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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.
  4. "Product Information. Cordarone Intravenous (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 Patients who develop hypersensitivity pneumonitis should be withdrawn permanently from amiodarone therapy and treated with steroids.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.
  4. Akoun GM, Milleron BJ, Badaro DM, Mayard CM, Liote HA "Pleural T-lymphocyte subsets in amiodarone-associated pleuropneumonitis." Chest 95 (1989): 596-7
  5. Cendrasekhar A, Barke RA, Druck P "Recurrent amiodarone pulmonary toxicity." South Med J 89 (1996): 85-6
  6. Polkey MI, Wilson POG, Rees PJ "Amiodarone pneumonitis: no safe dose." Respir Med 89 (1995): 233-5
  7. Wright AJ, Brackenridge RG "Pulmonary infiltration and bone marrow depression complicating treatment with amiodarone." Br Med J 284 (1982): 1303
  8. Morrow B, Shorten GD, Sylvester W "Postoperative amiodarone pulmonary toxicity." Anaesth Intensive Care 21 (1993): 361-2
  9. Adams GD, Kehoe R, Lesch M, Glassroth J "Amiodarone-induced pneumonitis: assessment of risk factors and possible risk reduction." Chest 93 (1988): 254-63
  10. Wilson BD, Lippmann ML "Susceptibility to amiodarone-induced pulmonary toxicity: relationship to the uptake of amiodarone by isolated lung cells." Lung 174 (1996): 31-41
  11. Akoun GM, Cadranel JL, Blanchette G, Milleron BJ, Mayaud CM "Bronchoalveolar lavage cell data in amioidarone-associated pneumonitis: evaluation in 22 patients." Chest 99 (1991): 1177-82
  12. Pollak PT, Sharma AD, Carruthers SG "Relation of amiodarone hepatic and pulmonary toxicity to serum drug concentrations and superoxide dismutase activity." Am J Cardiol 65 (1990): 1185-91
  13. Kudenchuk PJ, Pierson DJ, Greene HL, Graham EL, Sears GK, Trobaugh GB "Prospective evaluation of amiodarone pulmonary toxicity." Chest 86 (1984): 541-8
  14. Manolis AS, Tordjman T, Mack KD, Estes NA III "Atypical pulmonary and neurologic complications of amiodarone in the same patient." Arch Intern Med 147 (1987): 1805-9
  15. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  16. Fraire AE, Guntupalli KK, Greenberg SD, Cartwright J, Jr Chasen MH "Amiodarone pulmonary toxicity: a multidisciplinary review of current status." South Med J 86 (1993): 67-77
  17. Valle JM, Alvarez D, Antunez J, Valdes L "Bronchiolitis obliterans organizing pneumonia secondary to amiodarone: a rare aetiology." Eur Respir J 8 (1995): 470-1
  18. Burland RJ, Millard FJ "Fibrosing alveolitis associated with amiodarone." Eur J Respir Dis 65 (1984): 616-9
  19. Pollak PT, Sami M "Acute necrotizing pneumonitis and hyperglycemia after amiodarone therapy." Am J Med 76 (1984): 935-9
  20. Rakita L, Sobol SM, Mostow N, Vrobel T "Amiodarone pulmonary toxicity." Am Heart J 106 (1983): 906-16
  21. Reasor MJ, Kacew S "An evaluation of possible mechanisms underlying amiodarone-induced pulmonary toxicity." Proc Soc Exp Biol Med 212 (1996): 297-304
  22. Jessurun GAJ, Crijns HJGM "Amiodarone pulmonary toxicity - dose and duration of treatment are not the only determinants of toxicity." BMJ 314 (1997): 619-20
  23. Hargreaves MR, Benson MK "Amiodarone pneumonitis: no safe dose." Respir Med 90 (1996): 119
  24. Piccione W Jr, Faber LP, Rosenberg MS "Amiodarone-induced pulmonary mass." Ann Thorac Surg 47 (1989): 918-9
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.
  4. "Product Information. Cordarone Intravenous (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
  4. Imgram DV, Jaggarao NS, Chamberlain DA "Ocular changes resulting from therapy with amiodarone." Br J Ophthalmol 66 (1982): 676-9
  5. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
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.
  4. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  5. Gottlieb SS, Packer M "Deleterious hemodynamic effects of lidocaine in severe congestive heart failure." Am Heart J 118 (1989): 611-2
  6. "Product Information. Quinidex (quinidine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  7. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  8. Ravid S, Podrid PJ, Lampert S, Lown B "Congestive heart failure induced by six of the newer antiarrhythmic drugs." J Am Coll Cardiol 14 (1989): 1326-30
  9. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  10. Thomson P, Melmon K, Richardson J, Cohn K Steinbrunn W, Cudihee R, Rowland M "Lidocaine pharmacokinetics in advanced heart failure, liver disease, and renal failure in humans." Ann Intern Med 78 (1973): 499-508
  11. Prescott LF, Adjepon-Yamoah KK, Talbot RG "Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure." Br Med J 1 (1976): 939-41
  12. "Product Information. Adenocard (adenosine)." Fujisawa, Deerfield, IL.
