If the indication for amiodarone is compelling, lung disease should not necessarily be an absolute contraindication. There is disagreement and a lack of evidence to guide monitoring for pulmonary toxicity.
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Constipation, anorexia, taste disturbance, benign corneal microdeposits, and blue-grey pigmentation of the skin which is slow to appear but generally irreversible, are all relatively common in chronic usage. Copies of the wallchart 'Medical management of severe anaphylactoid and anaphylactic reactions' are still available from The 2006 edition of Australian Medicines Handbook will be available in January 2006. Similarly the concentrations and effects of flecainide, quinidine, phenytoin and cyclosporin tend to rise with amiodarone.
A loading dose is required when initiating treatment.
Antiarrhythmic drugs can reduce the frequency of shocks.
Some patients develop extra pyramidal symptoms or peripheral neuropathy.
Both drugs are significantly more effective than placebo. During the COVID-19 pandemic, you need to continue to take your usual medicines and stay as healthy as possible.
A very recent comparative study reported combination therapy with amiodarone and a beta blocker to be markedly and significantly more effective at reducing implantable cardioverter-defibrillator shocks than either beta blocker alone or sotalol.Amiodarone can be given orally or intravenously. There is some evidence of synergy between beta blockers and amiodarone in terms of efficacy against tachyarrhythmias and the combination is not necessarily contraindicated.
09 Jun 2020
For reasons which are not entirely clear, the much feared complication of torsades de pointes is much less commonly seen with amiodarone than with other drugs that prolong the QT interval.
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