Amiodarone Hydrochloride interactions

Food & lifestyle

• grapefruit juice

  Major

  Metabolism

  Grapefruit juice may significantly increase the plasma concentrations of orally administered amiodarone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits.

  What to do: Patients treated with oral amiodarone should avoid consumption of grapefruits and grapefruit juice. In addition, oral amiodarone should be administered consistently with regard to meals.

  3 sources

  1. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  2. Libersa CC, Brique SA, Motte KB, et al. "Dramatic inhibition of amiodarone metabolism induced by grapefruit juice." Br J Clin Pharmacol 49 (2000): 373-8
  3. Meng X, Mojaverian P, Doedee M, Lin E, Weinryb I, Chiang ST, Kowey PR "Bioavailability of Amiodarone tablets administered with and without food in healthy subjects." Am J Cardiol 87 (2001): 432-5

Conditions

Conditions in which Amiodarone Hydrochloride needs care, as documented in this source.

• Arrhythmias, Cardiac

  Major

  Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.

  62 sources

  1. Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
  2. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
  3. Strasberg B, Sclarovsky S, Erdberg A, et al. "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
  4. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
  5. Lo KS, Gantz KB, Stetson PL, et al. "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
  6. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
  7. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
  8. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7

  Show all 62 sourcesShow fewer sources

  9. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
  10. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
  11. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
  12. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
  13. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
  14. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
  15. Damle R, Levine J, Matos J, et al. "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
  16. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
  17. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
  18. Hii JT, Wyse DG, Gillis AM, et al. "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
  19. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
  20. Bauman JL, Bauernfeind RA, Hoff JV, et al. "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
  21. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
  22. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
  23. Au PK, Bhandari AK, Bream R, et al. "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
  24. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
  25. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
  26. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
  27. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
  28. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
  29. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
  30. "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
  31. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
  32. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  33. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals (2002):
  34. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
  35. "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
  36. "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
  37. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
  38. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
  39. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
  40. "Product Information. Adenocard (adenosine)." Fujisawa (2001):
  41. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):
  42. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
  43. "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
  44. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
  45. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
  46. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7
  47. "Product Information. Norpace (disopyramide)." Searle (2001):
  48. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
  49. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
  50. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
  51. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
  52. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
  53. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  54. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
  55. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  56. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
  57. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):
  58. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
  59. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
  60. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
  61. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
  62. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22

• Cardiomyopathies

  Major

  Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

  17 sources

  1. Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
  2. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
  3. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
  4. Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
  5. Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
  6. Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
  7. Prescott LF, Adjepon-Yamoah KK, Talbot RG "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J 1 (1976): 939-41
  8. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):

  Show all 17 sourcesShow fewer sources

  9. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
  10. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
  11. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  12. "Product Information. Adenocard (adenosine)." Fujisawa (2001):
  13. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
  14. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  15. Singh SN, Fletcher RD, Fisher SG, et al. "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med 333 (1995): 77-82
  16. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  17. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):

• Diseases requiring dialysis

  Major

  Amiodarone and its active metabolite are not removed by hemodialysis.

  4 sources

  1. Jacobs MB "Serum creatinine increase associated with amiodarone therapy." N Y State J Med 87 (1987): 358-9
  2. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  3. Pollak PT, Sharma AD, Carruthers SG "Creatinine elevation in patients receiving amiodarone correlates with serum amiodarone concentration." Br J Clin Pharmacol 36 (1993): 125-7
  4. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):

• Respiratory Insufficiency

  Major

  Pulmonary toxicities such as hypersensitivity pneumonitis or interstitial/alveolar pneumonitis are potentially fatal (approximately 10% of the time) and have occurred in as many as 10% to 17% of patients administered daily dosages of approximately 400 mg of amiodarone. More frequently, asymptomatic abnormal diffusion capacity has been observed. Patients with preexisting pulmonary dysfunction does not appear to have an increased risk of pulmonary toxicity; however, they have a poorer prognosis if toxicity does develop. Thus, the risks and benefits of amiodarone therapy should be weighed carefully. Clinical monitoring of pulmonary function, including chest X-ray (baseline and every 3 to 6 months) and pulmonary function tests (with diffusion capacity), is recommended in all patients receiving amiodarone therapy. Any new respiratory symptom during treatment should be evaluated promptly and thoroughly, since toxicity is more likely to be reversible if diagnosed and managed early. Patients who develop hypersensitivity pneumonitis should be withdrawn permanently from amiodarone therapy and treated with steroids. In the case of interstitial/alveolar pneumonitis, steroid therapy and dosage reduction or discontinuation of amiodarone, if possible, usually result in clinical improvement. Subsequent rechallenge with amiodarone at reduced dosages does not always lead to return of toxicity and may be considered in some patients. The use of a lower loading dose and maintenance doses may also decrease the incidence of amiodarone- induced pulmonary toxicity.

