 569% of control

Sparfloxacin 1.0E-04 Prolonged CTD75 to 365% of control

Sunitinib 1.0E-05

1.0E-04 Prolonged CTD75 to 162% of control

Terfenadine

5.5E-08 7.8E-08 2.5E-06 Prolonged CTD75 to 134% of control

Thioridazine 2.5E-06 6.1E-07 1.4E-06 1.0E-05 Prolonged CTD75 to 166% of control

Tolterodine 1.0E-07 1.0E-04 Prolonged CTD75 to 425% of control

Ziprasidone 1.0E-06 1.2E-07 1.6E-07 Prolonged CTD75 to 360% of control

Page 6: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

Supplemental Table 6: Assessment of CTD75 prolongation by QT prolonging and non-prolonging compounds in the blinded 35 compound test set. The test set includes 16 compounds carried over from the 90 compound training set, 2 tested twice with separate concentration titrations, and 17 new compounds (effect referenced). Test concentrations causing CTD75 prolongation beyond 140% of control calcium transient duration or causing cessation of spontaneous calcium transient activity are tabulated.

QT Prolonging Compounds QT Non-Prolonging Compounds

Compound Name CTD75 Prolongation CT Stopped Compound Name CTD75 Prolongation CT Stopped

Arsenic trioxide Not Detected

Aspirin Not Detected

Azithromycin (230; 372) Not Detected

Forskolin Not Detected Barium chloride (373) Not Detected

Levcromakalim Not Detected 10uM

Bay K8644 (374) 25nM 100uM Mexiletine (Set 1) Not Detected 100uM

Bepridil (Set 1) Not Detected 10uM Mexiletine (Set 2) Not Detected 50uM

Bepridil (Set 2) 1.11uM 10uM Nicorandil Not Detected Chlorpromazine Not Detected 5uM Nimodipine Not Detected 10uM

Dimenhydrinate (375) 10uM 100uM Nisoldipine Not Detected 1uM

Dofetilide 1nM

Nitrendipine Not Detected 1uM

E4031 (376) 10nM

NS1463 Not Detected 100uM

Flecainide 1uM 100uM Pinacidil Not Detected Ibutilide 1nM

Primidone Not Detected

Mesoridazine (219) 10uM

Serotonin Not Detected

Procainamide Not Detected

Verapamil Not Detected 10uM

Propoxyphene (377) 10uM 100uM Quinidine 10uM 100uM Ranolazine 100uM

Spafloxacin 100uM Sunitinib 11.1uM Terfenadine Not Detected 10uM

Veratridine (378) 10uM 100uM

Page 7: Supplement Supplemental Table 1Supplement Supplemental Table 1: Clinical parameters of non-QT-prolonging drugs, including mode of action, regulatory status, molecular weight (MW),

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