Amiodarone

Amiodarone hydrochlorideCordaroneCardinormPacerone
Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of irregular heartbeats.wikipedia
225 Related Articles

Ventricular fibrillation

fibrillationV-fibventricular fibrillation VF
This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.
The medication epinephrine or amiodarone may be given if initial treatments are not effective.

Atrial fibrillation

atrial fibrilationparoxysmal atrial fibrillationAtrial fibrillation with rapid ventricular response
This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.
Hence, kidney function and electrolytes are routinely determined, as well as thyroid-stimulating hormone (commonly suppressed in hyperthyroidism and of relevance if amiodarone is administered for treatment) and a blood count.

Ventricular tachycardia

polymorphic ventricular tachycardiapulseless ventricular tachycardiamonomorphic ventricular tachycardia
This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia. In these cases, amiodarone can be used regardless of the individual's underlying heart function and the type of ventricular tachycardia; it can be used in individuals with monomorphic ventricular tachycardia, but is contraindicated in individuals with polymorphic ventricular tachycardia as it is associated with a prolonged QT interval which will be made worse with anti-arrhythmic drugs.
An implantable cardiac defibrillator or medications such as calcium channel blockers or amiodarone may be used to prevent recurrence.

Cardioversion

direct current cardioversionElectrical cardioversionsynchronized cardioversion
These individuals should be cardioverted.
Drugs like amiodarone, diltiazem, verapamil and metoprolol are frequently given before cardioversion to decrease the heart rate, stabilize the patient and increase the chance that cardioversion is successful.

WHO Model List of Essential Medicines

World Health Organization's List of Essential MedicinesList of Essential MedicinesModel List of Essential Medicines
It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.

Pulmonary fibrosis

lung fibrosisfibrosislung scarring
Some individuals were noted to develop pulmonary fibrosis after a week of treatment, while others did not develop it after years of continuous use.

Cardiac arrest

sudden cardiac deathsudden deathcardiopulmonary arrest
Evidence in cardiac arrest, however, is poor. In 2015, Gilead Sciences warned health care providers about people that began taking the hepatitis C drugs ledipasvir/sofosbuvir or sofosbuvir along with amiodarone, who developed abnormally slow heartbeats or died of cardiac arrest.
This includes the use of atropine, lidocaine, and amiodarone.

Paroxysmal supraventricular tachycardia

PSVTparoxysmal supraventricular
This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrillation and paroxysmal supraventricular tachycardia.
SVT that does not involve the AV node may respond to other anti-arrhythmic drugs such as sotalol or amiodarone.

Hypothyroidism

hypothyroidhypo-underactive thyroid
Targeted screening may be appropriate in a number of situations where hypothyroidism is common: other autoimmune diseases, a strong family history of thyroid disease, those who have received radioiodine or other radiation therapy to the neck, those who have previously undergone thyroid surgery, those with an abnormal thyroid examination, those with psychiatric disorders, people taking amiodarone or lithium, and those with a number of health conditions (such as certain heart and skin conditions).

Thyroid

thyroid glandthyroid folliclethyroid function
Induced abnormalities in thyroid function are common.
Another cause is excess iodine availability, either from excess ingestion, induced by the drug amiodarone, or following iodinated contrast imaging.

Sofosbuvir

SovaldiPSI-7977
In 2015, Gilead Sciences warned health care providers about people that began taking the hepatitis C drugs ledipasvir/sofosbuvir or sofosbuvir along with amiodarone, who developed abnormally slow heartbeats or died of cardiac arrest.
In combination with ledipasvir, daclatasvir or simeprevir it is not recommended with amiodarone due to the risk of an abnormally slow heartbeat.

Digitalis

foxglovefoxglovesdigitalis glycosides
Amiodarone can worsen the cardiac arrhythmia brought on by digitalis toxicity.
Also, the classic drug of choice for ventricular fibrillation in emergency setting, amiodarone, can worsen the dysrhythmia caused by digitalis, therefore, the second-choice drug lidocaine is more commonly used.

