5 Dead. Abbreviated T itle: STAT Trial Version Date : 08/17/2022 125 16.2 APPENDIX B: DRUGS KNOWN TO SIGNIFICANTLY PROLONG THE QTC* Generic Name* Brand Name* Aclarubicin Aclacin and others Amiodarone Cordarone and others Anagrelid e Agrylin and others Arsenic trioxide Trisenox Astemizole Hismanal Azithromycin Zithro max and others Bepridil Vascor Chloroquine Aralen Chlorpromazine Thorazine and others Cilostazol Pletal Ciprofloxacin Cipro and others Cisapride Propulsid Citalopram Celexa and others Clarithromycin Biaxin and others Cocaine Cocaine Disopyramide Norpace Dofetilide Tikosyn Domp erido ne Motilium and others Donepezil Aricept Dronedarone Multaq Droperidol Inapsine and others Erythromycin E.E.S. and others Escitalopram Cipralex and othe rs Flecainide Tambocor and others Fluconazole Diflucan and others Gatif loxacin Tequin Grepafloxacin Raxar Halofantrine Halfan Generic Name* Brand Name* Haloperidol Haldol (US & UK) and others Ibogaine None Ibutilide Corvert Levofloxacin Levaquin and others Levomepromazine (methotrimeprazine) Nosinan and others Levomethadyl acetate Orlaam L evosulpiride Lesuride and others Mesoridazine Serentil Methadone Dolophine and others Moxifloxacin Avelox and others Ondansetron Zofran and others Oxaliplatin Eloxatin Papaverine HCl ( Intraco ronary) None Pentamidine (systemic) Pentam Abbreviated T itle: STAT Trial Version Date : 08/17/2022 126 Pimozide Orap Probucol Lorelco Procainamide Pronestyl and others Propofol Diprivan and others Quinidine Quinaglut e and others Roxithromycin Rulide and others Sevoflurane Ultane and others Sotalol Betapace and others Sparfloxacin Zagam Sulpiride Dogmatil and others Sultopride Barnetil and others Terfenadine Seldane Terlipressin Teripre ss and others Terodiline Micturin and others Thioridazine Mellaril and others Vandetanib Caprelsa * CredibleMeds.org Abbreviated T itle: STAT Trial Version Date : 08/17/2022 127 16.3 APPENDIX C PARTICIPANT ’S MEDICATION DIARY ________________________ 16.3.1 Lead In Participant ’s ID _________________________ Treatment LEAD IN:_____________________ Part icipant SX-682 Dose:________ __________ Treatment Dates:______________________ INSTRUCTIONS TO THE PARTICIPANT : 1. Complete this form for two -week per iod on the trial.