Drug interactions with amiodarone

Am Heart J. 1983 Oct;106(4 Pt 2):924-30. doi: 10.1016/0002-8703(83)90017-0.

Abstract

There are a number of important drug interactions with amiodarone. This agent appears to have a marked effect on the kinetics of some commonly used cardiovascular drugs, such as warfarin, digoxin, quinidine, and procainamide, and has dynamic interactions with others, such as the beta blockers and some calcium antagonists. Bleeding has been reported, apparently caused by a potentiation of the anticoagulant effect of warfarin by amiodarone. Torsades de pointes has been observed when quinidine, propafenone, or mexiletine is given together with amiodarone. Furthermore, amiodarone may interact with beta-blocking agents and some of the calcium antagonists to produce symptomatic sinus bradycardia and sinus arrest, especially in a latent or overt sick sinus syndrome. During surgery, amiodarone may induce hypotension and an atropine-resistant bradycardia, possibly by interacting with anesthetic agents. A knowledge of the time of onset, extent, duration, and possible mechanisms of the interactions of amiodarone with other cardioactive drugs is still incomplete, but further studies are of great therapeutic importance.

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects
  • Amiodarone / adverse effects*
  • Anti-Arrhythmia Agents / adverse effects
  • Arrhythmia, Sinus / chemically induced
  • Benzofurans / adverse effects*
  • Blood Coagulation Disorders / chemically induced
  • Calcium / antagonists & inhibitors
  • Digoxin / adverse effects
  • Drug Interactions*
  • Drug Synergism
  • Heart Arrest / chemically induced
  • Humans
  • Kinetics
  • Quinidine / adverse effects
  • Tachycardia / chemically induced
  • Warfarin / adverse effects

Substances

  • Adrenergic beta-Antagonists
  • Anti-Arrhythmia Agents
  • Benzofurans
  • Warfarin
  • Digoxin
  • Quinidine
  • Amiodarone
  • Calcium