Amiodarone or Multaq: Where Should Patients Turn?

Portland, ORWhen it comes to taking amiodarone, much of the concern is about amiodarone and simvastatin interaction. Although it is true that the combination of amiodarone and simvastatin can cause complications, amiodarone by itself has reportedly been linked to an increased risk of pulmonary toxicity, which could potentially be deadly.

Patients who are concerned about amiodarone could take Multaq, but Multaq is also associated with serious side effects. According to the US Food and Drug Administration (FDA), Multaq has been linked to two cases of acute liver failure that required liver transplants. Although the FDA says those side effects are rare, the warnings and precautions section of the drug's label is being updated.

Patients taking Multaq are warned to watch for signs of liver damage including nausea, vomiting, fever, fatigue, jaundice and dark urine, according to InPharm (01/17/11).

Because of serious risks associated with amiodarone, the FDA warns that patients should only be put on amiodarone to treat life-threatening, recurrent ventricular arrhythmias that have not responded to other treatment. Furthermore, the FDA warns that amiodarone can cause fatal toxicities, including pulmonary toxicity.

This means that patients with atrial fibrillation—usually a less serious condition than ventricular fibrillation—are not recommended to take amiodarone as a treatment. The reason being that the risks associated with taking amiodarone outweigh the potential benefits.

According to the FDA, pulmonary toxicity is fatal approximately 10 percent of the time. The FDA notes that pulmonary toxicity has occurred in rates as high as 17 percent in patients with ventricular arrhythmias who took doses of approximately 400 mg daily.

Furthermore, when amiodarone is taken in combination with simvastatin (Zocor), patients are at risk of rhabdomyolysis, a muscle injury that can result in kidney failure or death. Patients who take more than 20 mg per day of simvastatin along with amiodarone are reportedly at increased risk of developing the potentially fatal condition.

Finally, the FDA notes that amiodarone can make ventricular arrhythmia worse in two to five percent of patients. Although this side effect is seen in other antiarrhythmic medications, the effect is reportedly prolonged in patients on amiodarone because it takes longer to be excreted from the patient's body.