Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Amioderone Side Effects

Forum: The Heart Forum
Topic: Tachycardia


I have ARVD and have an ICD for six months. I started on Sotalol but side effects were severe. Then put on Pacerone (amioderone) for last four months. It controls the v-tach fine but I am experiencing some intermittant light-headedness. I am most concerned with an occasional blood pressure elevation to around 90-100 in diastolic when I am normally in mid 70's to mid 80's. My head also feels like pressure and turns red around top of head and ear on left side and I seem to get hot like I have high temperature This subsides after an hour or two. My question is: Does Amioderone cause elevated blood pressure and redness of face and hands along with temperature elevation? And what about light-headed stuff that happens occasionally (once or twice a week). Please let me know, I am most concerned about blood pressure issue. I had an angiogram two years ago and was clean, could I be developing blockages so soon as to affect blood pressure or is blood pressure medication related. I look forward to your reply.

Regards,

MichaelK

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Dear Michael,

Thank you for your question. Amiodarone (brand names Codarone, Pacerone) is an antiarrhythmic drug used for a variety of different heart rhythms. It is a Class III antiarrhythmic drug and has both antiarrhythmic effects and beta-blocker effects. It has a very long half life (about 90 days) and is cleared by the liver. The dosage will generally be higher during a loading period and is then decreased to usually 200 mg a day for maintenance dosing.

Contraindications to is use include severe sinus node dysfunction and in those with any known hypersensitivity to the drug.

There are several serious potential side effects and careful monitoring of the drug is necessary. Potential side effects are lung toxicity that could potentially result in death and liver injury.

Less serious side effects are corneal deposits, photosensitivity (sensitivity to the sun), thyroid abnormalities and new arrhythmias.

Drug interactions to be aware of are with digoxin, other antiarrhythmics, warfarin, beta blockers and calcium channel blockers.

Flushing has been reported in 1-3% of patients taking the drug.

Blue skin discoloration has been reported in less than 1% of patients taking the drug.

There are no reports of hypertension due to amiodarone.

Be sure to discuss with your doctor before starting or stopping any medication.

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.

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