As a treatment for various heart disorders, amiodarone has come to the rescue of many patients. They often have taken other medications to try to treat abnormal or irregular heartbeats but to no avail. The drug has a clinically proven track record of being an effective treatment for certain heart diseases and has saved many lives. When experienced at all, amiodarone side effects are usually mild.
However, amiodarone is a potent drug that only a licensed, competent physician or healthcare provider should prescribe. A variety of factors will influence whether amiodarone can be taken, including the patient’s medical history, the current state of health, and use of other drugs at the proposed time frame to take the medication.
Below we cover the amiodarone side effects, its potential benefits, and circumstances where it may not be recommended.
What Is Amiodarone?
Amiodarone is a prescription medication that is used to treat certain types of serious, often life-threatening irregularities in the heartbeat of a patient.
Frequently prescribed when other drugs have not worked, amiodarone can restore a person’s normal heart rhythm and help maintain a steady, regular heartbeat. Often referred to as an anti-arrhythmic drug, amiodarone prevents the transmission of certain electrical signals in the heart that might cause heartbeat irregularities.
Amiodarone can be taken orally in tablet form, either as a generic drug or as a brand-name medication. The drug can also be taken via intravenous injection; in this form, only a physician or health care provider can administer it. An initial injection of amiodarone at the hospital can be followed up in tablet form at home.
Amiodarone is typically taken once or twice a day, but the doctor may prescribe higher doses, either initially or throughout the course of taking the drug. Amiodarone can be taken with or without food, but the physician will typically recommend one way or the other for all doses.
It is commonly recommended that the patient not drink grapefruit juice while taking the drug as this can increase the amount of amiodarone in the bloodstream. An experienced physician will tailor the dosage according to a variety of factors, so the physician’s directions should be carefully followed to avoid amiodarone side effects.
The Good
Amiodarone is often prescribed as a medical treatment for two heart rate problems, ventricular fibrillation, and ventricular tachycardia.
Ventricular tachycardia is caused by electrical signals that abnormally affect the pumping of the lower chambers of the heart. Typically, the lower chambers beat too fast for the heart’s upper chambers, resulting in abnormal blood flow from the heart to the rest of to the body.
Also known as V-fib, ventricular fibrillation is a condition in which the heart’s lower chambers “quiver” instead of beating normally.
Causes of ventricular fibrillation include:
- A prior condition of ventricular tachycardia
- Insufficient blood flow to the heart or problems with the aorta
- Damage to the heart’s muscle
- Forms of cardiomyopathy
- Drug toxicity
- Sepsis (an infection in the body)
Amiodarone is also used to prevent atrial fibrillation, a condition where the heart rate is irregular or rapid; the condition can cause stroke, heart failure, and other problems. Here, amiodarone can either be prescribed after surgery or to treat atrial fibrillation’s recurrent form.
The Bad
Common amiodarone side effects include:
- Headaches
- Nausea
- Vomiting
- Sensitivity to sunlight
- Fatigue
- Tremors in parts of the body
- Lack of coordination or unusual bodily movements
- Constipation
- Insomnia
- Stomach pain
- Decreased sex drive or performance
These side amiodarone side effects are often mild, can disappear after an initial reaction, or may not even be related to the patient taking amiodarone. If the symptoms persist or increase in severity, you can consult your physician.
Other Side Effects of Amiodarone
Other side effects of amiodarone are rarer and are preventable by the use of a qualified medical provider to prescribe and, in the case of intravenous injection, administer amiodarone.
Remember that amiodarone side effects listed above as “common” are not so common when they are severe, when they persist for an extended period, or when they indicate a separate, more severe condition.
Allergic Reactions
Symptoms of an allergic reaction can include skin rashes, itching or hives. The patient taking the medication may also experience swelling in the tongue, lips, or face.
Skin Side Effects
Amiodarone side effects relating to the skin are: toxic epidermal necrolysis, which in its extreme forms is characterized by skin that looks scalded and separates from the body; Stevens-Johnson syndrome which is a severe reaction to amiodarone in the skin; eczema; skin cancer; and bullous dermatitis, which is a blistering disease that can afflict the skin and mucous membrane.
Some patients have also reported to experiencing changes of skin color to blue or gray. Patients have also experienced sunburn beyond what would be expected from typical sun exposure.