QT interval

QTcQTc intervalCorrected QT interval
In these cases, amiodarone can be used regardless of the individual's underlying heart function and the type of ventricular tachycardia; it can be used in individuals with monomorphic ventricular tachycardia, but is contraindicated in individuals with polymorphic ventricular tachycardia as it is associated with a prolonged QT interval which will be made worse with anti-arrhythmic drugs.
Some antiarrhythmic drugs, like amiodarone or sotalol, work by getting a pharmacological QT prolongation.

Hyperthyroidism

thyrotoxicosishyperthyroidoveractive thyroid

Jod-Basedow phenomenon

Jod-Basedow phenomenaJod-Basedow Effect
The source of iodine may be from the diet, administration of the iodinated contrast for medical imaging, or amiodarone (an antiarrhythmic drug).

Cytochrome P450

cytochrome P450 oxidaseP450CYP450
Many substrates for CYP3A4 are drugs with a narrow therapeutic index, such as amiodarone or carbamazepine.

Optic neuropathy

optic atrophyoptic atrophy, autosomal dominantoptic atrophies, hereditary
Optic neuropathy, nonarteritic anterior ischemic optic neuropathy (N-AION), occurs in 1-2% of people and is not dosage dependent.

Simvastatin

Zocorsimvastatin acid
On August 8, 2008, the FDA issued a warning of the risk of rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone.
A lower dose is also recommended in people taking the calcium channel blockers, verapamil and diltiazem, as well as those taking amiodarone.

Epididymitis

epididymo-orchitisinflammation of the epididymispain and swelling of one or both testicles
Amiodarone is sometimes responsible for epididymitis.
Chemical epididymitis may also result from drugs such as amiodarone.

Wolff–Chaikoff effect

Wolff-Chaikoff effectWolf-Chaikoff
Amiodarone also causes an anti-thyroid action, via Wolff–Chaikoff effect, due its large amount of iodine in its molecule, which causes a particular "cardiac hypothyroidism " with bradycardia and arrhythmia.
The Wolff–Chaikoff effect also explains the hypothyroidism produced in some patients by several iodine-containing drugs, including amiodarone.

Heart

cardiachuman heartapex of the heart
The pharmacokinetics of numerous drugs, including many that are commonly administered to individuals with heart disease, are affected by amiodarone.
These may work by manipulating the flow of electrolytes across the cell membrane (such as calcium channel blockers, sodium channel blockers, amiodarone, or digoxin), or modify the autonomic nervous system's effect on the heart (beta blockers and atropine).

Madarosis

Loss of eyelashes
Loss of eyelashes has been linked to amiodarone use.

Digoxin

digitalisdigitalinLanoxin
Particularly, doses of digoxin should be halved in individuals taking amiodarone.
Examples commonly used in patients with heart problems include spironolactone, verapamil and amiodarone.

Dronedarone

Multaqdronedarone hydrochloride
This is partially supported by dronedarone which is noniodinated benzofuran derivative of amiodarone, where the arylmethanone is conserved.
It was recommended as an alternative to amiodarone for the treatment of atrial fibrillation and atrial flutter in people whose hearts have either returned to normal rhythm or who undergo drug therapy or electric shock treatment i.e. direct current cardioversion (DCCV) to maintain normal rhythm.

Ledipasvir/sofosbuvir

Harvoniledipasvir-sofosbuvirSofosbuvir and ledipasvir
In 2015, Gilead Sciences warned health care providers about people that began taking the hepatitis C drugs ledipasvir/sofosbuvir or sofosbuvir along with amiodarone, who developed abnormally slow heartbeats or died of cardiac arrest.
Ledipasvir/sofosbuvir should additionally be avoided when taking amiodarone or other drugs that lower heart rate; there is a serious risk of the heart slowing or stopping when ledipasvir/sofosbuvir is used with such drugs.