  24 sources

  1. Rakita L, Sobol SM, Mostow N, Vrobel T "Amiodarone pulmonary toxicity." Am Heart J 106 (1983): 906-16
  2. Pollak PT, Sharma AD, Carruthers SG "Relation of amiodarone hepatic and pulmonary toxicity to serum drug concentrations and superoxide dismutase activity." Am J Cardiol 65 (1990): 1185-91
  3. Pollak PT, Sami M "Acute necrotizing pneumonitis and hyperglycemia after amiodarone therapy." Am J Med 76 (1984): 935-9
  4. Piccione W Jr, Faber LP, Rosenberg MS "Amiodarone-induced pulmonary mass." Ann Thorac Surg 47 (1989): 918-9
  5. Manolis AS, Tordjman T, Mack KD, Estes NA III "Atypical pulmonary and neurologic complications of amiodarone in the same patient." Arch Intern Med 147 (1987): 1805-9
  6. Wright AJ, Brackenridge RG "Pulmonary infiltration and bone marrow depression complicating treatment with amiodarone." Br Med J 284 (1982): 1303
  7. Akoun GM, Cadranel JL, Blanchette G, Milleron BJ, Mayaud CM "Bronchoalveolar lavage cell data in amioidarone-associated pneumonitis: evaluation in 22 patients." Chest 99 (1991): 1177-82
  8. Kudenchuk PJ, Pierson DJ, Greene HL, Graham EL, Sears GK, Trobaugh GB "Prospective evaluation of amiodarone pulmonary toxicity." Chest 86 (1984): 541-8

  Show all 24 sourcesShow fewer sources

  9. Akoun GM, Milleron BJ, Badaro DM, Mayard CM, Liote HA "Pleural T-lymphocyte subsets in amiodarone-associated pleuropneumonitis." Chest 95 (1989): 596-7
  10. Adams GD, Kehoe R, Lesch M, Glassroth J "Amiodarone-induced pneumonitis: assessment of risk factors and possible risk reduction." Chest 93 (1988): 254-63
  11. Burland RJ, Millard FJ "Fibrosing alveolitis associated with amiodarone." Eur J Respir Dis 65 (1984): 616-9
  12. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  13. Fraire AE, Guntupalli KK, Greenberg SD, Cartwright J, Jr Chasen MH "Amiodarone pulmonary toxicity: a multidisciplinary review of current status." South Med J 86 (1993): 67-77
  14. Morrow B, Shorten GD, Sylvester W "Postoperative amiodarone pulmonary toxicity." Anaesth Intensive Care 21 (1993): 361-2
  15. Vanmieghem W, Coolen L, Malysse I, Lacquet LM, Demedts MGP "Amiodarone and the development of ARDS after lung surgery." Chest 105 (1994): 1642-5
  16. Polkey MI, Wilson POG, Rees PJ "Amiodarone pneumonitis: no safe dose." Respir Med 89 (1995): 233-5
  17. Valle JM, Alvarez D, Antunez J, Valdes L "Bronchiolitis obliterans organizing pneumonia secondary to amiodarone: a rare aetiology." Eur Respir J 8 (1995): 470-1
  18. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  19. Wilson BD, Lippmann ML "Susceptibility to amiodarone-induced pulmonary toxicity: relationship to the uptake of amiodarone by isolated lung cells." Lung 174 (1996): 31-41
  20. Cendrasekhar A, Barke RA, Druck P "Recurrent amiodarone pulmonary toxicity." South Med J 89 (1996): 85-6
  21. Hargreaves MR, Benson MK "Amiodarone pneumonitis: no safe dose." Respir Med 90 (1996): 119
  22. Oren S, Turkot S, Golzman B, London D, Bendor D, Weiler Z "Amiodarone-induced bronchiolitis obliterans organizing pneumonia (BOOP)." Respir Med 90 (1996): 167-9
  23. Reasor MJ, Kacew S "An evaluation of possible mechanisms underlying amiodarone-induced pulmonary toxicity." Proc Soc Exp Biol Med 212 (1996): 297-304
  24. Jessurun GAJ, Crijns HJGM "Amiodarone pulmonary toxicity - dose and duration of treatment are not the only determinants of toxicity." BMJ 314 (1997): 619-20

• Sick Sinus Syndrome

  Major

  The use of amiodarone is contraindicated for use in patients with cardiogenic shock, severe sinus node dysfunction causing marked sinus bradycardia, second- or third-degree AV block, or symptomatic bradycardia in the absence of a functioning pacemaker.

