title: Hepatic Dysfunction in Patients Receiving Intravenous Amiodarone.
abstract: OBJECTIVE
  Amiodarone is a commonly used antiarrhythmic drug. Hepatotoxicity following chronic oral administration occurs in 1% to 3% of patients. Hepatotoxicity following intravenous (IV) administration is infrequent but may be associated with dramatic increases in serum transaminases. We describe the incidence of liver toxicity among patients receiving IV amiodarone during a 5-year period.
  
  
  METHODS
  This was a single-center retrospective review of patients receiving IV amiodarone for any cause. The outcome measures were development of elevated serum transaminases and the relation of transaminitis to all-cause 30-day mortality.
  
  
  RESULTS
  A total of 1510 patients received amiodarone intravenously between 2005 and 2011; 77 (5%) developed elevated liver enzymes. Enzyme elevation was divided into mild (100-300 IU/L), moderate (300-1000 IU/L), and severe (>1000 IU/L). The median alanine aminotransferase was 189 (37-10,006) IU/L and aspartate aminotransferase was 253 (84-12,005) IU/L. The 30-day mortality among those with transaminitis was 22%; however, no patient died of amiodarone-related liver disease.
  
  
  CONCLUSIONS
  Amiodarone can cause severe elevation in liver enzymes. The incidence of severe transaminitis is low; deaths following IV amiodarone are rarely caused by drug-induced liver failure.
authors: From the Department of Medicine and Pharmacy Service, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
authors: Ali
authors: A
authors: Hashmi
authors: From the Department of Medicine and Pharmacy Service, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
authors: Nicole R
authors: NR
authors: Keswani
authors: From the Department of Medicine and Pharmacy Service, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
authors: Sharon
authors: S
authors: Kim
authors: From the Department of Medicine and Pharmacy Service, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas.
authors: David Y
authors: DY
authors: Graham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone