Risk factors for the development of specific noncardiovascular adverse effects associated with amiodarone.
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.
Tisdale
J E
JE
Department of Pharmacy Practice, College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, Michigan 48202, USA.
Follin
S L
SL
Ordelova
A
A
Webb
C R
CR
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
D000638:Amiodarone