Amiodarone in the aged
"Amiodarone is widely considered to be the most effective antiarrhythmic drug available.1 It is commonly used to treat atrial fibrillation and ventricular arrhythmias. Amiodarone, and its active metabolite desethylamiodarone, have multiple effects on cardiac depolarisation and repolarisation. Although it primarily blocks potassium channels, amiodarone potentiates its effect through all four of the classic Vaughan Williams mechanisms of antiarrhythmic action.
Despite its efficacy, amiodarone is a challenging drug to use in clinical practice due to its prolonged half-life, multiple adverse effects and drug interactions. These adverse effects are particularly problematic for older people who are more susceptible to drug toxicities and who have higher rates of polypharmacy. There is also a lack of information regarding the safety of amiodarone in older people.2 A cardiologist’s opinion is recommended before prescribing.
[Unfortunately, it was prescribed by a cardiologist.]
Amiodarone can have adverse effects in multiple organ systems including the lungs, heart, liver, thyroid, gut, skin, nerves and eyes.3 Its use is also implicated in a range of drug–drug interactions with commonly prescribed cardiovascular drugs.4"
CONCLUSIONS: In this global postmarketing study, interstitial lung disease and bradycardia were more frequently reported in older adults treated with amiodarone. These findings support vigilant monitoring for these adverse events, particularly in older patients.
Amiodarone can have adverse effects in multiple organ systems including the lungs, heart, liver, thyroid, gut, skin, nerves and eyes.3 Its use is also implicated in a range of drug–drug interactions with commonly prescribed cardiovascular drugs.4"
Also read from 2025: The Safety Profile of Amiodarone Among Older Adults (Age ≥75 Years): A Pharmacovigilance Study from the FDA Data. | Read by QxMD
In our case, there was "no vigilant monitoring."
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