Amiodarone

Question 1

Amiodarone dosing

Answer 1

200mg 3 times a day for 1 week,

then reduced to 200 mg twice daily for a further week, followed by maintenance dose, usually 200 mg daily

Question 2

MHRA ALERT

Answer 2

risk of severe bradycardia and heart block when antiretrovirals taken with amiodarone

Question 3

half life

Answer 3

50 days- potential drug interactions.

AV BLOCK WITH BB, diltiazem and verapamil

Question 4

Side effects

Answer 4

NOT NEPHRITIS

Corneal microdeposits
Patients taking amiodarone may develop corneal microdeposits (reversible on withdrawal of treatment). However, if vision is impaired or if optic neuritis or optic neuropathy occur, amiodarone must be stopped to prevent blindness and expert advice sought.

Thyroid function
Amiodarone contains iodine and can cause disorders of thyroid function; both hypothyroidism and hyperthyroidism can occur. Hypothyroidism can be treated with replacement therapy without withdrawing amiodarone if it is essential; careful supervision is required.

Hepatotoxicity
Amiodarone is also associated with hepatotoxicity and treatment should be discontinued if severe liver function abnormalities or clinical signs of liver disease develop.

Pulmonary toxicity
Pneumonitis should always be suspected if new or progressive shortness of breath or cough develops in a patient taking amiodarone.

Photosensitivity reaction- wear SPF WIDE SPECTRUM SUNSCREEN

Constipation
movement disorders
sleep disorders
taste altered
vomiting

Question 5

Monitoring

Answer 5

ECG with IV use

BEFORE TREATMENT:

• Serum potassium concentration should be measured before treatment.
• Chest x-ray required before treatment.

BEFORE AND EVERY 6 MONTHS:

• Thyroid function
• Liver function

Patients at high risk of bradycardia should be monitored continuously for 48 hours in an appropriate clinical setting after starting concomitant treatment.