  4 sources

  1. Veltri EP, Reid PR "Sinus arrest with intravenous amiodarone." Am J Cardiol 58 (1986): 1110-1
  2. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  3. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  4. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):

• Vision Disorders

  Major

  Optic neuropathy and/or neuritis has occurred during administration of amiodarone and has resulted in visual impairment such as changes in visual acuity, decrease in peripheral vision, and blindness. Optic toxicity can occur at any time following initiation of amiodarone. Therapy with amiodarone should be administered cautiously in patients with visual defects. Regular ophthalmologic examinations including fundoscopy and slit- lamp examinations are recommended.

  5 sources

  1. Imgram DV, Jaggarao NS, Chamberlain DA "Ocular changes resulting from therapy with amiodarone." Br J Ophthalmol 66 (1982): 676-9
  2. Feiner LA, Younge BR, Kazmier FJ, Stricker BH, Fraunfelder FT "Optic neuropathy and amiodarone therapy." Mayo Clin Proc 62 (1987): 702-17
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  4. Thystrup JD, Fledelius HC "Retinal maculopathy possibly associated with amiodarone medication." Acta Ophthalmol (Copenh) 72 (1994): 639-41
  5. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):

• Hepatic Insufficiency

  Moderate

  There have been rare reports of fatal hepatocellular necrosis after treatment with amiodarone. In patients with life-threatening arrhythmias, the potential risk of hepatic injury should be weighed against the potential benefit of amiodarone therapy. Patients with hepatic impairment should be monitored for evidence of progressive hepatic injury. Consideration should be given to reducing the rate of administration or withdrawing treatment if needed.

  2 sources

  1. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Amiodarone Hydrochloride (amiodarone)." Bedford Laboratories (2010):

• Hypothyroidism

  Moderate

  Amiodarone inhibits peripheral conversion of thyroxine (T4) to triiodothyronine (T3) and also contributes inorganic iodine that can result in altered thyroid function tests, hypothyroidism, or hyperthyroidism. Therapy with amiodarone should be administered cautiously in patients with thyroid dysfunction. Clinical monitoring, including baseline and periodic evaluation of thyroid function is recommended. Modification of thyroid therapy may be necessary.

  15 sources

  1. Figge J, Dluhy RG "Amiodarone-induced elevation of thyroid stimulating hormone in patients receiving levothyroxine for primary hypothyroidism." Ann Intern Med 113 (1990): 553-5
  2. Figge HL, Figge J "The effects of amiodarone on thyroid hormone function: a review of the physiology and clinical manifestations." J Clin Pharmacol 30 (1990): 588-95
  3. Mehra A, Widerhorn J, Lopresti J, Rahimtoola SH "Amiodarone-induced hyperthyroidism: thyroidectomy under local anesthesia." Am Heart J 122 (1991): 1160-1
  4. Singh BN, Nademanee K "Amiodarone and thyroid function: clinical implications during antiarrhythmic therapy." Am Heart J 106 (1983): 857-69
  5. Mazonson PD, Williams ML, Cantley LK, Dalldorf FG, Utiger RD, Foster JR "Myxedema coma during long-term amiodarone therapy." Am J Med 77 (1984): 751-4
  6. Enia G, Costante G, Catalano C, Zoccali C, Maggiore Q "Severe hypothyroidism induced by amiodarone in a dialysis patient." Nephron 46 (1987): 206-7
  7. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  8. Roti E, Minelli R, Gardini E, Bianconi L, Braverman LE "Thyrotoxicosis followed by hypothyroidism in patients treated with amiodarone. A possible consequence of a destructive process in the thyroid." Arch Intern Med 153 (1993): 886-92