Lung Side Effects
The patient may experience wheezing, shortness of breath, coughing, chest pain, or spitting up of blood.
Vision Side Effects
Symptoms of adversely affected vision can include blurred vision or higher sensitivity to light. Patients have also experienced seeing colored halos around objects.
A patient may develop microdeposits in the cornea, or a condition called optic neuritis which is an inflammation that can damage the optical nerve.
Liver problems
Symptoms of liver problems include severe or unexplained tiredness or weakness, yellowing of the skin or the whites of the eyes, and dark urine. The patient may also have increased levels of the enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the liver.
The patient may also develop a form of hepatitis or even cirrhosis of the liver.
Heart Side Effects
Patients have reported chest pain and irregular, fast or slow heartbeats as amiodarone side effects. Other symptoms related to the heart are unexplained weight loss or weight gain, dizziness, or lightheadedness.
In severe cases, there can be congestive heart failure (CHF), where the heart is unable to pump sufficient blood to the organs and extremities of the body. Symptoms of CHF can include shortness of breath, asthma of the heart, pooling of blood in the liver or elsewhere in the body, swelling of the heart, or bluish skin.
In rare instances the patient can develop shock, which in medical terminology refers to a condition brought on by a sudden drop in blood flow through the body, depriving the body’s vital organs of nutrients and oxygen.
Gastrointestinal Problems
Extensive nausea or vomiting may show severe gastrointestinal problems. Other symptoms include stomach pain or the spitting up of blood.
Thyroid problems
Indications of thyroid problems can include unexplained excessive sweating, weight loss or gain, unusual thinning of hair, or intolerance to the heat or the cold. The patient may also be afflicted with hypothyroidism or hyperthyroidism, which are, respectively, insufficient or excessive production of hormones by the thyroid gland. The patient may develop thyroid nodules, which are lumps in the thyroid gland or even develop thyroid cancer.
Genital Side Effects
The male patient may experience impotence. Pain and swelling of the scrotum or testicles may show epididymitis, which is swelling of the tube (called the epididymis) at the back of the testicle that stores and carries sperm. Other symptoms of epididymitis include discharge from the penis, pain in the groin, fever, or blood in the semen.
Neural Damage or Disorders
Reported symptoms of neural problems include:
- Pain, tingling, or numbness in the hands or feet
- Muscle weakness
- Uncontrollable movements
- Difficulties in walking
- Symptoms similar to those of Parkinson’s disease
Drugs That Interact with Amiodarone
If your physician has prescribed you to use amiodarone, he will be aware of interactions with other drugs when taken with amiodarone. Drug interactions may not only depend on the drug itself but on drug dosage levels.
Patients should never change or discontinue the recommended dosage of amiodarone without consulting their doctor or health provider first. The interactions below are not an exhaustive listing.
Be sure that your physician is aware of all medications you are taking or have taken in the recent past. Don’t be afraid to ask questions about amiodarone and its potential side effects.
Some products that may interact with this drug include fingolimod and certain drugs prescribed to treat hepatitis C such as ledipasvir or sofosbuvir and sofosbuvir.
There are drugs besides amiodarone which will cause what is called QT prolongation, which is a heart rhythm disorder. Drugs which can cause QT prolongation include dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics such as clarithromycin and erythromycin, quinolone, and antibiotics such as levofloxacin.
Some drugs can affect the removal of amiodarone from the body. These drugs include azole antifungals such as itraconazole, cimetidine, cobicistat, certain protease inhibitors, rifampin, and St. John’s wort.
Amiodarone can slow down the removal of other medications from your body. Such drugs include clopidogrel, phenytoin, atorvastatin, lovastatin, trazodone, and warfarin.
Other Contraindications of Amiodarone
Patients with sinus node dysfunction may not be eligible for amiodarone since sinus nodes may adversely affect the pumping of blood to the body by the heart. Patients may also be prevented from using amiodarone if they suffer from one of the forms of hypersensitivity. Also, amiodarone should not be taken while breastfeeding: it will enter the breast milk and therefore the infant.
Amiodarone Side Effects – Conclusion
Amiodarone is a medication proven to be an effective treatment for certain abnormalities in heartbeat rates. When experienced at all, side effects are normally mild. Do your homework in finding the right physician or medical facility: you can prevent severe amiodarone side effects when you adhere to the recommended dosage as determined by qualified medical professionals.
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