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Is Amiodarone Dead?

Background: Amiodarone is a class III antidysrhythmic first released for human use in 1962. As with other drugs in this class, amiodarone acts by blocking potassium channels thus prolonging the action potential. This, in turn, leads to a lengthening of depolarization of the atria and ventricles. The drug spread rapidly through US hospitals as it was touted as “always works, and no side effects,” by it’s pharmaceutical manufacturer (Bruen 2016).

Of course, nothing comes free and soon after the drug became widely used, a multitude of adverse effects became apparent. These included minor issues – sun sensitivity and corneal deposits – to major ones – thyroid dysfunction…

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Articles of Interest

The Strange History of Amiodarone

Clinicians from all over the world (except in the United States) quickly began using the drug to treat cardiac arrhythmias of all sorts. The reputation of amiodarone spread far and wide—amiodarone, the word was, was a unique antiarrhythmic drug that almost always worked, and had virtually no side effects. Both of these assertions, of course, proved false.

Adverse reactions of Amiodarone

Amiodarone, a versatile class III antiarrhythmic drug, is considered one of the most effective agents in counteracting supraventricular and ventricular tachyarrhythmia. The drug, however, has a high toxicity profile involving diverse organs.

Amiodarone and the “dizzy” ­patient

Beware of neurotoxicity, among other side effects, when treating patients with amiodarone. Patients will typically complain of tremor, but also “dizziness” as an umbrella term for an unsteady gait. There are various levels of the nervous system where amiodarone can impair ambulation...

Amiodarone Side Effects Can Be Life Threatening

Amiodarone side effects can be lethal. That is why it is imperative that this drug be monitored carefully. Lung toxicity can be irreversible!

Amiodarone: A Newly Discovered Association with Bilateral Vestibulopathy

Bilateral vestibulopathy (BVP) is a debilitating disorder characterized by the hypofunction of both vestibular end organs or nerves. The most frequent identifiable causes of BVP are ototoxic drug effects, infectious and autoimmune disorders. However, the majority of cases remain idiopathic. Very recently, the first discovery of a clinical case of Amiodarone-associated BVP has been reported.

Amiodarone: Most Effective and Most Toxic

Amiodarone (Cordarone) is considered one of the most effective antiarrhythmic drugs, but it’s also one of the most toxic. It may affect your lungs, eyes, thyroid, liver, skin, heart, and nervous system. Also, amiodarone has a long half-life. It is retained in the body for up to 45 days after the drug has been discontinued. Many Electrophysiologists (EPs) considered it a drug of last resort or a drug that should only be used for a short time. (Cardiologists in general prescribe amiodarone more readily than EPs.

What Is It, How Does It Work, What Is It Used For, Side Effects, and More

The most common adverse effects of amiodarone include nausea, vomiting, weight loss, bluish-grey discoloration of the skin, hypothyroidism or hyperthyroidism, liver disease, and photosensitivity. In addition, amiodarone can often deposit in the cornea (transparent outer covering of the eye), making it appear translucent or opaque. Fortunately, this side effect is reversible once the medication is stopped and may not cause any significant vision problems.

Resources

DailyMed

Amiodarone hydrochloride is indicated for the treatment of documented, life-threatening recurrent ventricular fibrillation and life-threatening recurrent hemodynamically unstable tachycardia in adults who have not responded to adequate doses of other available antiarrhythmics or when alternative agents cannot be tolerated.

EBM Consult

Amiodarone is generally considered a class III antiarrhythmic drug especially with prolonged use and results in lengthening of the action potential. It also has activity similar to class I agents...