title: Risk factors for the development of specific noncardiovascular adverse effects associated with amiodarone.
abstract: Noncardiovascular adverse effects associated with amiodarone result in substantial morbidity. Adverse effects involving the skin, liver, thyroid, and lungs have been reported in as many as 57%, 55%, 11%, and 13% of patients, respectively. Although risk factors for some amiodarone-induced adverse effects have been identified, risk factors for these specific side effects have not been systematically evaluated. Therefore, risk factors for development of amiodarone-induced dermatologic, hepatic, thyroid, or pulmonary adverse effects were identified using univariate analysis in 44 patients receiving the drug for supraventricular or ventricular arrhythmias (mean duration of therapy 99.5 +/- 110.8 weeks). Dermatologic side effects occurred in 4 (9.1%) patients. Patients who experienced dermatologic side effects were younger than patients who did not (mean age, 48.3 +/- 15.8 years versus 60.1 +/- 9.5 years, respectively; P = .03). Patients younger than 60 years of age were more likely to develop photosensitivity or blue-gray skin discoloration than those aged 60 or older (P = .05). Hepatic adverse effects occurred in 3 (6.8%) patients. Left ventricular ejection fraction was lower in those who developed hepatic adverse effects than in those who did not (15.0 +/- 4.0% versus 39.1 +/- 13.9%, P = .005). Adverse thyroid effects occurred in 6 (13.6%) patients; and pulmonary fibrosis occurred in 2 (4.5%) patients. No specific risk factors for adverse thyroid effects or pulmonary fibrosis were revealed. In conclusion, age less than 60 may be a risk factor for amiodarone-induced dermatologic adverse effects, whereas severely depressed left ventricular ejection fraction may be a risk factor for hepatic side effects associated with amiodarone.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan 48202, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Tisdale
authors.forename: S L
authors.initials: SL
authors.lastname: Follin
authors.forename: A
authors.initials: A
authors.lastname: Ordelova
authors.forename: C R
authors.initials: CR
authors.lastname: Webb
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy / Q000503:physiopathology; D056486:Chemical and Drug Induced Liver Injury; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008171:Lung Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011658:Pulmonary Fibrosis / Q000139:chemically induced; D012189:Retrospective Studies; D012307:Risk Factors; D012871:Skin Diseases / Q000139:chemically induced*; D013959:Thyroid Diseases / Q000139:chemically induced*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D000638:Amiodarone