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Nexterone (amiodarone) Disease Interactions

There are 10 disease interactions with Nexterone (amiodarone):

Major

Amiodarone (Includes Nexterone) ↔ Dialysis

Severe Potential Hazard, High plausibility

Applies to: hemodialysis

Amiodarone and its active metabolite are not removed by hemodialysis.

References

  1. Jacobs MB "Serum creatinine increase associated with amiodarone therapy." N Y State J Med 87 (1987): 358-9
  2. Pollak PT, Sharma AD, Carruthers SG "Creatinine elevation in patients receiving amiodarone correlates with serum amiodarone concentration." Br J Clin Pharmacol 36 (1993): 125-7
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 4 references
Major

Amiodarone (Includes Nexterone) ↔ Pulmonary Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Pulmonary Impairment

Pulmonary toxicities such as hypersensitivity pneumonitis or interstitial/alveolar pneumonitis are potentially fatal (approximately 10% of the time) and have occurred in as many as 10% to 17% of patients administered daily dosages of approximately 400 mg of amiodarone. More frequently, asymptomatic abnormal diffusion capacity has been observed. Patients with preexisting pulmonary dysfunction does not appear to have an increased risk of pulmonary toxicity; however, they have a poorer prognosis if toxicity does develop. Thus, the risks and benefits of amiodarone therapy should be weighed carefully. Clinical monitoring of pulmonary function, including chest X-ray (baseline and every 3 to 6 months) and pulmonary function tests (with diffusion capacity), is recommended in all patients receiving amiodarone therapy. Any new respiratory symptom during treatment should be evaluated promptly and thoroughly, since toxicity is more likely to be reversible if diagnosed and managed early. Patients who develop hypersensitivity pneumonitis should be withdrawn permanently from amiodarone therapy and treated with steroids. In the case of interstitial/alveolar pneumonitis, steroid therapy and dosage reduction or discontinuation of amiodarone, if possible, usually result in clinical improvement. Subsequent rechallenge with amiodarone at reduced dosages does not always lead to return of toxicity and may be considered in some patients. The use of a lower loading dose and maintenance doses may also decrease the incidence of amiodarone- induced pulmonary toxicity.

References

  1. Oren S, Turkot S, Golzman B, London D, Bendor D, Weiler Z "Amiodarone-induced bronchiolitis obliterans organizing pneumonia (BOOP)." Respir Med 90 (1996): 167-9
  2. Vanmieghem W, Coolen L, Malysse I, Lacquet LM, Demedts MGP "Amiodarone and the development of ARDS after lung surgery." Chest 105 (1994): 1642-5
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 24 references
Major

Amiodarone (Includes Nexterone) ↔ Sinus Node Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Heart Block, Cardiogenic Shock

The use of amiodarone is contraindicated for use in patients with cardiogenic shock, severe sinus node dysfunction causing marked sinus bradycardia, second- or third-degree AV block, or symptomatic bradycardia in the absence of a functioning pacemaker.

References

  1. Veltri EP, Reid PR "Sinus arrest with intravenous amiodarone." Am J Cardiol 58 (1986): 1110-1
  2. Williamson BD, Hummel J, Niebauer M, Man C, Strickberger SA, Daoud E, Morady F "Bradycardia-facilitated polymorphic ventricular tachycardia caused by amiodarone after radiofrequency modification of atrioventricular conduction." Am Heart J 130 (1995): 399-401
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 4 references
Major

Amiodarone (Includes Nexterone) ↔ Visual Impairment

Severe Potential Hazard, Low plausibility

Applies to: Visual Defect/Disturbance

Optic neuropathy and/or neuritis has occurred during administration of amiodarone and has resulted in visual impairment such as changes in visual acuity, decrease in peripheral vision, and blindness. Optic toxicity can occur at any time following initiation of amiodarone. Therapy with amiodarone should be administered cautiously in patients with visual defects. Regular ophthalmologic examinations including fundoscopy and slit- lamp examinations are recommended.

References

  1. Feiner LA, Younge BR, Kazmier FJ, Stricker BH, Fraunfelder FT "Optic neuropathy and amiodarone therapy." Mayo Clin Proc 62 (1987): 702-17
  2. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Thystrup JD, Fledelius HC "Retinal maculopathy possibly associated with amiodarone medication." Acta Ophthalmol (Copenh) 72 (1994): 639-41
View all 5 references
Major

Antiarrhythmics (Includes Nexterone) ↔ Cardiovascular Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Congestive Heart Failure, Hypotension

Antiarrhythmic agents can induce severe hypotension (particularly with IV administration) or induce or worsen congestive heart failure (CHF). Patients with primary cardiomyopathy or inadequately compensated CHF are at increased risk. Antiarrhythmic agents should be administered cautiously and dosage and/or frequency of administration modified in patients with hypotension or adequately compensated CHF. Alternative therapy should be considered unless these conditions are secondary to cardiac arrhythmia.

