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Author: Admin | 2025-04-28
Antidepressants could cause QT prolongation, but not all interactions are supported by primary literature.Phenytoin, fosphenytoinIncreases serum phenytoin concentrations or decreases amiodarone concentrations. Delayed onset.Monitor for CNS toxicity and amiodarone clinical efficacy. Adjust doses accordingly.*These are examples only. See current texts and reviews for further information.Table 5 -Amiodarone and miscellaneous agents: examples of clinically significant interactions*CyclosporineElevated cyclosporine levels; levels can increase 2- to 3-fold.Supratherapeutic cyclosporine levels affect every organ system. Delayed onset. Monitor levels and adjust dose accordingly.Grapefruit/grapefruit juiceIncreased amiodarone levels. Can occur with 200 - 300 mL of juice or with whole fruit segments.Anesthetic agentsAdditive effect, which increases risk of hypotension and bradycardia.Close monitoring is necessary.*These are examples only. See current texts and reviews for further information.References:REFERENCES:1. Goldschlager N, Epstein AE, Naccarelli G, et al. Practical guidelines for clinicians who treat patients with amiodarone. Arch Intern Med. 2000;160: 1741-1748.2. Yamreudeewong W, DeBisschop M, Martin LG, Lower DL. Potentially significant drug interactions of class III antiarrhythmic drugs. DrugSaf. 2003;26: 421-438.3. Fuster V, Ryden LE, Asinger RW, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol. 2001;38: 1231-1266. 4. American Heart Association. AHA 2005 Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care. Part 7.2: Management of cardiac arrest. Circulation. 2005;112(suppl 24):IV-58-IV-66.5. Hohnloser SH, Klingenheben T, Singh BN. Amiodarone-associated proarrhythmic effects: a review with special reference to torsade de pointes tachycardia. Ann Intern Med. 1994;121:529-535.6. Siddowat LA. Amiodarone: guidelines for use and monitoring. Am FamPhysician. 2003;68:2189-2196.7. Sanoski CA, Bauman JL. Clinical observations with the amiodarone/warfarin interaction: dosing relationships with long-term therapy. Chest. 2002;121:19-23.8. Zocor
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