• Amiodarone can also ↓ heart rate by its intrinsic beta-blocker effects.

Adverse Effects

  • Highly lipid soluble molecule with a long half-life
  • Long-term amiodarone use can be associated with numerous adverse effects, and thus active surveillance is required. 1
  • The most important toxic effects are: 1
    • hepatic (elevated liver enzyme activities in 15%-30% and cirrhosis in <3%),
    • cardiac (QT prolongation or AV block),
    • thyroid (hypothyroidism in 6% or hyperthyroidism in 0.9%-2.0%),
    • pulmonary (interstitial lung disease and pulmonary fibrosis in 1%-17%),
    • ocular (corneal deposits in >90% or optic neuritis in <2%), and
    • skin (photosensitivity in 25%-75% or blue-gray discoloration in 4%-9%).

Figure source: 1

Footnotes

  1. Tseng AS, Kowlgi GN, DeSimone CV. Antiarrhythmic Drugs for Atrial Fibrillation in the Outpatient Setting: Common Clinical Scenarios and Pearls for the Primary Care Clinician. Mayo Clin Proc. 2021 Aug;96(8):2230-2242. doi: 10.1016/j.mayocp.2021.01.010. Epub 2021 Jun 10. PMID: 34119307. 2 3