References

  1. Halkin H, Meffin P, Melmon KL, Rowland M "Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite." Clin Pharmacol Ther 17 (1975): 669-76
  2. Crouthamel WG "The effect of congestive heart failure on quinidine pharmacokinetics." Am Heart J 90 (1975): 335-9
  3. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 17 references
Major

Antiarrhythmics (Includes Nexterone) ↔ Proarrhythmic Effects

Severe Potential Hazard, High plausibility

Applies to: Arrhythmias, Abnormal Electrocardiogram

Antiarrhythmic agents can induce or worsen ventricular arrhythmias. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes have occurred in some patients. Patients with underlying cardiac dysfunction, bradycardia, hypokalemia, hypomagnesemia, or high antiarrhythmic serum concentrations are at increased risk for drug-induced arrhythmias. Therapy with antiarrhythmics should be used with extreme caution in patients with or predisposed to arrhythmias. Evidence of improved survival is lacking for use of antiarrhythmic therapy in asymptomatic, non-life-threatening arrhythmias. Therapy with antiarrhythmic agents should be reserved for patients with life-threatening arrhythmias.

References

  1. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  2. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  3. Andrivet P, Beaslay V, Canh VD "Torsades de pointe with flecainide-amiodarone therapy." Intensive Care Med 16 (1990): 342-3
View all 62 references
Moderate

Amiodarone (Includes Nexterone) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

There have been rare reports of fatal hepatocellular necrosis after treatment with amiodarone. In patients with life-threatening arrhythmias, the potential risk of hepatic injury should be weighed against the potential benefit of amiodarone therapy. Patients with hepatic impairment should be monitored for evidence of progressive hepatic injury. Consideration should be given to reducing the rate of administration or withdrawing treatment if needed.

Moderate

Amiodarone (Includes Nexterone) ↔ Neurologic Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Neurologic Disorder, Parkinsonism

Reversible and dose-related nervous system toxicity such as dizziness, paresthesia, tremor and involuntary movements, lack of coordination, abnormal gait and ataxia is commonly noted in patients receiving amiodarone. Therapy with amiodarone should be administered cautiously and dosage modifications considered in patients with or predisposed to neurologic dysfunction.

References

  1. Lim PK, Trewby PN, Storey GC, Holt DW "Neuropathy and fatal hepatitis in a patient receiving amiodarone." Br Med J 288 (1984): 1638-9
  2. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. Trohman RG, Castellanos D, Castellanos A, Kessler KM "Amiodarone-induced delirium." Ann Intern Med 108 (1988): 68-9
View all 9 references
Moderate

Amiodarone (Includes Nexterone) ↔ Thyroid Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperthyroidism, Hypothyroidism

Amiodarone inhibits peripheral conversion of thyroxine (T4) to triiodothyronine (T3) and also contributes inorganic iodine that can result in altered thyroid function tests, hypothyroidism, or hyperthyroidism. Therapy with amiodarone should be administered cautiously in patients with thyroid dysfunction. Clinical monitoring, including baseline and periodic evaluation of thyroid function is recommended. Modification of thyroid therapy may be necessary.

References

  1. Mulligan DC, Mchenry CR, Kinney W, Esselstyn CB, Numann PJ, Roher H, Albertson D "Amiodarone-induced thyrotoxicosis: clinical presentation and expanded indications for thyroidectomy." Surgery 114 (1993): 1114-9
  2. Harjai KJ, Licata AA "Effects of amiodarone on thyroid function." Ann Intern Med 126 (1997): 63-73
  3. Roti E, Minelli R, Gardini E, Bianconi L, Braverman LE "Thyrotoxicosis followed by hypothyroidism in patients treated with amiodarone. A possible consequence of a destructive process in the thyroid." Arch Intern Med 153 (1993): 886-92
View all 15 references
Moderate

Antiarrhythmics (Includes Nexterone) ↔ Electrolyte Imbalance

Moderate Potential Hazard, High plausibility

Applies to: Hypokalemia, Hyperkalemia, Magnesium Imbalance

Electrolyte imbalance can alter the therapeutic effectiveness of antiarrhythmic agents. Hypokalemia and hypomagnesemia can reduce the effectiveness of antiarrhythmic agents. In some cases, these disorders can exaggerate the degree of QTc prolongation and increase the potential for torsades de pointes. Hyperkalemia can potentiate the toxic effects of antiarrhythmic agents. Electrolyte imbalance should be corrected prior to initiating antiarrhythmic therapy. Clinical monitoring of cardiac function and electrolyte concentrations is recommended.

References

  1. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  3. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 13 references

Nexterone (amiodarone) drug Interactions

There are 852 drug interactions with Nexterone (amiodarone)

Nexterone (amiodarone) alcohol/food Interactions

There is 1 alcohol/food interaction with Nexterone (amiodarone)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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