  13. "Product Information. Quiniglute (quinidine)." Berlex, Richmond, CA.
  14. Ochs HR, Grube E, Greenblatt DJ, Arendt R "Intravenous quinidine in congestive cardiomyopathy." Eur J Clin Pharmacol 19 (1981): 173-6
  15. Singh SN, Fletcher RD, Fisher SG, et al. "Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia." N Engl J Med 333 (1995): 77-82
  16. Swiryn S, Kim SS "Quinidine-induced syncope." Arch Intern Med 143 (1983): 314-6
  17. "Product Information. Cordarone Intravenous (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
  4. "Product Information. Bretylol (bretylium)." DuPont Pharmaceuticals, Wilmington, DE.
  5. Nora MO, Chandrasekaran K, Hammill SC, Reeder GS "Prolongation of ventricular depolarization: ECG manifestation of mexiletine toxicity." Chest 95 (1989): 925-8
  6. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  7. Morganroth J, Horowitz LN "Incidence of proarrhythmic effects from quinidine in the outpatient treatment of benign or potentially lethal ventricular arrhythmias." Am J Cardiol 56 (1985): 585-7
  8. Cheesman M, Ward DE "Exacerbation of ventricular tachycardia by tocainide." Clin Cardiol 8 (1985): 47-50
  9. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  10. Lo KS, Gantz KB, Stetson PL, et al "Disopyramide-induced ventricular tachycardia." Arch Intern Med 140 (1980): 413-4
  11. Said SAM, Somer ST, Luttikhuis HAO "Flecainide-induced JT prolongation, t wave inversion and ventricular tachycardia during treatment for symptomatic atrial fibrillation." Int J Cardiol 44 (1994): 285-7
  12. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  13. Reed R, Falk JL, O'Brien J "Untoward reaction to adenosine therapy for supraventricular tachycardia." Am J Emerg Med 9 (1991): 566-70
  14. Ben-Sorek ES, Wiesel J "Ventricular fibrillation following adenosine administration. A case report." Arch Intern Med 153 (1993): 2701-2
  15. Meurer MK "A 21-year-old woman with rapid atrial fibrillation after adenosine administration." J Emerg Nurs 17 (1991): 135-6
  16. Anderson JL, Popat KD "Paradoxical ventricular tachycardia and fibrillation after intravenous bretylium therapy." Arch Intern Med 141 (1981): 801-2
  17. Hii JT, Wyse DG, Gillis AM, et al "Propafenone-induced torsade de pointes: cross-reactivity with quinidine." Pacing Clin Electrophysiol 14 (1991): 1568-70
  18. Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH "Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs." JAMA 270 (1993): 2590-7
  19. Riccioni N, Castiglioni M, Bartolomei C "Disopyramide-induced QT prolongation and ventricular tachyarrhythmias." Am Heart J 105 (1983): 870-1
  20. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  21. Raehl CL, Patel AK, LeRoy M "Drug-induced torsade de pointes." Clin Pharm 4 (1985): 675-90
  22. Boriani G, Biffi M, Frabetti L, Azzolini U, Sabbatani P, Bronzetti G, Capucci A, Magnani B "Ventricular fibrillation after intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation." Am Heart J 131 (1996): 1214-6
  23. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  24. "Product Information. Tonocard (tocainide)." Merck & Co, Inc, West Point, PA.
  25. "Product Information. Norpace (disopyramide)." Searle, Skokie, IL.
