Summary
Amiodarone is an extremely effective antiarrhythmic agent for the treatment of both life-threatening ventricular arrhythmias and refractory supraventricular tachyarrhythmias. Subjective minor side effects are common with amiodarone but rarely require discontinuation of therapy and are often handled by dose reduction. Serious end-organ toxicity, including pulmonry fibrosis and drug-induced hepatitis, have been the most common indications for discontinuing amiodarone therapy in these patients.
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Burger A, Dinichett C, Nicod P, Jenny N, LeMarchand BP, et al. Effect of amiodarone on serum triiodothyronine, reverse triiodothyronine, thyroxin and thyrotropin: a drug influencing peripheral metabolism of thyroid hormones. Journal of Clinical Investigation 58: 255–259, 1976
Greene HL, Graham EL, Werner JA, et al. Toxic and therapeutic effects of amiodarone in the treatment of cardiac arrhythmias. Journal of the American College of Cardiology 2: 1114–1128, 1983
Hamer A, Peter T, Mandel WJ, Scheinman MM, Wales D. The potentiation of warfarin anticoagulation by amiodarone and anticoagulant treatment. Circulation 65: 1025–1029, 1982
Harris L, McKenna WJ, Rowland E, Krikler DM. Side effects and possible contraindications of amiodarone use. American Heart Journal 106: 916–921, 1983
Heger JJ, Prystowsky EN, Jackman WM, et al. Amiodarone: clinical efficacy and electrophysiology during long-term therapy for recurrent ventricular tachycardia or ventricular fibrillation. New England Journal of Medicine 305: 539–545, 1981
Heger JJ, Prystowsky EN, Miles WM, Zipes DP. Clinical use and pharmacology of amiodarone. Medical Clinics of America 68: 1339–1366, 1984
Ingram DV. Ocular effects in long-term amiodarone therapy. American Heart Journal 106: 902–940, 1983
Kaplan LJ, Cappaert WE. Amiodarone keratopathy: correlation to dosage and duration. Archives of Ophthalmology 100: 601–620, 1982
Kerin NZ, Blevins RD, Kerner N, Faitel K, Frumin H, et al. A low incidence of proarrhythmia using low-dose amiodarone. Journal of Electrophysiology 2: 289–295, 1988
Magro SA, Lawrence EC, Wheeler SH, Krafchek J, Lin HT, et al. Amiodarone pulmonary toxicity: prospective evaluation of serial pulmonary function tests. Journal of the American College of Cardiology 12: 781–788, 1988
Marchlinski FE, Gansler S, Waxman HL, Josephson ME. Amiodarone pulmonary toxicity. Annals of Internal Medicine 97: 839–845, 1982
Marcus FI. Drug interactions with amiodarone. American Heart Journal 106: 924–929, 1983
Marcus FI, Fontaine GH, Frank R, Grosgogeat Y. Clinical pharmacology and therapeutic applications of the antiarrhythmic drug amiodarone. American Heart Journal 101: 480–493, 1981
Marpinowitz U, Rabinovici J, Goldfarb D, Many A, Bank H. Interaction between warfarin sodium and amiodarone. Correspondence. New England Journal of Medicine 304: 671–672, 1981
Martino E, Safran M, Aghini-Lombardi F, et al. Environmental iodine intake and thyroid dysfunction during chronic amiodarone therapy. Annals of Internal Medicine 101: 28–34, 1984
McGovern B, Garan H, Kelly E, Ruskin JN. Adverse reactions during treatment with amiodarone hydrochloride. British Medical Journal 287: 175–180, 1983
McKenna WJ, Harris L, Rowland E, Whitelaw A, Storey G, et al. Amiodarone therapy during pregnancy. American Journal of Cardiology 51: 1231–1233, 1983
Meier C, Bauer B, Muller U, Ludin HP. Neuropathy during chronic amiodarone therapy. Journal of Neurology 220: 231–239, 1979
Moysey JO, Jaggarao NSV, Grundy EM, Chamberlain DA. Amiodarone increases plasma digoxin concentrations. British Medical Journal 282: 272, 1981
Naccarelli GV, Rinkenberger RL, Dougherty AH, Giebel RA. Amiodarone: pharmacology and antiarrhythmic and adverse effects. Pharmacotherapy 5: 298–313, 1985