  Show all 15 sourcesShow fewer sources

  9. Unger J, Lambert M, Jonckheer MH, Denayer P "Amiodarone and the thyroid: pharmacological, toxic and therapeutic effects." J Intern Med 233 (1993): 435-43
  10. Hauptman PJ, Fyfe B, Mechanick J, Lansman S, Gass A "Fatal hyperthyroidism after amiodarone treatment and total lymphoid irradiation in a heart transplant recipient [published erratum appears in J Heart Lung Transplant 1993 Jul-Aug;12(4):572]." J Heart Lung Transplant 12 (1993): 513-6
  11. Mulligan DC, Mchenry CR, Kinney W, Esselstyn CB, Numann PJ, Roher H, Albertson D "Amiodarone-induced thyrotoxicosis: clinical presentation and expanded indications for thyroidectomy." Surgery 114 (1993): 1114-9
  12. Martino E, Aghinilombardi F, Bartalena L, Grasso L, Loviselli A, Velluzzi F, Pinchera A, Braverman LE "Enhanced susceptibility to amiodarone-induced hypothyroidism in patients with thyroid autoimmune disease." Arch Intern Med 154 (1994): 2722-6
  13. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  14. Harjai KJ, Licata AA "Amiodarone induced hyperthyroidism: a case series and brief review of literature." Pacing Clin Electrophysiol 19 (1996): 1548-54
  15. Harjai KJ, Licata AA "Effects of amiodarone on thyroid function." Ann Intern Med 126 (1997): 63-73

• Neurologic Manifestations

  Moderate

  Reversible and dose-related nervous system toxicity such as dizziness, paresthesia, tremor and involuntary movements, lack of coordination, abnormal gait and ataxia is commonly noted in patients receiving amiodarone. Therapy with amiodarone should be administered cautiously and dosage modifications considered in patients with or predisposed to neurologic dysfunction.

  9 sources

  1. Roth RF, Itabashi H, Louie J, Anderson T, Narahara KA "Amiodarone toxicity: myopathy and neuropathy." Am Heart J 119 (1990): 1223-4
  2. Trohman RG, Castellanos D, Castellanos A, Kessler KM "Amiodarone-induced delirium." Ann Intern Med 108 (1988): 68-9
  3. Werner EG, Olanow CW "Parkinsonism and amiodarone therapy." Ann Neurol 25 (1989): 630-2
  4. Manolis AS, Tordjman T, Mack KD, Estes NA III "Atypical pulmonary and neurologic complications of amiodarone in the same patient." Arch Intern Med 147 (1987): 1805-9
  5. Palakurthy PR, Iyer V, Meckler RJ "Unusual neurotoxicity associated with amiodarone therapy." Arch Intern Med 147 (1987): 881-4
  6. Lim PK, Trewby PN, Storey GC, Holt DW "Neuropathy and fatal hepatitis in a patient receiving amiodarone." Br Med J 288 (1984): 1638-9
  7. Pellissier JF, Pouget J, Cros D, De Victor B, Serratrice G, Toga M "Peripheral neuropathy induced by amiodarone chlorhydrate: a clinicopathological study." J Neurol Sci 63 (1984): 251-66
  8. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):

• Water-Electrolyte Imbalance

  Moderate

  Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsade de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

  13 sources

  1. "Product Information. Tonocard (tocainide)." Merck & Co., Inc (2002):
  2. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals (2002):
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories (2002):
  4. "Product Information. Xylocaine (lidocaine)." Astra-Zeneca Pharmaceuticals (2002):
  5. "Product Information. Procan SR (procainamide)." Parke-Davis (2001):
  6. "Product Information. Pronestyl (procainamide)." Apothecon Inc (2001):
  7. "Product Information. Quinidex Extentabs (quiNIDine)." Wyeth-Ayerst Laboratories
  8. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim (2001):
  10. "Product Information. Rythmol (propafenone)." Knoll Pharmaceutical Company
  11. "Product Information. Norpace (disopyramide)." Searle (2001):
  12. "Product Information. Cordarone (amiodarone)." Apothecon Inc (2022):
  13. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn (2001):

Therapeutic duplication

Drug classes that overlap with Amiodarone Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• antiarrhythmics

  The recommended maximum number of medicines in the 'antiarrhythmics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antiarrhythmics' category.

  Example product in the source data (US market): Bupivacaine/lidocaine/triamcinolone

• antiarrhythmics

  The recommended maximum number of medicines in the 'antiarrhythmics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antiarrhythmics' category.

  Example product in the source data (US market): Nuedexta

• antiarrhythmics

  The recommended maximum number of medicines in the 'antiarrhythmics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antiarrhythmics' category.

  Example product in the source data (US market): Trandolapril/verapamil

• antiarrhythmics

  The recommended maximum number of medicines in the 'antiarrhythmics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antiarrhythmics' category.

  Example product in the source data (US market): Epinephrine/lidocaine