  26. Tzivoni D, Keren A, Stern S, Gottlieb S "Disopyramide-induced Torsade de pointes." Arch Intern Med 141 (1981): 946-7
  27. Celiker A, Tokel K, Cil E, Ozkutlu S, Ozme S "Adenosine induced torsades de pointes in a child with congenital long QT syndrome." Pacing Clin Electrophysiol 17 (1994): 1814-7
  28. Strickberger SA, Man KC, Daoud EG, et al. "Adenosine-induced atrial arrhythmia: a prospective analysis." Ann Intern Med 127 (1997): 417-22
  29. Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT "Adenosine-induced atrial fibrillation." Am J Emerg Med 14 (1996): 300-1
  30. Stratmann H, Walter K, Kennedy H "Torsade de pointes associated with elevated N-acetylprocainamide levels." Am Heart J 109 (1985): 375-6
  31. Buss J, Neuss H, Bilgin Y, Schlepper M "Malignant ventricular tachyarrhythmias in association with propafenone treatment." Eur Heart J 6 (1985): 424-8
  32. Sulke AN, Holt P, Sowton GE "Acceleration of conduction within an accessory pathway with propafenone." Int J Cardiol 28 (1990): 105-7
  33. Romer M, Candinas R "Adenosine-induced non-sustained polymorphic ventricular tachycardia." Eur Heart J 15 (1994): 281-2
  34. Nathan AW, Hellestrand KJ, Bexton RS, Camm AJ "Fatal ventricular tachycardia in association with propafenone, a new class IC antiarrhythmic agent." Postgrad Med J 60 (1984): 155-6
  35. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  36. Damle R, Levine J, Matos J, et al "Efficacy and risks of moricizine in inducible sustained ventricular tachycardia." Ann Intern Med 116 (1992): 375-81
  37. Exner DV, Muzyka T, Gillis AM "Proarrhythmia in patients with the Wolff-Parkinson-White Syndrome after standard doses of intravenous adenosine." Ann Intern Med 122 (1995): 351-2
  38. Cocco G, Strozzi C, Chu D, Pansini R "Torsades de pointes as a manifestation of mexiletine toxicity." Am Heart J 100 (1980): 878-80
  39. Faggiano P, Gardini A, Daloia A, Benedini G, Giordano A "Torsade de pointes occurring early during oral amiodarone treatment." Int J Cardiol 55 (1996): 205-8
  40. Dhein S, Schott M, Gottwald E, Klaus W "Electrocardiological profile and proarrhythmic effects of quinidine, verapamil and their combination: a mapping study." Naunyn Schmiedebergs Arch Pharmacol 352 (1995): 94-101
  41. Bauman JL, Bauernfeind RA, Hoff JV, et al "Torsade de pointes due to quinidine: observations in 31 patients." Am Heart J 107 (1984): 425-30
  42. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  43. Heisler BE, Ferrier GR "Proarrhythmic actions of flecainide in an isolated tissue model of ischemia and reperfusion." J Pharmacol Exp Ther 279 (1996): 317-24
  44. Strasberg B, Sclarovsky S, Erdberg A, et al "Procainamide-induced polymorphous ventricular tachycardia." Am J Cardiol 47 (1981): 1309-14
  45. Sclarovsky S, Lewin RF, Kracoff O, Strasberg B, Arditti A, Agmon J "Amiodarone-induced polymorphous ventricular tachycardia." Am Heart J 105 (1983): 6-12
  46. Koenig W, Schinz AM "Spontaneous ventricular flutter and fibrillation during quinidine medication." Am Heart J 105 (1983): 863-5
  47. Wesley RC Jr, Turnquest P "Torsades de pointe after intravenous adenosine in the presence of prolonged QT syndrome." Am Heart J 123 (1992): 794-6
  48. Hohnloser SH, Vandeloo A, Baedeker F "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol 26 (1995): 852-8
  49. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  50. Au PK, Bhandari AK, Bream R, et al "Proarrhythmic effects of antiarrhythmic drugs during programmed ventricular stimulation in patients without ventricular tachycardia." J Am Coll Cardiol 9 (1987): 389-97
  51. Stavens CS, McGovern B, Garan H, Ruskin JN "Aggravation of electrically provoked ventricular tachycardia during treatment with propafenone." Am Heart J 110 (1985): 24-9
  52. Oberg KC, Otoole MF, Gallastegui JL, Bauman JL "''late'' proarrhythmia due to quinidine." Am J Cardiol 74 (1994): 192-4
  53. Dougherty AH, Gilman JK, Wiggins S, Jalal S, Naccarelli GV "Provocation of atrioventricular reentry tachycardia: a paradoxical effect of adenosine." Pacing Clin Electrophysiol 16 (1993): 8-12
  54. 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
  55. Engler RL, LeWinter M "Tocainide-induced ventricular fibrillation." Am Heart J 101 (1981): 494-6
  56. Orebaugh SL, Handy M "Intravenous adenosine therapy accelerating rate of paroxysmal supraventricular tachycardia." Am J Emerg Med 10 (1992): 326-30
  57. Morganroth J, Pratt CM "Prevalence and characteristics of proarrhythmia from moricizine (themozine)." Am J Cardiol 63 (1989): 172-6
  58. Chia BL "Disopyramide induced atypical ventricular tachycardia." Aust N Z J Med 10 (1980): 665-8
  59. Hohnloser SH, Klingenheben T, Singh BN "Amiodarone-associated proarrhythmic effects - a review with special reference to torsade de pointes tachycardia." Ann Intern Med 121 (1994): 529-35
