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Amiodarone Drug Interactions.

Article Excerpt
Byline: ANTOINE T. JENKINS, PharmD, CARRIE OLIPHANT, PharmD, BCPS and TIMOTHY H. SELF, PharmD-Series Editor

Amiodarone, a class III antiarrhythmic, has become the drug of choice for the management of supraventricular and ventricular arrhythmias.1,2 Although not an FDA-approved indication, the use of amiodarone to treat atrial fibrillation is supported by practice guidelines from the American College of Cardiology/American Heart Association (AHA) and the European Society of Cardiology.3 The AHA 2005 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care suggest that amiodarone may be considered-before other antiarrhythmic therapy is given-for treatment of recurrent ventricular fibrillation and pulseless ventricular tachycardia that is resistant to CPR, precordial shocks, and vasopressors.4

A HIGH-RISK AGENT

Although amiodarone is widely used, it must be considered a high-risk agent. The drug has an extensive adverse-effect profile, including thyroid, hepatic, and pulmonary toxicities.5,6 Before therapy is initiated, baseline thyroid, liver, and pulmonary function tests are recommended. In addition, a baseline chest radiograph and eye examination should be performed. Because of the extremely long half-life of amiodarone, its effects can persist long after it has been discontinued.

Furthermore, amiodarone is...