Nademanee K, Kannan R, Hendrickson J, Ookhtens M, Kay I, et al. Amiodarone-digoxin interaction: clinical significance, time course of development, potential pharmacokinetic mechanisms and therapeutic implications. Journal of the American College of Cardiology 4: 111–116, 1984
Nademanee K, Singh BN, Hendrickson JA, Reed AW, Melmed S. et al. Pharmacokinetic significance of serum reverse T3 levels during amiodarone treatment: a potential method for monitoring chronic drug therapy. Circulation 62: 202–221, 1982
Poucell S, Ireton J, Valencia-Mayoral P, et al. Amiodarone-associated phospholipidosis and fibrosis of the liver. Gastroenterology 86: 926–936, 1984
Raeder EA, Podrid PJ, Lown B. Side effects and complications of amiodarone therapy. American Heart Journal 109: 975–983, 1985
Rakita L, Sobol SM, Mostow N, Vrobel T. Amiodarone pulmonary toxicity. American Heart Journal 106: 906–914, 1983
Rees A, Dalal JJ, Reid PG, Henderson AH. Dangers of amiodarone and anticoagulant treatment. British Medical Journal 282: 1756–1757, 1981
Rinkenberger RL, Prystowsky EN, Jackman WM, Naccarelli GV, Heger JJ, et al. Drug conversion of nonsustained to sustained ventricular tachycardia during serial electrophysiologic studies: identification of drugs that exacerbate tachycardia and potential mechanisms. American Heart Journal 103: 177–184, 1982
Rosenbaum MB, Chiale PA, Haedo A, Lazzari JO, Elizari MV. Ten years of experience with amiodarone. American Heart Journal 106: 957–964, 1983
Rotmensch HH, Belhassen B, Swanson BN, et al. Steady-state serum amiodarone concentrations: relationships with antiarrhythmic efficacy and toxicity. Annals of Internal Medicine 101: 462–469, 1984
Saal AK, Warner JA, Greene HL, Sears GK, Graham EL. Effect of amiodarone on serum quinidine and procainamide levels. American Journal of Cardiology 53: 1264–1267, 1984
Sanmarti A, Permanyer-Miralda G, Castellanos JM, Fos-Sala M, Galard RM, et al. Chronic administration of amiodarone and thyroid function: a follow-up study. American Heart Journal 108: 1262–1268, 1984
Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditta A, et al. Amiodarone-induced polymorphous ventricular tachycardia. American Heart Journal 105: 6–12, 1983
Shea P, Lal R, Kim SS, Schechtman K, Ruffy R. Flecainide and amiodarone interaction. Journal of the American College of Cardiology 7: 1127–1130, 1986
Simon JB, Manley PN, Brien JF, Armstrong PW. Amiodarone hepatotoxicity simulating alcoholic liver disease. New England Journal of Medicine 311: 167–172, 1984
Singh BN, Nademanee K. Amiodarone and thyroid function: clinical implications during antiarrhythmic therapy. American Heart Journal 106: 857–868, 1983
Soussi A, Colonna D. Troubles du rythme auriculaire et amiodarone. Journal des Agreges 7: 43, 1974
Tartini R, Kappenberger L, Steinbrunn W, Mayer UA. Dangerous interactions between amiodarone and quinidine. Lancet 1: 1327–1330, 1982
Van Roojj WJ, Van der Meer SC, Van Rayen EA, Van Zandwijk N, Darmanata JI. Pulmonary gallium-67 uptake in amiodarone pneumonitis. Journal of Nuclear Medicine 25: 211–213, 1984
Vos AK, Van Ramstrost AGS, Grosfeld JCM, Goossens JP. A peculiar cutaneous pigmentation from Cordarone. Dermatologica 145: 297–303, 1972
Westveer DC, Gadowski GA, Gordon S, Timmis GC. Amiodarone-induced ventricular tachycardia. Annals of Internal Medicine 97: 561–562, 1982
Wilson FM, Schmitt TE, Grayson M. Amiodarone-induced cornea verticillata. Annals of Ophthalmology 12: 657–660, 1980
Zipes DP, Prystowsky EN, Heger JJ. Amiodarone: electrophysiologic actions, pharmacokinetic and clinical effects. Journal of the American College of Cardiology 3: 1059–1071, 1984
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Naccarelli, G.V., Rinkenberger, R.L., Dougherty, A.H. et al. Adverse Effects of Amiodarone. Med Toxicol Adverse Drug Exp 4, 246–253 (1989). https://doi.org/10.1007/BF03259911
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DOI: https://doi.org/10.1007/BF03259911