  60. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  61. Kinney EL, Field EH, Salmon MP, Zelis R "Cardiac arrhythmias associated with disopyramide." N Engl J Med May (1990): 1146
  62. Schweitzer P, Mark H "Torsade de pointes caused by disopyramide and hypokalemia." Mt Sinai J Med 49 (1982): 110-4
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. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  2. Lim PK, Trewby PN, Storey GC, Holt DW "Neuropathy and fatal hepatitis in a patient receiving amiodarone." Br Med J 288 (1984): 1638-9
  3. Trohman RG, Castellanos D, Castellanos A, Kessler KM "Amiodarone-induced delirium." Ann Intern Med 108 (1988): 68-9
  4. Manolis AS, Tordjman T, Mack KD, Estes NA III "Atypical pulmonary and neurologic complications of amiodarone in the same patient." Arch Intern Med 147 (1987): 1805-9
  5. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Roth RF, Itabashi H, Louie J, Anderson T, Narahara KA "Amiodarone toxicity: myopathy and neuropathy." Am Heart J 119 (1990): 1223-4
  7. Pellissier JF, Pouget J, Cros D, De Victor B, Serratrice G, Toga M "Peripheral neuropathy induced by amiodarone chlorhydrate: a clinicopathological study." J Neurol Sci 63 (1984): 251-66
  8. Werner EG, Olanow CW "Parkinsonism and amiodarone therapy." Ann Neurol 25 (1989): 630-2
  9. Palakurthy PR, Iyer V, Meckler RJ "Unusual neurotoxicity associated with amiodarone therapy." Arch Intern Med 147 (1987): 881-4
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
  4. Enia G, Costante G, Catalano C, Zoccali C, Maggiore Q "Severe hypothyroidism induced by amiodarone in a dialysis patient." Nephron 46 (1987): 206-7
  5. Mehra A, Widerhorn J, Lopresti J, Rahimtoola SH "Amiodarone-induced hyperthyroidism: thyroidectomy under local anesthesia." Am Heart J 122 (1991): 1160-1
  6. Figge J, Dluhy RG "Amiodarone-induced elevation of thyroid stimulating hormone in patients receiving levothyroxine for primary hypothyroidism." Ann Intern Med 113 (1990): 553-5
  7. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  8. Martino E, Aghinilombardi F, Bartalena L, Grasso L, Loviselli A, Velluzzi F, Pinchera A, Braverman LE "Enhanced susceptibility to amiodarone-induced hypothyroidism in patients with thyroid autoimmune disease." Arch Intern Med 154 (1994): 2722-6
  9. Singh BN, Nademanee K "Amiodarone and thyroid function: clinical implications during antiarrhythmic therapy." Am Heart J 106 (1983): 857-69
  10. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  11. Hauptman PJ, Fyfe B, Mechanick J, Lansman S, Gass A "Fatal hyperthyroidism after amiodarone treatment and total lymphoid irradiation in a heart transplant recipient [published erratum appears in J Heart Lung Transplant 1993 Jul-Aug;12(4):572]." J Heart Lung Transplant 12 (1993): 513-6
  12. Harjai KJ, Licata AA "Amiodarone induced hyperthyroidism: a case series and brief review of literature." Pacing Clin Electrophysiol 19 (1996): 1548-54
  13. Mazonson PD, Williams ML, Cantley LK, Dalldorf FG, Utiger RD, Foster JR "Myxedema coma during long-term amiodarone therapy." Am J Med 77 (1984): 751-4
  14. Unger J, Lambert M, Jonckheer MH, Denayer P "Amiodarone and the thyroid: pharmacological, toxic and therapeutic effects." J Intern Med 233 (1993): 435-43
  15. Figge HL, Figge J "The effects of amiodarone on thyroid hormone function: a review of the physiology and clinical manifestations." J Clin Pharmacol 30 (1990): 588-95
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.
  4. "Product Information. Mexitil (mexiletine)." Boehringer-Ingelheim, Ridgefield, CT.
  5. "Product Information. Pronestyl (procainamide)." Apothecon Inc, Plainsboro, NJ.
  6. "Product Information. Corvert (ibutilide)." Pharmacia and Upjohn, Kalamazoo, MI.
  7. "Product Information. Xylocaine (lidocaine)." Astra USA, Westborough, MA.
  8. "Product Information. Rhythmol (propafenone)." Knoll Pharmaceutical Company, Whippany, NJ.
  9. "Product Information. Ethmozine (moricizine)." DuPont Pharmaceuticals, Wilmington, DE.
  10. "Product Information. Tambocor (flecainide)." 3M Pharmaceuticals, St. Paul, MN.
  11. "Product Information. Procan SR (procainamide)." Parke-Davis, Morris Plains, NJ.
  12. "Product Information. Cordarone Intravenous (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  13. "Product Information. Cordarone (amiodarone)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 13 references

Nexterone (amiodarone) drug Interactions

There are 889 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.
Unknown No information available.

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

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