Syndrome of inappropriate antidiuretic hormone secretion induced by amiodarone therapy.
We describe a case of amiodarone induced hyponatremia consistent with the syndrome of inappropriate antidiuretic hormone (SIADH) that developed during amiodarone loading, similar to three prior reports. The hyponatremia improved after a lower maintenance dose was initiated. This episode was reported online to the FDA (http://www.fda.gov/medwatch), and future amiodarone labeling will include SIADH as a potential side effect (personal communication, Wyeth Medical Science). Clinicians should be aware of this rare but serious complication, especially in light of the neurological effect of profound hyponatremia. Amiodarone induced SIADH may develop during the loading phase, and may respond to dose reduction without termination of drug.
Aslam
M Kamran
MK
Department of Internal Medicine, The University of Texas, Southwestern Medical Center, Dallas, Texas 75390-9047, USA
Gnaim
Charlie
C
Kutnick
Jay
J
Kowal
Robert C
RC
McGuire
Darren K
DK
D000284:Administration, Oral; D000368:Aged; D000638:Amiodarone / Q000009:adverse effects* / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced / Q000175:diagnosis; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D055502:Secondary Prevention; D017180:Tachycardia, Ventricular / Q000188:drug therapy*; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone